This document discusses cerebral palsy (CP), a group of permanent disorders caused by damage to the developing brain that affects body movement and muscle tone. CP symptoms can range from mild to severe and vary depending on the location and degree of brain damage. It is classified in different ways including by the affected body parts (topographical), type of movement abnormality (neuromotor), and functional ability. While CP is non-progressive, physical therapy and management of symptoms can help reduce impairments and secondary complications over the lifespan.

1. CEREBRAL PALSY, STROKE, AND
TRAUMATIC BRAIN INJURY
Chapter 14

2. INTRODUCTION
 Cerebral Palsy, Stroke, and Traumatic Brain
Injury
 Different causes, similar results: brain
damage
 Still encouraged to participate in physical
activity

3. CEREBRAL PALSY
 Refers to a group of permanent disabling
symptoms resulting from damage to the
motor control areas of the brain
 Nonprogressive
 Originates before, during, or shortly after
birth
 Symptoms vary widely, ranging from severe
to mild
 Other impairments and secondary medical
complications

4. CAUSES OF CP
 Pre-natal, Natal, and Post-natal causes
 Rubella, Rh incompatibility, prematurity, birth
trauma, anoxia, meningitis, poisoning, brain
hemorrhages or tumors, and other forms of
brain injury
 Results from causal pathways rather than
any single factor

5. INCIDENCE
 Estimated 800,000 children and adults in the
US with CP
 Only about 10% of those cases are acquired
 The number of new cases has increased by
25% over the last decade
 8,000 babies and infants diagnosed each
year
 1,200 to 1,500 preschool aged

6. CLASSIFICATIONS
 The degree and location of the brain damage
affects the symptoms that are displayed
 Because of the variety of symptoms,
classification systems have been put in
place.
1. Topographical
2. Neuromotor
3. Functional

7. TOPOGRAPHICAL
 Based on the body segments affected
 Typically used by the medical community
 Classes include:
 Monoplegia
 Diplegia
 Hemiplegia
 Paraplegia
 Triplegia
 Quadriplegia

8. NEUROMOTOR
 American Academy for
CP and Developmental
Medicine
 Three main types
1. Spasticity
2. Athetosis
3. Ataxia
 Characteristics are
not distinct

9. NEUROMOTOR: SPASTICITY
 Results from damage to motor areas of the
cerebrum
 Characterized by increased muscle tone
 Strong exaggerated muscle contractions are
common
 Associated with hyperactive stretch reflex

10. NEUROMOTOR: ATHETOSIS
 Caused by damage to the basal ganglia
 Results in an overflow of motor impulses to
the muscles
 Also known as dyskinetic CP
 Muscle tone fluctuates, especially in muscles
that control the head and neck.
 Lordotic standing posture
 Aphasia and articulation difficulties

11. NEUROMOTOR: ATAXIA
 Caused by damage to the cerebellum
 Hypotonicity
 Usually not diagnosed until child attempts to
walk
 Wide-based gait is typical
 Nystagmus is also commonly observed

12. FUNCTIONAL
 Used in the field of education
 Based on ability due to the severity of the
disability
 Important implications for physical education
and sport

13. Clas
s
Description
I Severe spasticity or with poor functional range of motion and strength in
all extremities
II Severe to moderate spastic or athetoid quadriplegic; poor functional
strength in all extremities, and poor trunk control
III Moderate quadriplegic or triplegic; severe hemiplegia; fair to normal
strength in one upper extremity
IV Moderate to severe diplegic; good functional strength and minimal
control problems in upper extremities and torso
V Moderate to severe diplegic or hemiplegic; moderate to severe
involvement in one or both legs; good functional strength; good balance
when assistive devices are used
VI Moderate to severe quadriplegic; fluctuating muscle tone producing
involuntary movements in trunk and both sets of extremities;
VII Moderate to minimal spastic hemiplegic; good functional ability on
nonaffected side
VIII Minimal hemiplegic, monoplegic, diplegic, or quadriplegic; might have
minimal coordination problems; good balance

14. GENERAL EDUCATIONAL CONSIDERATIONS
 CP is not a disease. It is not to be treated but
managed.
 Manage both motor and associated
disabilities
 In some cases surgery can be done
 There has been some advanced research in
the use of stem cells
 Physical therapy is common, especially in
younger patients with CP

15. FIVE AIMS WHEN WORKING WITH PEOPLE WITH
CP
1. Reducing musculoskeletal impairments to improve function
and quality of life
2. Enabling children to function optimally given their existing
impairments
3. Preventing or limiting development of secondary
implications
4. Altering the natural course of the disorder
5. Promoting wellness and fitness over the life span
Attention must also be given to the psychological and
social development of people with CP.