Tuesday, February 21, 2017

Cerebral Palsy and Physiotherapy.

What is Cerebral Palsy?

                          It is a non-progressive neuromotor disorder of cerebral origin.
The etiology of Cerebral palsy is owing to the brain damage, this damage caused by the brain injury or abnormal development  of brain.It oftenseems that the c.p is a congenital disease and it's very rarely gets after birth.There is no obvious reason why a child has cerebral palsy.The main causes include:
(1) Infection in early part of pregnancy. 
(2) Lack of oxygen to brain.
(3) Abnormal brain development.
                                                (4) A genetic link.

                                     1.Spastic C.P                                                                                                            2.Athetoid C.P
                              3.Ataxic C.P
                              4.Mixed C.P


                               This is the commonest type of C.P and it's common signs are stiff muscles,joint tightness and involuntary jerky movements. In spastic c.p the most common injured area in brain is motor cortex. The motor cortex is the area in the brain in charge of all body movements. 

The different types of Spastic C.P are:
1.Spastic Monoplegia.
2.Spastic Diplegia.
3.Spastic Hemiplegia.
4.Spastic Triplegia.
5.Spastic Quadriplegia.

                                     In this type of c.p any muscle groups can be affected and the symptoms will vary in different people but there are some common symptoms they are stiff and tight muscles, contractures, abnormal gait, crossed knees, walking on tiptoes, abnormal reflexes.


                      Another name of this c.p is dyskinetic c.p and it is associated with movement disorder owing to the damage in developing brain especially in the basal ganglia. In this type of c.p both hypotonia and hypertonia are present.The symptoms will vary between patients some have minor problems but other have lot of problems and disabilities. The different forms of athetoid c.p are Dystonia, Chorea, Athetosis,Chorea Athetoid, Ataxia,  Dyskinesia.

                       This is the least commonest type of c.p.In this typeof c.p children also have  problems in oral and speech.What ever problems they have, unfortunately we have no treatment to cure but we have some treatment that helps the children to cope up with their difficulties.


               Around 10% of children suffering from c.p have a combination of two or more types.The most common form is spastic and athetoid c.p, the main cause is injury to both the pyramidal and extrapyramidal tracts of brain.
                        As with other forms of c.p mixed one is also non progressive and the condition doesn't worsen, the level of disability depends upon the severity of the injuries within the brain.


            The people who have c.p are challenging the common problems like posture, gait and coordination:- the physical therapy mainly concentrates on gait & coordination.The ultimate aim of physiotherapy is to achieve the body control and motor function.Along with the child physiotherapy the parents should get training the ways to keep the child muscles strong and joint flexible.

The physiotherapist again classified the c.p according to the Gross Motor Functional Classification System(G.M.F.C.S).

G.M.F.C.S Level 1 - Walks without limitations
G.M.F.C.S Level 2 - Walks with limitations
G.M.F.C.S Level 3 - Walks with adaptive equipment assistance.
G.M.F.C.S Level 4 - Self mobility with use of powered mobility                                                                                      assistance 
G.M.F.C.S Level 5 - Transported in a manual wheelchair.
                       The child should get intensive physiotherapy as soon as possible to achieve the maximum potential. This is a lifelong condition and the persons get benefits of physiotherapy throughout his life.

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