Physical Therapy Strategies for Cerebral Palsy

The goal of physical therapy is to improve the quality of everyday life. For people who have cerebral palsy, physical therapy, both in the clinical and home setting, is essential to optimize function. Physical therapy specifics change as the patient's needs change, but the underlying strategies remain consistent.

Importance of Stretching

• People with cerebral palsy need regular muscle stretching. The muscles in spastic limbs tend to become tightened and lose flexibility; muscle shortening is a common development in the extremities that are affected. Stretching helps keeps muscles flexible. The more flexible muscles are, the easier it is for the patient to move and the less limited his daily activities. Positioning aids are sometimes used to improve the quality of stretching. Stretching must be practiced on a daily basis to be effective.

Importance of Strengthening

• Stronger muscles function better. When children with cerebral palsy have strengthening exercises included as a regular part of their physical therapy, they have better neuromuscular response, are better able to move their muscles in a coordinated fashion and have a greater range of motion. Stronger muscles also do a better job supporting the weight of the body, especially important in growing children. Care must be taken to strengthen the correct muscles while avoiding injury; this is where the input of a physical therapist is crucial. Strengthening exercises should be performed on a regular basis.

Importance of Regular Review

• The diagnosis of cerebral palsy is usually made in infancy, and physical therapy is begun shortly thereafter. Physical therapy strategies and plans must be regularly reviewed and adapted to the changing needs of the patient. For example, the changing shape and weight of the body during puberty can stress muscles in a new ways, and require a change in the exercise regimen. Children learning to walk need to learn how to fall while minimizing injury. If equipment such as wheelchairs or walkers are used, they must be replaced as the patient grows or needs change. As physical therapy goals are met, new goals are established. If there are injuries or surgeries, accommodations must be made during the recovery period. The best physical therapy results come from a partnership between the patient and his support network working together with his doctors and physical therapy team.