Cerebral palsy (CP) is a term that describes collective disorders that often affect normal movement and posture development. Cerebral palsy results from an injury in the brain. The injury may occur before birth, during birth, or up to two years after a child’s birth. The injuries that could lead to cerebral palsy include infection, trauma, stroke, or loss of oxygen. The effects after the injury do not always immediately present themselves in the child. However, a child’s ability to perform day-to-day activities worsens as a he/she grows and develops. Children and adults who have cerebral palsy may have difficulties seeing, moving, feeling, touching, hearing, communicating, and thinking. They are also prone to seizures. The challenges resulting from cerebral palsy may be mild to severe. If you are in Las Vegas, NV, and need physical therapy services for a child or adult with cerebral palsy, contact Suarez Physical Therapy for more information.
How Common is Cerebral Palsy?
In every 1,000 infants born in the United States, cerebral palsy (CP) affects approximately four. In recent years, the number of children diagnosed with cerebral palsy has grown. The increase in cerebral palsy cases is attributed to the increased survival rate of premature babies and babies born with low birth weight. The good news is that there has been a notable improvement in the life expectancy of adults suffering from CP. People suffering from CP, both children, and adults, can significantly benefit from physical therapy at all stages in their lives.
Physical therapists play an essential role in helping people living with CP improve their physical functions. They help them become independent and perform daily tasks like using the wheelchair, walking, moving from the wheelchair to the car, bed, or bathtub. Physical therapists also advise families of children with CP to access the right equipment.
Definition of Cerebral Palsy
Cerebral palsy is a broad term referring to a group of disorders affecting coordination and muscle movement. In many cases, CP affects other functions like hearing, vision, and sensation. The term cerebral means that it has something to do with a person’s brain. The term palsy means a problem or a weakness with body movement. As outlined by the Centers for Disease Control and Prevention (CDC), cerebral palsy is the leading cause of motor disabilities in children. This condition occurs when there is an injury in the developing brain and translates the effects to motor skills development. There are several types of CP. Different CP types are named according to the area of the body affected and the type of the movement problem:
Spastic cerebral palsy is the most typical type of cerebral palsy. It affects around 80% of all individuals with CP. This type of CP causes exaggerated reflexes and stiff muscles, which makes it challenging to walk. Many people who have spastic cerebral palsy have walking challenges like making scissor-like movements while walking or crossing their knees. Paralysis and muscle weakness may also occur in people with spastic CP. The symptoms of spastic CP may affect the whole body or just one body side.
Hypotonic CP causes overly relaxed muscles or a reduced muscle tone. As a result, the arms and the legs of people with hypotonic CP appear floppy and move easily like a rag doll. Children with hypotonic CP have little to no control over their heads and could have challenges breathing. Many children suffering from this type of CP may have difficulties sitting as they mature due to their compromised muscles. They may also have walking abnormalities, poor reflexes, or problems speaking.
Dyskinetic Cerebral Palsy
People suffering from Dyskinetic CP have challenges controlling their body movements. This disorder causes abnormal or involuntary movements in the legs, arms, and hands. In some cases, Dyskinetic CP may also affect the face and the tongue. The movements can be rapid and jerk or slow and writhing. As a result, dyskinetic CP makes it difficult for the patient to sit, walk, swallow, or talk.
Ataxic CP is the rarest type of CP. It manifests through voluntary muscle movements, which are often jerky, clumsy, and disorganized. Persons with this type of CP have difficulties with coordination and balance. They might have problems walking or performing motor functions like writing and grasping objects.
Some people exhibit a mixture of symptoms resulting from various types of cerebral palsy. These people are said to have mixed CP. In most mixed CP cases, people face a mix of Dyskinetic CP and Spastic CP.
- Quadriplegia — This type of CP affects both legs, arms, neck, and trunk control
- Hemiplegia — This type of CP affects only one side of the body
- Diplegia — This type of CP affects both legs in most cases or arms in less common cases.
- Monoplegia — This type of CP affects only one limb. It is a rare type of cerebral palsy.
The Signs and Symptoms of Cerebral Palsy
The signs and symptoms of cerebral palsy may vary from one person to the other. Signs of CP may manifest when a baby is only several months old. Usually, parents notice signs of cerebral palsy before a child is two years old. Some of the early signs of CP are:
- The inability of difficulties holding the head up like other babies of a similar age
- Difficulties reaching for objects with the arms
- Challenges while sitting, rolling, crawling, or walking.
The other early signs of CP related to movement are:
- Tight muscles — The muscle tightness worsens with illness, stress, and time.
- Tight joints that do not stretch or bend all the way — This symptom usually manifests in the hands, hips, knees, elbows, and ankles.
- A decline in movements that the child was already performing
- Muscle weakness
- Slower movement compared to other children of the same age
- Lesser or reduced movement of the arms, legs, trunk, or the neck
- Lack of coordination
- Muscle tremors
- Floppy muscles, especially in the trunk or the neck.
The additional symptoms of CP that may manifest include:
- Learning disorders, even in a case where the child has average intelligence
- Trouble speaking or being understood
- Vision problems
- Hearing problems
- Joint pain — The joint pain results from poor posture or right muscles
- Decrease mouth-muscle coordination or strength — This results in increased drooling or problems eating
- Difficulty holding urine
- Slower-than-normal growth
Many children are born with CP but do not show signs of the disorder until several months or years later. Usually, the signs of CP appear before a child reaches 3 or 4 years. Early diagnosis of CP is essential. Therefore, you should take the proper action when you suspect that your child has CP.
Classification of Cerebral Palsy
Cerebral palsy is classified into five levels:
- Level 1 cerebral palsy — In this level, a patient can be able to walk without limitations.
- Level 2 — A person with level 2 cerebral palsy can walk long distances without limitations but can't jump or run.
- Level 3 — A person with level 3 cerebral palsy can stand with no support and sit with little support.
- Level 4 — A patient with level 4 cerebral palsy requires assistive devices to walk.
- Level 5 — A person with level 5 cerebral palsy requires support to maintain their neck position or maintain their head.
Causes of Cerebral Palsy
Injury to the growing brain or abnormal brain development is the leading cause of CP. CP may occur if an injury affects the section of the brain that regulates body movement, posture, and coordination. In most cases, brain damage happens before birth but may occur in the early years of life. In some instances, the exact causes of cerebral palsy are not known. However, the possible leading causes of cerebral palsy are:
- Severe jaundice in the infant
- Gene mutation due to an abnormal brain development
- Asphyxia neonatorum — This is a lack of oxygen during labor and delivery
- Maternal infections like herpes simplex and German measles
- Brain infections like meningitis and encephalitis
- Bleeding in the brain or Intracranial hemorrhage
- Head injuries due to a fall, car accident, or child abuse
Risk Factors for Cerebral Palsy
Various factors could put babies at a higher risk of cerebral palsy:
- Low weight birth
- Premature birth
- Being twins or triplets
- A low Apgar score — An Apgar score helps assess the baby’s physical health at birth.
- Breach birth — A breech birth occurs when a baby's feet or buttocks come out first instead of the head.
- Rh Incompatibility — A Rh incompatibility occurs when the mother’s blood Rh type is not compatible with that of the baby.
- Maternal exposure to harmful substances while pregnant — Toxic substances include methyl mercury.
Diagnosis of Cerebral Palsy
Your child’s doctor may notice a delay in the child’s movement and refer the child to a physical therapist (PT). A child might be seeing a physical therapist (PT), but he or she doesn’t have a diagnosis. In this case, the PT may refer the child’s parents or guardians to a child’s pediatrician. The child’s PT may analyze the child's medical history if CP is suspected. For example, the PT may ask questions about the child's birth, the mother's pregnancy, and the child's general health. The PT will also ask about the parent's or the guardian's general concerns. As part of the evaluation to diagnose CP, the physical therapist may:
- Conduct a hands-on assessment of the child’s muscle tone, flexibility, strength, and reflexes.
- The PT may also observe the child in different positions to assess their movement patterns.
- The PT will determine how well a child can sit, grasp objects, or stand — Assessing a child’s development milestones is a great way to determine whether a child has CP.
Usually, the physical therapist works together with your child’s doctor to order further tests. The additional tests include imaging scans or blood work to help reach a final diagnosis.
How a Physical Therapist Helps Cerebral Palsy Patients
A physical therapist plays an essential role in the fitness and health of any person with CP. Physical therapists help people with CP gain movement and strength to function through different life stages. PTs come in handy in providing care at different stages of a patient's development.
Physical therapists tailor their services to meet the unique needs of every patient. PTs work alongside other health care providers to recognize changing treatment priorities. Other health care providers who may work alongside the PT include occupational therapists, language/speech pathologists, orthotists/prosthetists, and durable medical equipment companies.
Physical Therapy From Birth To 4 Years
A PT can work alongside a caregiver to support your child’s movement development. A physical therapist provides treatment for feeding, movement, self-calming, play, and positioning.
They recommend at-home changes to enhance communication and movement development. In addition, PT helps improve play skills, vision, and hearing. Often, children learn many skills through play. Your physical therapist will create an individual program with play activities that match the child’s unique needs. Physical therapy in children below four years aims to improve movement, strength, and function. Young children receive physical therapy services from their homes, an outpatient clinic, or a daycare center. The therapist will modify the treatment program as the child develops and his or her needs change.
Physical Therapy in Children Between 5 and 18 Years
Physical therapists can train caregivers to take care of children with cerebral palsy to achieve their functional goals. PTs adjust the treatment plan and goals as a child ages. Every year, children with CP struggle to adapt and master new settings in preschool and school environments. Between the ages of 5 and 18 years, children experience a growth spurt. Therefore, adjustments in PT and any other equipment that a child uses are necessary. Depending on his or her needs, a child may receive PT services in the community, school, or both. School-based physical therapy aims to give children the best learning environment.
For children in this age range, the PT focuses on eliminating posture issues and joint mobility problems. CP patients form lifelong habits during the adolescence stage. Developing a personal fitness program for adolescents living with CP helps improve health and function for the rest of their lives.
Many children suffering from CP are often at risk of not getting enough physical exercise, which leads to medical and weight issues. These issues will significantly impact the quality of life of the children and their caregivers. While developing individual home exercise programs, PTs consider a person’s strengths, abilities, and interests. As part of the physical therapy program, the PT may recommend sports like swimming, bowling, volleyball, cycling, basketball, and tennis to promote physical well-being. These sports also encourage participation in social activities with friends.
Physical Therapy in Adults Above 18 Years
Many people suffering from CP live active and fulfilling lives as adults. A majority of them enjoy families and careers. For adults with CP, physical therapists usually focus on:
- Energy conservation
- Pain management
- Use of ideal adaptive equipment
- Adapting to changes and enhancing independence at home and in the workplace.
Many adults with CP usually experience pain in the muscles and joints. Many physical therapists have long-term relationships with their clients from childhood. They help the patients manage any CP-related issues that may arise in adulthood. Physical therapists recommend exercise routines to help adults living with CP reduce joint pains and remain strong. For instance, aquatic therapy is particularly beneficial to adults with CP.
Choosing the Right Physical Therapist
With so many physical therapists available, what kind of physical therapist do you need if you have cerebral palsy? Most physical therapists have the necessary education and experience to handle patients who have cerebral palsy. However, below are some of the factors to consider to ensure that you choose the right doctor:
- The physical therapist should have ample experience in treating people with cerebral palsy.
- If your child has cerebral palsy, you should work with a physical therapist who has experience with treating children and infants.
- A PT should have completed training in neurological and/or pediatric physical therapy. In addition, he or she should be a board-certified clinical specialist. A PT with the proper training will have the right skills, knowledge, and experience.
To get the right physical therapist, you can use an online tool built by the American Physical Therapy Association. This tool is known as Find a PT. This tool will help you locate physical therapists in your area who possess the desired clinical expertise. Other general tips that you should follow when choosing an ideal PT or any other health care provider are:
- Get recommendations from friends, family, or other healthcare providers
- You should not hesitate to ask all the relevant questions during the initial consultation with a physical therapist. For instance, you should inquire whether the physical therapist has relevant experience helping people with cerebral palsy. You should also find out about the PT’s experience level.
- Online reviews from other clients who have worked with the PT can also help you determine whether the PT in question is reliable.
During the initial consultation with a physical therapist, you should describe all your symptoms in detail. You should also discuss your goals with the physical therapist.
Find a Physical Therapist Near Me
In most cases you do not need your doctor’s referral to consult a physical therapist. Physical therapists use non-invasive procedures to improve CP patients’ quality of life through hands-on care, prescribed movement, and patient education. A physical therapist will design a treatment plan that meets your specific needs, goals, and challenges. If you need reliable physical therapy services for a cerebral palsy patient in Las Vegas, NV, contact Suarez Physical Therapy at 702-368-6778. We will work together with you to develop the right strategies to help you or your child achieve your goals.