Physical Therapy Treatment for Cerebral Palsy

Cerebral palsy is a neurological disorder that damages the motor control centers of the brain, causing significant physical disability. It can occur during pregnancy, childbirth or early childhood and even very rarely in adulthood. Physical therapy (PT) is the most often recommended treatment to restore the patient's functional independence. In order to be successful, physical therapy will need to be applied throughout the child's developmental years.

Definition of PT

• PT is also known as physiotherapy and is a type of treatment that aims to restore an individual's full movement and functional ability when it is decreased by injury, disease, aging or other environmental factors. Physical therapy covers a wide scope of knowledge but is divided into specialty areas. Neurological PT is the specific area that focuses on rehabilitating the impairments caused by neurological disorders. Physical therapists who treat cerebral palsy often deal with young children, thus pediatric PT is another required specialty.

Neurological Development

• Medical theories state that neurological development is hierarchical. This means that lower-level functions need to be developed first before higher-level functions and that correcting the former influences restoration of the latter. For example, synapse reflexes or knee-jerk reactions are considered low-level functions. Any disability in this area will need to be initially dealt with before higher motor skills such as walking, can be properly developed. This is the theoretical basis for using physical therapy to treat cerebral palsy and other neurological disorders.

Bobath Treatment

• Bobath Treatment is one of the major guiding principles in physical therapy treatment of cerebral palsy and is also known as neuro-developmental treatment (NDT). The concept is named after the husband and wife team who invented it, Berta Bobath, a physiotherapist and Karel Bobath, a psychiatrist and neurophysiologist. The method is based on the human brain's regenerating ability after injury. It involves a carefully measured application of stress on a patient's central nervous and muscular system, such that the patient creates and reinforces their own sensorimotor capabilities.

Areas of Focus

• Physical therapy programs mostly involve physical exercises. These exercises focus on stretching, positioning, and building strength. Children with cerebral palsy often have tight or tensed muscles. Stretching exercises will help keep them loose and increase mobility. To even out muscle tone and further restore movement, positioning exercises are used. In such activities, braces, abduction pillows, knee immobilizers and other constrictive devices may be used to keep the child in the corrective position. Strength building exercises are divided into specific activities aimed at developing particular muscle groups. Leg and arm muscles are often the primary focus.

Associated Therapies

• Other disabilities caused by cerebral palsy also need to be treated by other methods. Occupational therapy is often combined with physical therapy as the former deals with fine motor skills and daily living activities such as dressing, bathing and toilet routines. Speech and language therapy is another concurrent treatment. This focuses on treating difficulties in articulation, eating and drinking caused by imprecise control of the oral and facial nervous and muscular structures.