Different Types Of Treatments For Children With Cerebral Palsy

The treatment administered to individuals affected with Cerebral Palsy (CP) need multidisciplinary approach including helps of orthopedic surgeon, occupational therapist, physical therapist, speech therapist etc. Treatment planning is depends upon many factor like diagnosis, complication, associated medical issues and grade of disability and movement disorder etc. Early treatment of cerebral palsy in children has the likelihood of bringing about the most positive change. Since every diagnosis differs from another, the type of treatment also varies.

Factors determining the type of treatment

Based on the following factors, courses of treatments are decided by doctors:

· Degree of disability

· Type of movement disorder

· Co-existing conditions

· Type of cerebral palsy

Treatment is inclusive of long and short term approaches to the specific condition of a child. The course for a child may involve physical therapy, surgery, medications and more.

Treatment options for cerebral palsy in children

1) Use of physical therapy- If CP has been detected at a very young age, therapy can be started at the same time. The method is personalized as per every case, and is focused on the most impacted areas of the body. Recommendations of physical therapy include strength training, stretching, muscle relaxation exercises and developmental program. The therapy also undergoes change as the child ages.

2) Occupational therapy- The idea behind occupational therapy is to increase independence amongst CP patients. For teens and adults, therapies may revolve around enhancing the patient’s ability to work. However, occupational therapy is meant to improve quality of life for people across a wide variety of age groups. Benefits of application include carrying out household tasks smoothly, mobility and independence in personal care.

3) Massage therapy- This form of therapy should not be used lightly. Vigorous oil massage can increase the spasticity & tightness in body. Light powder massage is necessary for relaxation of muscle and helps a lot in rehabilitation. Massage therapy is not just good for flexibility, but also for complete rejuvenation of soft body tissues. Therapists improve muscle functionality by targeting muscles, tendons, ligaments, joints and skin.

4) Use of speech therapy- Speech therapists helps in managing speech disorders in CP. Children can speak more clearly with the help of this therapy. Language and speech therapy focus both on the language and receptive parts of speech.

5) Necessary medications- Medications are very rarely required to manage abnormal movement pattern and spasticity. Medicine area also required for management of epilepsy. Medicine should not be given to these children without doctor recommendation.

Effective Diet For Children With Cerebral Palsy

Cerebral palsy (CP) is a neuromuscular disorder that affects muscular coordination, movement and muscle tone. Amongst children, it can be difficult to deal if not handled correctly.

These children are frequently affected with malnutrition because of various reasons.  The reasons can be as follows..

• Undernourishment or over nutrition,  hormonal problems

• Frequent infections

• loss of appetite because of constipation or gastro esophageal reflex

• Dependency on others for feeding

• problems in feeding, eating, drinking etc.

• Weight of the child 

However, with the administration of the right feeding and diet techniques, mealtime experiences can be enjoyed despite cerebral palsy in children.

• Estimate energy needs according to: age, activity level, growth rate and muscle tone More spasticity CP require more energy expenditure, Ambulatory spastic CP have medium energy expenditure while Wheel chair bound/non ambulatory have lower energy expenditure. Reduced physical activity leads to weight gain and Wt gain itself detrimental to person’s physical activity and it becomes vicious cycle. 

• The solution is good balanced diet having all the kind of nutrients including vegetables and fruits. 

• These children are more vulnerable to vitamin D deficiency because they are confined indoors. To prevent this regular exposure to sunlight is necessary. 

• Assessment and treatment of any hormone related problem should be done promptly.

• Standing, walking, outdoor activity, regular physical therapy must be done. The key is to be mobile as much as possible. 

Type of nutritional problems for CP children     

Reasons of Nutrition related problems in cerebral palsy in children

1) Feeding, Eating, Drinking and Swallowing Difficulties (FEDS),

2) Oro-motor Difficulties

3) Sensory  Difficultés 

4) Self-Feeding 

5) Gastro-esophageal Reflux

6) Constipation 

7) Tooth Decay

FEDS (Feeding eating, drinking and swallowing) for this it is necessary to maintain posture of child and the body must be in one direction. You can use CP chair or corner chair if needed. The feeder must sit facing towards the child and try to develop coordination by supporting jaw and upper lip closure. The child must first learn to have liquids properly then semisolids and then solids. You must always give small bites and give second bite only after mouth is cleared of the first. Let the child take her own time.  Encourage child to eat himself, use various assistive devices for this. 

GOR: This can be potentially hazardous. If the child regurgitates the food and aspirates it into the lungs it can even be fatal. To prevent this always feed the child in propped up position and always give small but frequent meals.  Avoid giving acidic food and prevent or treat constipation. 

Digestive problems such as constipation and gastro esophageal reflux often make eating uncomfortable. These children are frequently constipated because of less mobility and faulty diet. Give them plenty of fibrous diet like green vegetables, fruits, whole grains etc.   These children are also very much vulnerable for tooth decay which further hampers their nutrition. To prevent this regular cleaning with soft toothbrush is necessary especially at night before sleeping.

Important Facts About Cerebral Palsy

A common childhood disease, Cerebral Palsy (CP) describes individuals with abnormalities in body posture, balance, speech, and movement, all of which are due to problems in the neurological process. This condition is not caused due to hereditary factors but from brain damage. Individuals affected by CP have the same kind of desires and goals as us, so we must not discriminate against them anywhere.

Symptoms of Cerebral Palsy

Have you noticed people around carefully as of late? People affected by CP may be exhibiting some of more of these symptoms. However, these are not the only Cerebral Palsy symptoms and these may vary from case to case.

•    Problem in coordination

•    Decreased or increased muscle tone

•    Tremors

•    Delays in attaining milestones

•    Difficulties in eating

Globally 17 million people are affected by CP. 15-20% of all physically disabled children face Cerebral Palsy, while 3/1000 of live births get this abnormality in India. It is certainly the most common motor disability for childhood across the world. Due to the developing nature of rural and semi-urban areas as well as less technology being used in these areas, cases of CP are high in India.

What can Cerebral Palsy affect?   

The abnormality may affect any of the following limbs:

•    Lower limb (Paraplegia)

•    Affects one side of body (Hemiplegia)

•    Affecting all four limbs but lower limb more severe than upper limb (Diplegia)

•    Affecting all four limbs (Quadriplegia). Sometimes face may be contorted as well

Prevention: cerebral palsy can’t be prevented fully but its incidence can be decrease by strict follow-up and good care given to mother and new born. Regular antenatal checkup under experienced gynecologist, regular ultrasound of foetus, regular intake of folic acid, iron, treatment of hypothyroidism, treatment of TORCH infection, delivery in hospital with good care to new born under pediatrician can decrease the incidence.  However, once CP has kicked in, there is no sure-shot cure as of now.

Medications, surgery and speech therapy, along with physiotherapy, have helped many people in leading a contented life. Exercises and muscle training help the body gradually regain control. Your regular doctor, upon confirmation of CP, is likely to recommend you to a specialist who can train children on the brain and various nervous conditions.  A series of tests will also be run by your neurologist and will also look to eliminate all other causes.