Cerebral palsy (CP) is a group of neurological disorders. It is caused by damage to the immature, developing brain, usually before birth. CP can have a broad range of effects. People with CP may have trouble seeing, hearing, feeling, thinking, or communicating. Difficulties can range from mild to severe. CP also typically affects movement, muscle coordination, and balance. This can result in problems moving and walking, abnormal muscle tone, exaggerated reflexes, and involuntary movements. There is no cure for CP, but early treatment can help.
Physical therapy is one of the most important forms of treatment for children with CP. PT can help children improve their movement skills, stay active, and perform daily tasks. PT can also help prevent movement problems from getting worse over time and reduce physical discomfort. Let’s look at a few of the ways PT can be helpful:
Take Advantage of Neuroplasticity
Neuroplasticity is the ability of the neurons and neural networks in the brain to form new connections and change their behavior. This can help the brain to adapt or “train” other areas to take over the function that the damaged part was intended to do. Neuroplasticity is highest during the first few years of life, when the brain is still developing and forming new connections. This means that early intervention PT can have a greater impact on the brain’s ability to reorganize and learn new skills.
Early PT can help children with CP enhance neuroplasticity by providing exercises and activities that stimulate and challenge their brain and nervous system. This could involve playing with children in different positions that challenge their balance and stability, encouraging the use of affected limbs, or using different forms of sensory stimulation.
Improve Motor Skills and Function
Children with CP often have difficulty with motor skills and function due to muscle spasticity, weakness, or stiffness.
PT helps children with CP improve their motor skills and function by providing exercises and activities that target the large muscles in the arms, legs, and abdomen. For example, a physical therapist may use strength training, stretching, or balance training to improve the child’s muscle tone, range of motion, and stability. For young children, a PT might also use functional training techniques like crawling, climbing, walking, or propelling a wheelchair to improve the child’s mobility and independence.
Prevent or Delay Secondary Complications
Secondary complications are problems caused or are worsened by the primary diagnosis of CP. These can include muscle atrophy, loss of range of motion, muscle spasticity, pain, joint inflammation, and contractures. Secondary complications affect the child’s daily function, health status, and quality of life.
PT can help children with CP prevent or delay secondary complications by providing exercises and activities that maintain or improve their physical health and functioning. Examples include massage or stretching to relax and lengthen the muscles, positioning devices to improve posture, or braces, splints, or orthotics to support and align the affected joints.
Increase Quality of Life and Well-being
Movement limitations and environmental barriers can affect the self-esteem, confidence, and social relationships of children who have CP.
PT can improve the quality of life and well-being of children with CP by providing exercises and activities that are tailored to their individual needs and goals. Adaptive equipment such as wheelchairs, crutches, or bicycles can help the child access their community and enjoy recreational activities. A physical therapist will also work with the child’s family and other professionals to provide education and support for the child’s overall health and development.
Conclusion
Early physical therapy is a vital form of treatment for children with cerebral palsy. It can help them take advantage of neuroplasticity, improve motor skills and function, prevent or delay secondary complications, and increase their quality of life and well-being. PT can help kids with CP be as independent, comfortable, and healthy as possible.
If you are looking for an early intervention physical therapist for your child with cerebral palsy, you can visit Choose PT to find one near you.
References
1. Physical Therapy for Cerebral Palsy – Improving Mobility. (n.d.). Retrieved from https://www.cerebralpalsyguide.com/treatment/physical-therapy/
2. Physical Therapy for Children with CP. (n.d.). Retrieved from https://www.cerebralpalsy.org/about-cerebral-palsy/treatment/therapy/physical-therapy
3. Cerebral palsy – Diagnosis and treatment – Mayo Clinic. (n.d.). Retrieved from https://www.mayoclinic.org/diseases-conditions/cerebral-palsy/diagnosis-treatment/drc-20354005
4. Cerebral Palsy and Physical Therapy. (2022, April 28). Retrieved from https://www.cerebralpalsyguidance.com/cerebral-palsy/treatment/physical-therapy
5. Therapy has long-lasting benefits for children with cerebral palsy. (2021, November 9). Retrieved from https://www.nih.gov/news-events/nih-research-matters/therapy-has-long-lasting-benefits-children-cerebral-palsy
6. Early Intervention for Cerebral Palsy: Examples & What to Do. (n.d.). Retrieved from https://www.flintrehab.com/cerebral-palsy-early-intervention/
7. Morgan, C., Fetters, L., Adde, L., Badawi, N., Bancale, A., Boyd, R. N., Chorna, O., Cioni, G., Damiano, D. L., Darrah, J., de Vries, L. S., Dusing, S., Einspieler, C., Eliasson, A.-C., Ferriero, D., Fehlings, D., Forssberg, H., Gordon, A. M., Greaves, S., Guzzetta, A., … Novak, I. (2021). Early Intervention for Children Aged 0 to 2 Years With or at High Risk of Cerebral Palsy: International Clinical Practice Guideline Based on Systematic Reviews. JAMA Pediatrics, 175(8), 846–858. https://doi.org/10.1001/jamapediatrics.2021.0878
8. Therapy for Cerebral Palsy | Early Intervention | CerebralPalsy.org. (n.d.). Retrieved from https://www.cerebralpalsy.org/about-cerebral-palsy/treatment/therapy
9. Early Intervention and the Importance of Early Identification of Cerebral Palsy – Physiopedia. (n.d.). Retrieved from https://www.physio-pedia.com/Early_Intervention_and_the_Importance_of_Early_Identification_of_Cerebral_Palsy
10. Cerebral Palsy Early Intervention. (n.d.). Retrieved from https://cprn.org/cerebral-palsy-early-intervention/
Expect to Get Better. You Probably Will.
Research has shown that positive expectations increase the chances of a good outcome. It’s the old self-fulfilling prophecy; your attitude determines your approach to situations. If you believe you’ll be successful, you’ll likely put in more effort. You’ll be more willing to try new things, take some risks and keep trying after failures or setbacks. A negative attitude will likely mean that you’ll take your first failure or setback as confirmation that what you’re trying won’t work or isn’t possible and you’ll give up. Why waste time and effort on something that’s doomed to failure anyway?
Your Expectations Influence Your Results
There’s some research to prove that positive thinking and expectations make a difference in rehab settings too. A review of 23 articles looking at outcomes for shoulder pain found a few interesting things. First, patients who expected to recover and believed that they had some control of the outcome, ended up doing better than those who didn’t. Second, optimistic patients were found to have less pain and disability after completing rehab. Third, patients who believed they’d have pain and disability after surgery tended to have – you guessed it – pain and disability after their surgery. Research says that you tend to get what you expect.
So Do Your Therapist’s
Your attitude is important, but what about your therapist’s? There isn’t much research specific to PT, but there is a study done in elementary schools that might give us some clues. Two psychologists – Rosenthal and Jacobs did a study showing that teacher expectations had an influence on student performance. They told teachers that randomly selected students in their classes were tested and found to be “late bloomers”. These students were expected to show large improvements in academic performance during the school year. When the students were tested 8 months later, the students the teachers believed would improve the most, did.
Why? When teachers think students have a lot of potential to improve, they hold them to higher standards. They teach more complex materials, don’t settle for simplistic answers and are more willing to spend time instructing and working with those students. It’s pretty easy to see how this could cross over into a PT clinic. If your PT thinks you can get better, they’ll probably put more effort into designing your program, spend more time with you and push you harder than someone they don’t believe has a lot of room for improvement.
To have the best chance for a good outcome, you and your therapist both need to expect one. You probably will.
References
● De Baets L, Matheve T, Meeus M, Struyf F, Timmermans A. The influence of cognitions, emotions and behavioral factors on treatment outcomes in musculoskeletal shoulder pain: a systematic review. Clin Rehabil. 2019 Jun;33(6):980-991. doi: 10.1177/0269215519831056. Epub 2019 Feb 22. PMID: 30791696.
● Rosenthal, R, and L. Jacobsen. Pygmalion in the classroom: teacher expectation and pupils’ intellectual development. New York: Holt, Rinehart and Winston, 1968.
