Overcoming challenges with cerebral palsy through exercise physiology

CP is very common, with 1 in 700 children being diagnosed. Therefore, spreading awareness is very important not only to increase the general public’s knowledge of the condition, but to better understand the challenges faced by those with CP on a daily basis.

March is cerebral palsy awareness month, which gives us the opportunity to both celebrate and educate others about cerebral palsy (CP). 

CP is very common, with 1 in 700 children being diagnosed. Therefore, spreading awareness is very important not only to increase the general public’s knowledge of the condition, but to better understand the challenges faced by those with CP on a daily basis.

What is Cerebral Palsy?

CP is a neurological condition that affects body movement. “Cerebral” refers to the brain and “palsy” refers to the impairment of motor function.  

What Causes Cerebral Palsy? 

This is quite often misunderstood, whereby people may assume that CP is genetic or hereditary. Although, genetics can play a role in the likelihood of CP occurring. In fact, CP is a result of issues or damage to the brain’s development before, during, or after birth. 

Do you know the main types of CP?

  1. Spastic CP→ hemiplegic or quadriplegic 

Approximately 85% of those with CP are diagnosed with spastic CP. This occurs when the damage sustained is to the brain’s motor cortex. Key characteristics are excessive flexion (or bend) of muscle groups in both the upper and lower extremity (i.e., elbows, hips, wrists, knees), this can also impact the child’s facial and tongue muscles.

  1. Ataxic CP

Far less common as only ~5% of overall CP diagnoses are ataxic (meaning lacking coordination). This is due to damage to the cerebellum (primarily responsible for coordination). In the upper limbs, tremor, shakiness, dysmetria (poor distance judgement), and difficulty performing precise finger movements/reduced fine motor skills is quite common. In the lower limb, a wide base of support, poor balance, and increased falls risk is common to look out for in those with ataxic CP. This CP type is also linked with speech and swallowing problems, yet another challenge faced by this population, and should be considered by those interacting with people with this sub-type of CP. 

  1. Dyskinetic CP

Another less common CP type as it only affects approx. 8% of CP patients. Dyskinesia occurs due to damage to the basal ganglia, an area of the brain responsible for motor control and learning, as well as executive function and behaviour/emotions. This CP type is commonly associated with twisting and repetitive movements (known as dystonia), unpredictable movements (known as chorea), and slow, continuous and involuntary movements (known as athetosis).

  1. Mixed/Combination

Finally, combinations of the above CP types can also occur, causing even more confusion or misunderstanding of the neurological condition. 

How can an Exercise Physiologist help?

An EP will begin by assessing the patient’s diagnosis, current functional state, in addition to personal goals and limiting factors. 

We then commence personalised neuro-rehabilitation to:

  • Improve function and gross motor control
  • Improve cardiovascular fitness and muscular endurance to delay fatigue onset
  • Improve wellbeing and quality of life
  • Maintain mobility and range of motion
  • Improve sleep quality

Take-home Message.

It is important to be patient with those with CP, to understand that they just want to fit in like everybody else, and find their place in the world. They just have to do this while facing countless physical challenges that those living without CP cannot empathise with or sometimes even fathom. 

If you or somebody you know has CP, and may not be functioning well in everyday life, please know that the support network for those with CP and their loved ones is vast, and there are many avenues with regard to treatment that can improve health and function outcomes.

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