The document discusses cerebral palsy (CP), a group of neurological disorders affecting movement and coordination, caused by brain damage or abnormalities during development. It outlines the aims, indications, contraindications, benefits, and risks of CP rehabilitation, emphasizing a multidisciplinary approach to enhance individuals' functional abilities and quality of life. Treatment strategies are categorized based on evidence strength, with various therapy options suggested to improve mobility, communication, and independence.

1. CEREBRAL PALSY REHABILITATION
The IIS University, Jaipur
Submitted by : Kavita Meena
Under the supervision of
Dr. Bhanwar Singh Takhar
IIS College of Physiotherapy & Allied Health Sciences

2. S.no Contents
1. Introduction
2. Definition
3. Team
4. Aim, Indications, Contraindications, Benefits, Risk
5. Goals, Causes and Rehabilitation Setting
6. References

3. INTRODUCTION
 Cerebral palsy (CP) refers to a group of neurological disorders that appear in infancy or early
childhood and permanently affect body movement and muscle coordination.
 CP is caused by damage to or abnormalities inside the developing brain that disrupt the brain's
ability to control movement and maintain posture and balance.
 The term cerebral refers to the brain; palsy refers to the loss or impairment of motor function.
 In some cases, the areas of the brain involved in muscle movement do not develop as expected
during fetal growth. In others, the damage is a result of injury to the brain either before,
during, or after birth.
 In either case, the damage is not reversible and the disabilities that result are permanent.
 There is no cure for cerebral palsy, but supportive treatments, medications, and surgery can
help many individuals improve their motor skills and ability to communicate with the world.

4.  Rehabilitation is combined and coordinated use of medical , therapeutic , social ,
educational and vocational measures for training or retraining the individual to
highest possible level of function.
 Cerebral palsy Rehabilitation is a comprehensive, multidisciplinary, and goal-
oriented process aimed at enhancing the functional abilities, independence and
quality of life of individuals.

6. Cerebral palsy Rehabilitation Team
 Physiatrist
 Physiotherapist
 Occupational therapists
 Speech therapist
 Neurologist
 Recreational Therapist
 Psychologists
 Behavior specialists
 Nutritionists
 Clinical social workers

7. Aims of CP Rehabilitation
 Improve mobility
 Enhance functional abilities
 Promote communication
 Increase independence
 Manage pain and discomfort
 Improve cognitive function
 Enhance social Participation
 Improve quality of life
 Prevent secondary complications

8. Causes
Prenatal Perinatal Postenatal
Maternal medical
conditions
Stroke
Congenital
malformations
Multiple gestation
Bleeding
Hypoglycemia
Brain injury
Infection
Oxygen
deprivation

9. Indication of CP Rehabilitation
1. Clinical Indication
 Delayed motor development
 Abnormal muscle tone
 Impaired reflexes
 Vision and hearing impairments
 Seizures or epilepsy
2. Developmental Indications
 Delayed speech or language development
 Cognitive delays
 Behavior challenges
 Intelectual ability
 Muscular weakness

10. Contra-Indication of CP Rehabilitation
 Infectious disease of nervous system
 Spinal issues
 Tumors
 Epilepsy
 Hypothermia
 Positioning
 Neuromuscular blockers
 Respiratory complications

11. Goals of CP Rehabilitation
GOALS
Long term
Goals
Prevent
Deformities
Maximize
Abilities
Long term
Goals

12. Benefits of CP Rehabilitation
1. Physical Benefits
a) Improve mobility
b) Increased strength and flexibility
c) Better posture and alignment
d) Reduced spasticity
2. Functional Benefits
e) Improved daily living skills
f) Increased independence
g) Better communication
h) Enhanced social participation
i) Improved intellectual activities

13. Risk of CP Rehabilitation
1. Physical Therapy Risks: Muscle Strain or Injury,Pain and Discomfort, Overexertion
2. Surgical Intervention Risks: Infections, Anesthesia complications, nerve damage
3. Speech and Occupational Therapy Risks
4. Medication Risks
5. Psychological and Emotional Risks:
6. Alternative Therapies Risks:
7. Assistive Devices and Technology Risks
8. Delayed or Incomplete Diagnosis:

14. Assessment Of Cerebral Palsy
Physical and
Neurological
exam
Brain
Imaging
Gross Motor
Functional
Measure
Fine motor
Functional
Measure
General
Movement
Assessment
Eating and
Drinking
ability
Clinical
History
Physical
Examination
Measurment
of Muscle
strength

15. Treatment Approaches
The "State of the Evidence Traffic Lights 2019" review categorises interventions for CP
into green, yellow, and red lights based on the strength of evidence.
1. Green Light Interventions (Effective)
 Constraint-Induced Movement Therapy (CIMT)
 Bimanual Training
 Task-Specific Training
 Serial Casting
2. Yellow Light Interventions (Promising but Limited Evidence)
 Virtual Reality
 Robot-Assisted Therapy
 Electrical Stimulation
 Hippotherapy
 Passive Stretching
 Static Weight-Bearing Exercises

16. 3. Red Light Interventions
 Neurodevelopmental Treatment (NDT) / Bobath Approach
 Patterning
 Sensory Integration Training

17. Treatment
Physical
therapy
Bracing &
Assisted
devices
Recreation
therapy
Stem cell
transplantatio
n
Gross
motor
developing
Speech
therapy
Occupational
therapy

18. Points to be Considered in Exercise Prescription
1. Frequency-: The most common frequency is once a week.
2. Intensity-: It depends on patients symptoms
3.Time-: 1-1.5 hours per session

19.  Das SP, Ganesh GS. Evidence-based approach to physical therapy in cerebral palsy. Indian journal of orthopaedics.
2019 Jan;53(1):20.
 Günel M. Rehabilitation of children with cerebral palsy from a physiotherapist's perspective. Acta Orthop
Traumatol Turc. 2009 Mar-Apr;43(2):173-80. Turkish. doi: 10.3944/AOTT.2009.173. PMID: 19448358.
 Jain S, Mathur N, Joshi M, Jindal R, Goenka S. Effect of serial casting in spastic cerebral palsy. The Indian Journal
of Pediatrics. 2008 Oct;75:997-1002.
 Mintaze Kerem G. Rehabilitation of children with cerebral palsy from a physiotherapist’s perspective. Acta Orthop
Traumatol Turc. 2009;34(2):173-80.
 Sharan D. Recent advances in management of cerebral palsy. The Indian Journal of Pediatrics. 2005 Nov
1;72(11):969-73.
 Enslin J, Rohlwink UK, Figaji A. Management of Spasticity After Traumatic Brain Injury in Children. Frontiers in
Neurology. 2020 Feb 21;11:126.
 Kantor, J.; Hlaváčková, L.; Du, J.; Dvořáková, P.; Svobodová, Z.; Karasová, K.; Kantorová, L. The Effects of Ayres
Sensory Integration and Related Sensory Based Interventions in Children with Cerebral Palsy: A Scoping Review.
Children 2022, 9, 483.
 Novak I, Morgan C, Fahey M, Finch-Edmondson M, Galea C, Hines A, et al.
State of the evidence traffic lights 2019: systematic review of interventions for preventing and treating children with
cerebral palsy
. Curr Neurol Neurosci Rep. 2020 Feb 21;20(2):3
Refrences

20. Thank
you