Cerebral palsy

If you or someone you care for has cerebral palsy, this summary will help you understand more about the condition and how physiotherapy can help.

What is cerebral palsy?

Cerebral palsy is a condition that affects movement, posture and co-ordination. It is a spectrum disorder, meaning that there is much variation in the levels of disability that someone with cerebral palsy will experience, ranging from barely noticeable to severe.

Symptoms may include difficulty and delay with movement, balance and coordination such as muscle stiffness, involuntary and uncontrolled movements, and shakiness. These symptoms often first become noticeable in the first months and years of life. Depending on their severity, the shape of some of the joints may change as the child grows, causing further mobility problems. These symptoms may be accompanied by epilepsy or impairment in sight and hearing, speech and language, intellect and learning, or behaviour.

What causes cerebral palsy?

Cerebral palsy is caused by damage to parts of the brain early in life - either during pregnancy, at the time of birth, or shortly after birth. The exact cause is not always known, but may include factors such as lack of oxygen, a bleed, excessive jaundice, trauma and infection.

How can physiotherapy help?

Physiotherapists play a key role in the team of healthcare professionals looking after people with cerebral palsy, which also includes orthopaedic consultants, paediatricians, podiatrists orthotists and occupational therapists. The physiotherapist becomes involved early on in a child's care. As the 'movement expert' on the team, his or her main aim is to help the person achieve their potential for physical independence and fitness levels, working closely with the person - and, in the case of children and young people - their parents or carers.

As a child grows older, the physiotherapist will advise them and their parents or carers on independent skills and lifestyle, enabling the young person to take on increasing responsibility in meeting challenges in education, at leisure and at home. When a young person is transferred to adult services, the physiotherapist will continue to work with them to solve problems - for example, mobility challenges - as they arise.

What will happen when I see a physiotherapist?

A session is likely to include:

a detailed assessment of how the muscles are working and any current challenges
advice about a range of exercises or physical activity.

It may also include:

a plan of care for the person with cerebral palsy – and, depending on their age and the severity of their disability, their parents or carers – including advice on handling, positioning, play, and posture – for example, during feeding, bathing, dressing and other activities
advice on using equipment such as splints, specially adapted seating, standing and mobility aids
advice for parents and carers on protecting themselves from injury.

Are there physiotherapists with extra training in this area?

Physiotherapists working with people with cerebral palsy may be members of the Association of Chartered Physiotherapists in Neurology (APCIN), while those working with children with cerebral palsy may be members of the Association of Paediatric Chartered Physiotherapists (APCP). Some physiotherapists are trained to use injections to reduce muscle tightness.

Meanwhile, how can I help myself?

If you have been given exercises to strengthen or stretch the muscles, build these into your daily routine - these can help prevent secondary problems developing in the joints.
Find a way to keep fit. This will help avoid obesity and osteoporosis, which could cause further problems.
If you find a particular daily task difficult, do seek help - there may be a way around it.
Make the most of the information and support available - see the contact details below.

Where can I get more information?

Finnie's Handling the Young Child with Cerebral Palsy at Home

By Eva Bower and Annabel Milne (2008). A classic book updated and re-released with lots of practical advice.

Scope

UK disability charity with a focus on cerebral palsy, providing a wide range of services, information and support. T 0808 800 3333 (helpline) W www.scope.org.uk