Cerebral palsy: What is it and how can physiotherapy help?
Cerebral palsy is a collective term for various movement and posture disorders caused by damage to the brain before, during or shortly after birth. The damage is not progressive, but the consequences can change over time. Cerebral palsy is the most common cause of motor disabilities in children and adolescents.
The effects of cerebral palsy can vary greatly depending on which areas of the brain are affected, how severe the damage is and what other factors play a role. The most common symptoms are
- Spasticity: increased muscle tension leading to stiff and uncontrolled movements
- Dyskinesia: involuntary movements that can, for example, tremble, twist or flail
- Ataxia: impaired coordination and balance that leads to difficulties in standing, walking or grasping
- Hypotonia: reduced muscle tone that leads to limp and powerless movements
In addition to motor problems, other impairments may also occur, such as
- Cognitive impairment: Difficulty learning, thinking or remembering
- Sensory disorders: Problems with seeing, hearing or feeling
- Communication disorders: Problems with speaking, understanding or expressing oneself
- Perceptual disorders: Problems processing information from the environment
- Behavioral disorders: Problems adapting to situations, dealing with emotions or building relationships
- Pain: chronic or acute pain in various parts of the body
- Urinary incontinence: involuntary loss of urine or difficulty urinating
- Musculoskeletal problems: changes to the bones, joints or muscles due to poor posture or overuse
- Epilepsy: seizures caused by disturbed electrical activity in the brain
How is cerebral palsy diagnosed?
The diagnosis of cerebral palsy is based on a thorough examination of the child by a doctor, taking into account the developmental history, clinical symptoms and the results of various tests. These may include, for example
- Imaging procedures such as ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI) to assess the structure of the brain
- Electroencephalography (EEG) to measure the electrical activity of the brain
- Electromyography (EMG) to measure the electrical activity of the muscles
- Blood tests to rule out possible genetic or metabolic causes
The diagnosis of cerebral palsy can sometimes be made shortly after birth if the child shows clear signs of brain damage. In other cases, however, it can take several months or years before the diagnosis is confirmed, as the symptoms only become apparent or change over time.
How is cerebral palsy treated?
The treatment of cerebral palsy is individually tailored to the needs and goals of the child and their family. There is no cure for the underlying brain damage, but there are many ways to alleviate the effects and improve quality of life. Treatment usually involves several specialist disciplines, such as
- Physiotherapy: a form of therapy that focuses on improving mobility, posture and balance
- Occupational therapy: a form of therapy that focuses on promoting independence and participation in everyday activities
- Speech therapy: a form of therapy that focuses on improving speech and communication skills
- Neuropsychology: a specialty that focuses on the assessment and promotion of cognitive, emotional and social development
- Orthopaedics: a specialty that focuses on the treatment of musculoskeletal problems
- Neurology: a specialty that focuses on the treatment of neurological problems such as epilepsy
Treatment can include various methods, such as
- Exercises: targeted movement exercises to improve muscle strength, stretching and coordination
- Manual therapies: targeted hand movements to promote joint mobility, blood circulation and relaxation
- Neurophysiological therapies: special therapy concepts based on the activation of reflexes or patterns to stimulate the central nervous system (e.g. Vojta, Bobath, Castillo Morales, Petö)
- Aids: special devices or materials that facilitate or support movement or communication (e.g. splints, orthoses, wheelchairs, speech computers)
- Medication: special drugs that reduce muscle tone or prevent seizures (e.g. Baclofen, botulinum toxin)
- Operations: surgical procedures that change muscle tone or correct joint misalignments (e.g. tendon lengthening, joint stiffening)
Treatment usually begins as early as possible and is continuously adapted to the child's stage of development and needs. Treatment is a long-term process that requires close cooperation between the child, their family and the treatment team.
How can physiotherapy help with cerebral palsy?
Physiotherapy is one of the most important pillars in the treatment of cerebral palsy. It has the following aims:
- To improve or maintain the child's ability to move
- To optimize or stabilize the child's posture
- To promote or train the child's balance and coordination
- To regulate or normalize the child's muscle tension
- To increase or maintain the child's muscular strength and endurance
- To prevent or reduce the child's muscle shortening or contractures
- To alleviate or prevent the child's pain
- To support or enable the child's independence and autonomy
Physiotherapy for cerebral palsy is based on an individual assessment of the child by a physiotherapist. Various aspects are taken into account