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Cerebral Palsy: (Brain Injury)

A definition of Cerebral Palsy

Spastic paralysis from cerebral palsy can result in the shortening of the muscle tendon unit due to its failure to keep pace with the growth of bones. Therefore, if a stretch can be maintained on this muscle group for a minimum of six hours per day, a contracture could be prevented or treated. To date, most people have used inhibitive casting to maintain a constant state of stretch on these muscle groups. Many individual cases have reported successful reduction of contractures due to cerebral palsy as a result of using Dynasplint® Systems six hours per day which mimics the same stretching time that occurs in the routine activities of a typically active child.

Cerebral palsy (CP) is an umbrella term for a group of disorders affecting body movement, balance, and posture. Loosely translated, cerebral palsy means “brain paralysis.” Cerebral palsy is caused by abnormal development or damage in one or more parts of the brain that control muscle tone and motor activity (movement). The resulting impairments first appear early in life, usually in infancy or early childhood. Infants with cerebral palsy are usually slow to reach developmental milestones such as rolling over, sitting, crawling, and walking. Common to all individuals with cerebral palsy is difficulty controlling and coordinating muscles. This makes even very simple movements difficult. Cerebral palsy may involve muscle stiffness (spasticity), poor muscle tone, uncontrolled movements and problems with posture, balance, coordination, walking, speech, swallowing and many other functions.

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CP is a condition comprising multiple disorders that affect the brain and nervous system, resulting in decreased motor skills that affect walking and other types of movement. The condition is often accompanies by other disturbances that may affect speech and hearing, and cognitive processes, such as learning and reasoning. CP can occur in a developing fetus, or in the weeks or months following birth, usually as a result of injury or infection of the brain or central nervous system which results in damage to the brain’s motor centers. Symptoms may be noticed as early as a few months following birth or as late as three years of age.

CP can occur with different degrees of severity, and is divided into specific subtypes.

Spastic Cerebral Palsy

About three-fourths of all individuals with Cerebral Palsy have spastic CP. In individuals who exhibit more than one subtype, spastic CP occurs in about one-third of these cases, as well. Spastic CP occurs following injury to the corticospinal tract or the motor cortex, and are hypertonic, meaning their muscles are stiff and inflexible. Reflexes are often exaggerated. Spastic CP can occur on one side of the body (spastic hemiplagia); in the lower extremities only or primarily (spastic diplegia); or in all four limbs of the body (spastic quadriplegia). Of these three, spastic diplegia is the most common.

Cerebral Palsy treatments in this group include physical and occupational therapy and use of orthotic devices, including canes, dynamic splints and braces, to aid in tone management, walking and improve balance and stability.

Dyskinetic/Athetoid Cerebral Palsy

Unlike spastic CP which involves increased or “hyper” muscle tone, dyskinetic or athetoid CP involves mixed muscle tone, making coordinated movements of any kind especially difficult. Individuals with this type of CP may have difficulty maintaining an upright position and may also exhibit involuntary motions.

Ataxic Cerebral Palsy

Individuals with may exhibit low muscle tone, known as hypotonia, as well as tremors. Fine motor skills, such as writing and using utensils, may be affected, as well as auditory and visual processing and perception and overall balance.

Hypotonic Cerebral Palsy

Hypotonic Cerebral Palsy is the most severe for of CP. Individuals with this type of CP appear limp and are unable to move or are severely limited in their ability to move.
Although CP is a motorsensory disorder, other systems can be affected, and many individuals also experience decreased cognitive function and ability; speech, hearing or vision problems; seizures; pain; digestive disorders, such as vomiting, constipation or difficulty swallowing; joint or bone disorders; contractures; drooling; incontinence; respiratory problems; behavioral problems; and slow growth.

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Cerebral Palsy is a lifelong disorder, and there is no cure. The effects of the condition are treated through various types of therapy and through the use of special assistive devices, including writing or typing devices; speech devices; and orthotics and dynamic splints designed to help improve mobility and balance and address issues of spasticity and abnormal muscle tone. Braces, splints and padding are often used to protect the joints from injury, especially in young children. Cerebral Palsy treatment for the symptoms and side effects of the disorder requires a multi-disciplinary approach, and in addition to physical therapy, should address proper diet, exercise and regular physical exams to ward off infections and other potential problems.

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