Cerebral Palsy Sneak Peak

EXERCISE REHABILITATION PROGRAMS FOR AN
INDIVIDUAL WITH CEREBRAL PALSY
Move 4 Health - Robyn Papworth BExSc, GCertAppExSc(Rehab), MDisStdsNovember 2014

What is Cerebral Palsy?
www.move4health.com.au | admin@move4health.com.au
 “Cerebral palsy (CP) is a static neurologic condition
resulting from brain injury that occurs before
cerebral development is complete”5

What is Cerebral Palsy?
 CP can be classified according to which body
parts are affected:
 Hemiplegia
 Diplegia
 Quadriplegia

Types of Cerebral Palsy
 Spastic CP
 Athetoid/Dystonia CP
 Ataxic CP
 Mixed CP

Aetiology(Reddihough and Collins, 2003).
 Because brain development continues during the
first two years of life, cerebral palsy can result from
brain injury occurring during the
 prenatal,
 peri/neonatal, or
 postnatal periods

Cerebral Palsy & Motor Control
 Afferent neural impulses provide information to the brain about a
stimulus from the environment (tap on the patellar tendon)
 The brain receives this information, processes it, and plans a reaction
back to the stimulus. The efferent neural impulses tell the body what
to do in response to the stimulus
 However, as a result of CP, “muscles receive incorrect neural impulses
to, and from, particular areas of the brain.
 These incorrect impulses, in turn, stimulate abnormal muscle
contractions.

Cerebral Palsy & Motor Control?

 Motor activity is necessary for interaction with the
physical world such as speaking, eating, dressing, or
interacting with your environment.1
 Any motor disability or injury will compromise and
limit the ability to move and interact in the
environment

 Difficulties with
exaggerated stretch
reflexes and poor spatial
relations can make
activities like filling up a
cup extremely difficult

CP is not just a motor disorder
 CP does not just impact a persons’ motor skills
 “The motor disorders of CP are often accompanied
by disturbances of:
 Sensation (abnormal pain and touch perceptions),
 cognition,
 communication,
 spatial awareness
 behaviour and/or
 seizure disorders affecting approximately 50% of
people with CP.”3

Why is Exercise Physiology so
important?
 We can design specific, functional, and achievable
exercise programs for individuals with CP
 We have the potential to:
 Improve an individual with CP's ability to complete
physically demanding tasks (e.g. negotiating stairs,
walking on uneven surfaces)
 Reduce the progression of physical symptoms of CP
(spasticity, contractures)
 Help them to maintain a higher level of physical
independence and quality of life

Exercise Program Design
 Each exercise that is prescribed needs to be specific
to the strengths, weaknesses, goals, interests and
potential of the individual

Exercise Program Types
 Exercises to:
 Reduce progression of physical symptoms
 Improve ADL’s
 Improve motor control and muscular tone
 Improve communication
 Increase physical activity levels
 Improve sensory integration
 Improve balance

Exercises to reduce progression of
physical symptoms
 Passive stretching
 Gentle mobilisation
 Safe handling

Exercises to improve strength
 Some researchers used to believe that strengthening
spastic muscles would only make them stiffer but a
research has found that strength training can be
benefit for individuals with cerebral palsy and other
CNS disorders. 1
 Research has shown that muscle force production
can be improved when the load is sufficient.2
 Improved strength can translate into functional
improvements in activities of daily living.2

Exercises to improve strength
 There are a wide range of different activities to
improve muscular strength:
 Neck Strength
 Make noises
 Throw/catch
 Core/Postural Control
 Horse riding
 Scooter board/fitball/dura
disc activities
 Swimming/rowing
 Lower Extremities (LE)
 Leg cycling (with/out supports)
 Stair climbing
 Sit-to-stand (with/out supports)
 Upper Extremities (UE)
 Rowing
 Arm cycling (with/out supports)
 Theraband exercises

Exercises to improve ADL’s
 Focus on muscles that
are causing the most
problems with mobility
in activities of daily
living.
 Postural assessments
are crucial to:
 Strengthen weak muscles
 Gently stretch tight
muscles

Exercises to improve motor control
 Fine motor skills
 Grasp/release
 Targeting
 Integrate relaxation
 Obstacle courses
 Tummy time

Exercises to improve communication
 Rhythm is important for language development.
 Sing songs,
 Play music,
 Imitate body movements
 Imitate the use of the mouth muscles
 Blow bubbles with varied straws
 Blow ping pong balls across the table with a straw

Exercises to improve sensory
integration
 Sensory integration
difficulties are
common
 A thorough sensory
assessment is crucial
 Sensory integration
programs are
designed for
 Sensory Avoidance
 Sensory Seeking

Exercises to improve balance
 Balance programs
are designed to the
person’s ability to
sit, stand, walk,
throw/catch, etc.

Exercises to improve balance
 Balance activities can include:
 Static/dynamic standing balance with/without standing
frame/eyes open/eyes closed/on a dura disc
 Dynamic sitting balance – on a dura disc or swing to
build up confidence
 Gentle seated/standing perturbations
 Dynamic throw/catch activities standing on two
feet/one foot/dura disc
 Timed Up & Go & obstacle courses

Remember…
 Information in this training package contains only
suggested guidelines. Each person with CP must be
considered and assessed individually and consult
with their medical team before commencing an
exercise program.

To view the full 62 page presentation
please contact
admin@move4health.com.au
for only $5.50 per staff member
Online live and pre-recorded webinars with voice
recording also available for
$15 - $35 per staff member

References
1. Damiano, D. (2006). Activity, Activity, Activity: Rethinking Our Physical Therapy Approach to Cerebral Palsy. Journal of the
American Physical Therapy Association, 86, pages1534-1540
2. Fowler, E., Kolobe, T., Damiano, D., Thorpe, D., Morgan, D., Brunstrom, J., Coster, W., Henderson, R., Pitetti, K., Rimmer, J.,
Rose, J., Stevenson, R. (2007). Promotion of Physical Fitness and Prevention of Secondary Conditions for Children With
Cerebral Palsy: Section on Pediatrics Research Summit Proceedings. Physical Therapy, 87, pages 1495-1510.
3. Verschuren, O., Ketelaar, M., Gorter, J., Helders, P., Uiterwaal, C., Takken, T. (2007). Exercise Training Program in Children
and Adolescents With Cerebral Palsy. Archives of Paediatrics & Adolescent Medicine, 161, 11, pages 1075 – 1081.
4. Scholtes, V., Becher, J., Beelen, A., Lankhorst, G. (2006). Clinical assessment of spasticity in children with cerebral palsy: a
critical review of available instruments. Developmental Medicine & Child Neurology, 48, pages 64–73
5. Krigger, K. (2006). Cerebral Palsy: An Overview. American Academy of Family Physicians, 73, 1, pages 91 – 99.
6. Reddihough, D., Collins, K. (2003). Australian Journal of Physiotherapy, 49, pages 7-12
7. Wai-mun Pin, T. (2007). Effectiveness of Static Weight-Bearing Exercises in Children with Cerebral Palsy. Pediatric Physical
Therapy, pages 62 – 73
8. Darrah, J., Wessel, J., Nearingburg, P., O’Connor, M. (1999). Evaluation of a Community Fitness Program for Adolescents
with Cerebral Palsy. Pediatric Physical Therapy, pages 18 – 23.
9. French, R. (2004). Cerebral Palsy. Retrieved 14th November, 2014 from the TAHPERD Website:
http://www.tahperd.org/LINKS/links_pdfs/APE%20factsheets/Cerebral_Palsy.pdf
10. The United Cerebral Palsy Research and Educational Foundation. (1999). Exercise Principles and Guidelines for Persons
with Cerebral Palsy and Neuromuscular Disorders Part One. Retrieved 12th November, 2014 from the United Cerebral
Palsy Association of Greater Indiana Website: http://www.ucpaindy.org/wp-content/uploads/2010/03/Exercise-
Principles-and-Guidelines-for-Persons-with-Cerebral-Palsy-and-Neuromuscular-Disorders.pdf

Cerebral Palsy Sneak Peak

Recommended

Recommended

More Related Content

What's hot

What's hot (20)

Viewers also liked

Viewers also liked (10)

Similar to Cerebral Palsy Sneak Peak

Similar to Cerebral Palsy Sneak Peak (20)

Recently uploaded

Recently uploaded (20)

Cerebral Palsy Sneak Peak