Cerebral palsy, or CP, is a neurological disorder of movement or motor function that begins before, during, or after birth. Children and adults with CP usually present with muscle tone that is too loose or too tight, difficulty walking, poor precise coordination, and functional impairments. Treatment varies by type of CP, although occupational therapy can benefit all types of CP. Therapeutic exercises can improve use of muscles and postural control for improved independence in daily life.
Overview of Occupational Therapy
Occupational therapists, or OTs, are health professionals with expertise in the occupations of daily life, including self care, leisure, play, work and school. They work in schools, hospitals, outpatient clinics, community centers and home health. School OTs will focus on helping the child with CP to develop posture and use of her hands to participate in academics, while hospital-based OTs may use electrical stimulation and splinting along with therapeutic exercises to improve the client's function.
Neuro-Developmental Treatment
Neuro-Developmental Treatment, or NDT, is a holistic approach to treating the child with CP. The therapist uses clinical reasoning, observation, and physical handling to gain an understanding of the client's abilities and limitations. Therapeutic exercises are geared towards improving the client's posture and basic movement patterns that allow for greatest function and minimize risk of deformities or complications. OTs obtain advanced training to become experts in this treatment approach.
Strengthening and Stretching
OTs help children and adults with CP through functional strengthening and range of motion exercises. For example, a child might lie prone over a therapy ball, bearing weight on her hands, to improve stability in her shoulder girdle and upper extremities. An adult might use clothespins to hang clothing items on a line above shoulder level to improve range of motion and finger strength. OTs also use passive stretching methods and other physical modalities such as electrical stimulation when it would benefit the client's function.
New Research
Evidence points to the effectiveness of a new method known as Constraint-Induced Therapy for individuals with hemiplegia, a type of CP where one side of the body is affected. The OT restrains the unaffected arm using a cast, while the child or adult uses the hemiplegic arm to perform exercises for a set number of hours over several weeks. Significant improvements have been noted across all areas of arm function as compared to traditional therapy methods.
References
- National Institute of Neurological Disorders and Stroke; Cerebral Palsy: Hope Through Research
- "Development of Hand Skills in the Child"; Jane Case-Smith and Charlane Pehoski; 1992
- "Archives of Physical Medicine and Rehabilitation"; Efficacy of Forced-Use Therapy in Hemiplegic Cerebral Palsy; In-Young Sung, Ju-Seok Ryu, Sung-Bom Pyun, Seung-Don Yoo, Woo-Hyun Song, Mi-Jeong Park; November 2005
