- Posted on: Nov 20 2017
Cerebral Palsy (CP) is a disorder that affects posture and movement due to damage to the brain. It is characterized by decreased functional abilities, delayed motor development and impaired muscle tone and movement patterns. Because of these, a patient with CP takes longer to do the task and uses a lot of his/her energy focusing on performing the task. A lot of times depending on the severity of the case, the patient cannot even initiate the movement or have difficulty transitioning. Even if he/she can move, there is decreased range of motion; therefore, making the child prone to contractures and deformities. There is decrease accuracy in movement; thereby, requiring assistance from another person or an external device to assist the patient. Because of slow, labored movements at times, a patient is missing out on social interaction which is important in creating a social and emotional life. Because of low or fluctuating muscle tone, postural instability arises. So, a child with CP might spend the entire Math class trying to sit upright instead of focusing on the class.
When positioning a patient with CP, alignment, comfort, and support must be considered. For a patient with hemiplegic CP, he/she weight bear on the uninvolved side because he/she feels safe or have better sensory awareness and muscular control. This, however, can lead to potentially shortening the involved side and impairing functional movement. Position like the “W” sitting should be avoided as the stability comes from the wide base of support rather than using the trunk muscles to control the movement. Even though the goal is to demonstrate proper posture, if the patient is not comfortable he/she will still change position; hence, patient’s comfort is also important. In handling a child with a neurologic deficit these should be considered:” (1) Allow the child to do as much movement as possible. (2) When carrying a child, encourage as much head and trunk control as the child can demonstrate (3) when trying to move the limbs of a child with spasticity, do not pull against the tightness. Move slowly and rhythmically (4) encourage a child to keep head in the midline of the body and hands in sight (5) children with low postural tone should be handled more vigorously (6) the child will not be in control of where your hands are (7) handling should be decreased as the child gains more control.
By: Rhia Vista, PTA