Exercise is important for children and adults with cerebral palsy to maintain cardiovascular fitness, flexibility and strength. Appropriate exercises and activities are determined by the type of cerebral palsy, severity, the person's age and cognitive status.
Individuals with increased muscle tone or spasticity need stretching exercises that maintain range-of-motion and prevent contractures, or shortening of muscles. Muscle tone refers to how much resistance occurs when a joint is moved. Range-of-motion refers to the degree to which joints can be moved, such as extending the elbow joint so that the arm is straight. Range-of-motion exercises can be
• Passive: someone else moves the person's body or
• Active: the person performs the movements himself.
Creating a Home Exercise Program
A physical or occupational therapist can prescribe a home exercise program. All exercises should be performed slowly in a quiet environment conducive to relaxation. Begin your sessions with aerobic exercise such as a walk on a treadmill, marching in place or swinging arms from side to side. Parents can prepare their children for exercise by rocking them from side to side while on their on their bellies, or by having them lie face down over a large therapy ball to relax their muscles. Parents should be constantly observing or talking to their children to avoid overstretching or pain and help the child to remain calm and interested.
Weight-Bearing Develops Strength
Positioning yourself prone (face down on your belly) develops neck, shoulder and arm strength. Adults can perform push-ups with knees bent. Parents can help children with cerebral palsy play while positioned on hands and knees or crawling. Other exercises that involve bearing weight include the following:
• Chair push-ups: while seated, push open palms down against a chair to lift your body slightly off the seat.
• Wall push-ups: standing with hands flat against the wall (about a foot away) push your body repeatedly away and toward the wall.
• Yoga stretch: while on your hands and kneels, move your buttocks to rest on your heels until your face touches floor, arms extended above head on the floor. Move back into the hands and knees position and repeat movements.
Stretching Exercises with Weights
Individuals with cerebral palsy often find it easier to grasp objects that are large enough to fit inside the palm. Grasping heavier objects also promotes motor control while strengthening the upper extremity. For example, small water bottles or hand weights are easy to grasp while performing the following movements:
• Position arms along sides of body; move them forward until they are above the head, then bring them back down.
• Position arms along sides of body, move them upward to look like you are flying until your hands face the sky, then bring them back down.
• Extend arms to your sides, like an airplane, then bring them together in front of your chest so that your thumbs touch. Then bring them back to airplane position.
Recreation That Strengthens
Many people avoid exercise unless it is fun, and individuals with cerebral palsy are no different. Swimming is one of the best full-body exercises because the buoyancy of the water makes it easy to move. Other beneficial forms of recreation include to following:
• Riding a bicycle or adapted large tricycle-develops coordination between the two sides of the body.
• Horseback riding: the rhythmic movement reduces spasticity and sitting on a horse promotes range-of-motion.
• Martial arts develops balance and motor control.
• Dancing is fun, social and gets your heart rate up.
• Teenagers or adults may consider an exercise program that involves nautilus or free weights to build strong bones as well as muscles. However, it is recommended that a health care professional provide guidance, to prevent injury.
References
- "The Recycling Occupational Therapist", Barbara Smith, M.S., OTR/L; 1997.
- "Handling the Young Cerebral Palsied Child at Home", Nancie R. Finnie; 1975.
- "Teaching Motor Skills to Children with Cerebral Palsy and Similar Movement Disorders", Sieglinde Martin, 2006.
