Cerebral Palsy Therapies

PHYSICAL THERAPY

Is a branch of rehabilitative health that is considered one of the most important aspects of treating children with cerebral palsy. Those with cerebral palsy experience mobility, function, posture and balance challenges of varying degrees, and physical therapy – which focuses on basic mobility such as standing, walking, climbing stairs, reaching or operating a wheelchair – is a key element in the multidisciplinary approach to increasing a child’s mobility.

Physical therapy is the rehabilitation of physical impairments by training and strengthening a patient’s large muscles – those in the arms, legs, and abdomen. The goal of physical therapy is to maximize functional control of the body, or increase gross motor function.

The goal of physical therapy is to help individuals:

  • develop coordination
  • build strength
  • improve balance
  • maintain flexibility
  • optimize physical functioning levels
  • maximize independence

Trained and licensed physical therapists identify mobility issues and determine the unique physical abilities and limitations of children, taking into account their age and cognitive functioning, after a diagnosis of cerebral palsy is made by a physician.

The therapist will then develop a course of treatment that will include exercises, stretches, and possibly assistive and adaptive equipment designed to achieve mobility. The treatment may also employ the use of passive modalities involving hot and cold packs, ultrasound technology or other means in which the child does not take an active role.

All treatment is designed to meet a child’s individual needs in a way that emphasizes physical fitness, and minimizes injuries and pain.

Additionally, a physical therapist provides positive reinforcement for a child by focusing on his or her capabilities, not limitations. The therapist will set goals for young patients, and work with them to meet predetermined benchmarks with confidence in a safe, supportive environment.

OCCUPATIONAL THERAPY

Is an integral part of a cerebral palsy patient’s overall treatment program. The goal of occupational therapy is to promote a child’s ability to perform daily rituals and activities in a way that will enhance their quality of life and make possible the enjoyment of independent living.

During occupational therapy, a trained therapist will guide the individual in adapting, compensating, and achieving maximum function levels. They take into account physical functioning abilities and limitations, cognitive functioning levels (i.e., reasoning and processing skills), emotional needs and desires, and ability and willingness to adapt and compensate. The existing home environment and support system play an important role, as well.

Occupational therapy is a form of therapeutic intervention. The goal of therapy if to ensure a child achieves the highest level of functional performance within their home, school, public and work environments. Occupational therapy employs adaptive processes to teach a child to perform tasks required in the normal course of a day.

This is accomplished by focusing on:

  • Identifying adaptive methods a child can learn to complete tasks
  • Breaking down essential tasks into smaller, do-able steps, often modified
  • Capitalizing on the need for accomplishment, pride, enjoyment and independence
  • Developing in a child a sense of place in their environment, at school, and in the community

SPEECH AND LANGUAGE THERAPY

Language, speech, breathing, chewing and swallowing difficulties can be present with various health conditions, including brain injury, cerebral palsy, cognitive impairment, hearing loss, and learning disabilities. Oral motor dysfunction, facial muscle impairment, is common in children with cerebral palsy. Oral motor functioning depends on an intricate process of sending and receiving messages to various facial, throat and neck muscles to coordinate breathing while talking, chewing, swallowing and digesting. Speech-language pathologists use augmentative or alternative communication methods with those who have little or no ability to speak. With assistance, children can learn to improve communication by strengthening muscles, making sounds, improving voices, correcting accents, and using compensatory strategies. Speech and language pathologists also address swallowing disorders, which, untreated, can lead to aspiration, malnutritian, respiratory distress, digestion difficulties, and pneumonia. They work closely with respiratory therapists, registered dietitians, and gastroenterologists to improve various associative conditions.

HIPPO THERAPY (HORSEBACK RIDING)

Hippo-therapy is a form of physical, occupational and speech therapy that uses equine (horse) movement to develop and enhance neurological and physical functioning by channeling the movement of the horse. This further develops physical and cognitive abilities. Hippotherapy is not to be confused with therapeutic horseback riding, in which individuals are taught specific riding skills. Hippotherapy is built on the concept that the individual and variable gait, tempo, rhythm, repetition and cadence of a horse’s movement can influence human neuromuscular development in humans. Horseback riding triggers a series of complex physical and mental reactions; such as making physical adjustments to maintain proper alignment on the horse. Riders must also plan movements to maintain balance on the horse, and be able to interact with the animal.

SUIT AND CAGE THERAPY

Most children wouldn’t take kindly to wearing a brightly-colored, banded suit over their clothing. But what if that suit, as different as it may look, restored the physical mobility? What if the suit provided a child proper posture, muscle tone, and patterns of movement previously lost to disability? That’s the premise made by practitioners of intensive suit therapy, a complex intervention that makes use of an orthotic suit comprised of a hat, vest, knee pads, and specifically-designed shoes that are worn by children and adults in a therapeutic setting. According to devotees of suit therapy, multiple adjustable rings and elastic bands on the garment can be adjusted to provide pressure and support to the muscle groups and joints affected by cerebral palsy that need more support than a child can provide. Strategically-placed bungee cords can be adjusted to typical flexor and extensor muscle groups; the entire suit acts as a soft exoskeleton that brings a child’s body into proper alignment by adjusting limbs to correct abnormal muscle tone and re-train a child’s brain to recognize correct muscle movements.  

The Universal Exercise Unit, also known as the 'cage' or 'spider', plays a vital role in therapy for children with CP in conjunction with the suit.  Using a pulley system, the cage provides low grade resistance and allows therapists to isolate a particular muscle group.  This therapy is used to strengthen weak muscles and improve muscle flexibility and tone.

When the cage is outfitted with bungee cords, it is referred to as a 'spider'.  Wearing a belt that the bungees connect to, children are able to jump, fly and flip.  These exercises promote balance, coordination, and sensory motor integration.

CONDUCTIVE EDUCATION

Conductive education is a comprehensive method of learning by which individuals with neurological and mobility impairment, like cerebral palsy, learn to specifically and consciously perform actions that children without such impairment learn through normal life experiences. Founded in the 1940s by Hungarian physician Professor Andras Peto, conductive education takes the position that motor disorders are learning disabilities, children are taught to see themselves as active participants in their own education; they are encouraged to be problem-solvers and develop a self-reliant “orthofunctional” personality that fosters participation, initiative, determination, motivation, independence, and self-sufficiency. Because of this, conductive education programs are not medically-based, but task oriented. The most striking difference between conductive education and conventional treatment is that it’s not a therapy, or a treatment. This approach takes into account that those with special needs have extra and different learning needs to accomplish actions. The program relies on a child’s natural abilities, not corrective, modified or adapted.

AQUA THERAPY

Aqua therapy (also known as Aquatic therapy), under the supervision of a trained and certified professional therapist, provides deep, intense exercise within a soothing and comforting environment. This form of therapy promotes physical functioning with the aid of water’s restorative and detoxifying properties. Water buoyancy makes aerobic and anaerobic exercises safe and effective by allowing an individual to ambulate freely in a way that doesn’t place undue stress on the musculoskeletal system from forces such as gravity and body weight. Aqua therapy takes place in both heated and non-heated environments, although warm water therapy provides a massage effect on muscles, joints and ligaments.


DOLPHIN THERAPY

Was developed more than 25 years ago by the American psychologist David E. Nathanson, who conducted his first study on the rehabilitative effects of dolphin therapy as early as 1978. A proven method of treatment, dolphin therapy enables special-needs children, including those with cerebral palsy, to interact with their surroundings in a constructive and playful way.

Benefits of Dolphin Therapy:

Central to the therapy is the encounter between the child and the dolphin. Research has shown that dolphins, which have long been known to be highly intelligent animals, are able to recognize the child's deficiency. This recognition helps the child to forge a connection with the dolphin, resulting in a relaxation and openness to learning and healing that can lead to developmental progress.

Not only does dolphin therapy benefit children with cerebral palsy by boosting their confidence in their own abilities, but it also benefits entire families. Parents, together with any brothers and sisters the child may have, are encouraged to be active participants in the therapeutic process. The participation of whole families in dolphin therapy helps foster a sense of togetherness and cooperation within the family – a fact that further aids in the patient's progress.

Advocates of dolphin therapy do not claim that it cures diseases like cerebral palsy. However, research has shown that disabled children learn up to four times faster when exploring their surroundings with dolphins. Also, research seems to suggest that the best results are achieved when a child engages in dolphin therapy for at least two weeks.

 

ASSISTIVE TECHNOLOGY (AAC)

Assistive Technology (AT) often plays a vital role in the lives of people with disabilities. AT is any item, piece of equipment, or product that is used to increase, maintain, or improve the functional capabilities of individuals with disabilities

Technology can be big–an automated lift for van or bath or small–a Velcro-attached grip for a fork or a pen. It can be new-age interactive voice activated software for speech therapy or a wheelchair. It can be high-tech–a computer screen operated by eye movement-or low-tech–a specially-designed door handle for people with muscle strength or dexterity problems.

Technology can be a substitute such as an alternative augmentative communication device that provides vocal output for a child who cannot communicate with her voice. This means that a child who cannot speak can push a button and ask her mom for an apple. Or tell her brother his x-box is too loud. It means a child in school can ask questions of his teacher or talk with his friends.