2. Definition
• Cerebral Palsy(cp) Is A Group Of Disorders Of Posture And Movement That Occur
Secondary To Damage To The Developing Fetal Or Infant Brain
3. Epidemiology
• Despite Treatment Advances, The Overall Prevalence Rates Have Neither Increased
Nor Decreased In The Past 20 Years (2.11 Per 1000 Live Births)
• In Children With Very Low Birth Weight (59.6 Per 1000 Live Births)
• Very Early Gestation (111.8 Per 1000 Live Births).
5. Classification
• Cp Can Be Classified At Least Three Different Ways:
• (1) By Distribution Of Involvement
• 2) By Type Of Abnormal Muscle Tone And Movement
• (3) By Severity Which Is Best Described According To The Gross Motor Function
Classification System (Gmfcs)
6. Distribution Of Involvement
1. hemiplegia. one side of the body affected.
2. quadriplegia. all limbs are affected (mainly the upper
limbs).
3. diplegia. all limbs are affected (mainly the lower
limbs).
4. triplegia. lower limbs and one arm affected.
5. paraplegia. lower limbs affected.
10. By Severity
1. Mild. Where The Child Is Independent And Even So Mild That He Only Appears To Be
Clumsy. The Non-motor Handicaps May Be The Greater Problem In These Children.
2. Moderate. Where The Child Can Achieve Partial Independence And Requires Aids
For Most Activities.
3. 3. Severe. When The Child Is Totally Or Almost Totally Helpless And A Wheelchair
Is Inevitable
11. Geographic Classification (Gage)
• – Diplegic (30%)
• – Hemiplegic (30%)
• – Dyskinetic (15%) (All Three Types May
Walk)
• – Quadriplegic (25%) (Most Will Not Walk)
12. Clinical Findings
A. Symptoms And Signs
1. Altered Muscle Tone, Motor Control, And Movement
2. Altered Or Persistent Reflexes
3. Secondary Musculoskeletal Findings
Equinus Deformity
Flexion Contractures
Hip Displacement
Scoliosis
Osteopenia
13. 4. Other Associated Findings
A. Seizure Disorders
B. Sensory Problems
C. Oromotor Dysfunction
D. Speech And Language Problems
E. Cognitive And Behavioral Issues
14. Physical Therapy Intervention
• Four Stages Of Care Are Used To Describe The Continuum Of Physical Therapy
Management Of The Child With Cp From Infancy To Adulthood. Physical Therapy
Goals And Treatment Are Presented Within The Framework Of These Four Stages:
1. Early Intervention,
2. Preschool,
3. School Age And Adolescence,
4. And Adulthood
15. Benefits Of Occupational Therapy
• Occupational Therapy Can Help Children By:
• Increasing Their Chance For Independence
• Improving Their Ability To Play And Learn
• Boosting Their Self-esteem And Confidence
• Helping Them Develop A Workable Routine
• Giving Them A Sense Of Accomplishment
• Improving Their Quality Of Life
16. • For Parents And Caregivers, Occupational Therapy Helps By:
• Reducing The Demand On Them
• Reducing Stress
• Providing A Sense Of Security
• Improving Their Quality Of Life
• Allowing Them To Watch Their Child Improve And Become Independent
17. Occupational Therapy Can Help With The
Following Issues Related To Each Type Of Cp:
Spastic
• Muscle Stiffness In The Upper And/Or Lower Limbs And Jerky Movements Characterize
Spastic Cerebral Palsy. Among Other Things, This Can Lead To Difficulty Getting
Dressed, Bathing, Using The Bathroom, Eating, Drinking, Writing And Holding Objects.
18. • Athetoid
• Children With Athetoid Cerebral Palsy Are Unable To Regulate Muscle
Tone, Which Makes It Difficult To Control Their Movements. Trouble With
Grasping Objects, Posture, Drooling, Swallowing, And Speaking Are
Common Among Children With Athetoid Cp.
19. Ataxic
• Problems With Balance And Coordination Are Common Among Children With Ataxic
Cerebral Palsy. These Children Often Struggle With Precise Movements And Have
Tremors Or Shakiness. This Makes It Difficult To Perform Tasks Like Writing Or Eating
That Require Precise Finger Movements, Or Repetitive Movements Like Clapping.
20. • What To Expect In Occupational Therapy
• As With Physical Therapy And Speech Therapy, Occupational Therapy Is Different For
Every Child With Cerebral Palsy. Each Child’s Occupational Therapy Treatment Plan Is
Highly Individualized And Tailored To Their Individual Physical, Intellectual And Social-
emotional Abilities.
21. • During Child’s First Therapy Session, The Occupational Therapist Will Perform A
Complete Evaluation.
• Most Children With Cerebral Palsy Need To Be Reevaluated Every Six To Nine
Months. After These Evaluations, The Occupational Therapist Will Tweak The
Treatment Plan Accordingly Based On Progress And Change.
22. Occupational Therapy Exercises Focus On The
Following Skill Areas
• Fine Motor Control
• Bilateral Coordination
• Upper Body Strength And Stability
• Crossing The Midline
• Visual Motor Skills
• Visual Perception
• Self-care
• Pediatric Constraint Induced Movement Therapy (CIMT)
23. • Tools
• Everyday Household Items (Straws, Clothes Pins, Tweezers,
Sponges, Etc.)
• Books
• Adaptive Scissors (With Spring Closures Or Grips For Easier Use)
• Writing Utensils
• Splints
• Adaptations To Clothing (Zipper Pulls, Button Hooks, Reachers)
• Toys To Help With The Development Of Motor Skills
• Games And Toys That Help With Motor And Cognitive Development
24. Assistive Devices
• Pencil Grips
• Specialized Feeding Utensils
• Seating And Positioning
Equipment
• Computer Software And
Accessibility
• Household Aids And Equipment
• School Chairs And Tables
• Toilet And Bathing Aids
• Tablets
