Therapeutic Exercises for Cerebral Palsy With an Occupational Therapist

An individual with cerebral palsy, or CP, has a brain injury that affects the motor functions. Cerebral palsy can cause stiff and/or weak muscles, uncontrolled movements and problems with coordination. Although there is no cure for cerebral palsy, all of these issues can be addressed with occupational therapy. This type of therapy focuses on helping individuals with daily living tasks, such as using a fork, writing with a pencil, making a phone call, or typing on a keyboard.

Motion

• Cerebral palsy often causes muscles to be stiff, a condition called spasticity. For this reason, occupational therapists, or OTs, use exercises, such as massage and stretching, to loosen spastic muscles and increase their clients' ability to use their limbs. Because OTs focus on tasks using fine motor skills, they usually concentrate on the neck, arm, shoulder, and hand muscles. In an occupational therapy session, an OT might start with a massage on the shoulders and arms, and then she could gently stretch the arms and hands, being careful not to move the tight muscles too far or too quickly. These stretches are called passive range of motion. If a client is able to move her own arms, the OT would also encourage her to do some active range of motion exercises, in which the client does the stretches on her own.

Senses

• Because cerebral palsy is caused by damage to the brain, individuals with this condition often have sensory issues. Occupational therapists address these issues through a variety of techniques. One commonly used method is called the Wilbarger Deep Pressure and Proprioceptive Technique. This method includes brushing, joint compression and oral swipes, all of which provide gentle sensory input that helps the brain organize itself and decreases hypersensitivity. The Wilbarger Technique must be administered or taught by trained professionals. The first step of this technique is brushing. The therapist uses a special brush to stimulate the skin of the arms, legs and back. Next, the therapist uses joint compression, which involves gentle pressure on the joints. For example, she could push the client's arm toward the body, pressing on the shoulder joint. For clients with oral defensiveness, or sensory problems in the mouth, an OT may administer an oral swipe, using his gloved finger to provide sensory input in the mouth.

Daily Living

• The main goal of occupational therapy is to help clients with the tasks of everyday living. For this reason, practicing these tasks is an important part of any OT session. Individuals with cerebral palsy have widely varying degrees of motor challenges, so the exercises used by OTs who treat them are highly individualized. An individual with mild CP, for example, might work on making her handwriting clearer, while an individual with little use of his hands could practice with a device that allows him to use his head to control a computer. These activities also vary with the client's age. An OT who works with babies uses toys and picture books to help them increase their motor skills, while an OT working with adults would focus on tasks her clients perform at work.