Cerebral palsy

Cerebral palsy (CP) is an umbrella term for a group of disorders affecting physical ability that is a result of brain injury during pregnancy, at birth or shortly after birth (less than 2 years). The injury associated with CP is permanent and generally does not worsen itself, however the physical impairments can change.

Physical difficulties include impaired postural control, balance, coordination, strength, sensation and proprioception (movement awareness). Non-physical difficulties include impaired speech, hearing, learning, vision and intellect. Epilepsy is also common in people with CP. Cerebral palsy can affect both legs (diplegia), an arm and a leg on the same side (hemiplegia) or all 4 limbs (quadriplegia).

Types of Cerebral Palsy

• Spastic – characterised by stiffness and jerky movements because of a disrupted balance between muscle groups.
• Dyskinetic – characterised by variable movement beyond a person’s control.
• Ataxic – characterised by movement that is poorly coordinated or clumsy.
• Mixed – characterised by a mixture of motor control problems

Common challenges:

• Difficulty with moving independently
• Hyperextending big toe (pointing upwards) or knees
• Excessive toe clawing (pointing downwards)
• Toe walking or walking without heels on the ground
• Scissoring gait
• Altered perceptual abilities and spatial awareness
• Difficulty manipulating objects
• Spasticity
• Difficulty with communication and speech
• Difficulty with cognition and learning
• Behavioural problems

The role of a paediatric or adult neurological physiotherapist in cerebral palsy:

Evidence shows that the physical difficulties faced by individuals with cerebral palsy can be improved with physiotherapy. Paediatric and adult neurological physiotherapists are physiotherapists with additional training and expertise in treating problems related to the brain, spinal cord, inner ear and nerves. As cerebral palsy affects into adulthood, it is important to consider the therapists’ experience in dealing with the effects of cerebral palsy as they transition across the lifespan, and we are one of very few services in Melbourne who provide neurological physiotherapy services for children and adults.

With skills in changing motor behaviour, muscle tone and optimising for function, neurological physiotherapists can provide a wealth of knowledge in helping people with cerebral palsy navigate the appropriate services as well as provide direct therapy for specific goal achievement. This may be in the form of intensive therapy or educating carers to provide therapy support for meaningful activities.

What our skilled therapists can offer:

• Deeply understand the individual’s movement difficulties
• Assess the complexity of posture and functional abilities, and how to promote greater participation and long term health
• Review current supports and equipment
• Design a personalised neurological rehabilitation program that is holistic and considers the 24-hour routine
• Provide hands-on treatment to teach the individual how to move better or more efficiently
• Provide advice on facilitating skill development and transfer into the individual’s daily life and education to caregivers
• Liaise with the individual’s network (e.g. kindergarten, school, work, other therapists) as appropriate