Cerebral Palsy (CP) is a lifelong neurological condition that affects movement and posture.
It can affect different parts of the body (one side, legs only, both arms and legs) in different ways (e.g. impairments in communication, mobility, learning, behaviour & emotional wellbeing); and it can be associated with epilepsy, intellectual disability, vision, and hearing impairments.
Since CP is as unique as each individual, at ORS we ensure that interventions are client-centred and/or family-centred Taking into account the goals and strengths of our clients with CP, using holistic and multi-disciplinary approaches. For instance, how can an ORS occupational Therapist (OT) and ORS physiotherapist help a paediatric client with CP?
An ORS occupational therapist can help by:
- Building independence with self-care tasks: Such as dressing, showering, and eating. Assistive Technology (AT) or equipment may be prescribed to help, such as commodes, stools, or adapted cutlery. The task may be broken down into smaller achievable steps, or we might teach different ways of doing a task, that works with the person’s unique positioning and arm/hand movements and strength.
- Developing the appropriate play skills for each developmental stage: For example from parallel play to cooperative play with others. Toys and games are purposely selected that will be accessible and match the CP clients’ interests and hand function. How to use these toys/games and how to use them with others is modeled and practiced. Â
- School readiness and school engagement: OTs can assist with creating the unique and optimal set-up for a child with CP to learn including supportive seating, location of the seat and locker in the classroom, sensory tools or strategies to assist with concentration or visual aids. How to manage their school bags and lunchboxes, and the best ways to draw/write is also assessed with strategies and/or AT provided.
An ORS physiotherapist can help by:
- Improving mobility and independence: Gait training is very important for children at this level and age group. Targeting static and dynamic balance and coordination during walking by engaging in appropriate exercises such as practicing navigating different surfaces and environments, coordination drills using various equipment, and obstacle courses to challenge motor planning significantly improves mobility and independence. Improving transfers (e.g. wheelchair to bed), stair navigation with support, and getting up from the floor independently are some functional skills that are important for the child to learn. If a child requires a mobility aid to walk it is very important that an appropriate assistive device is selected by the Physiotherapist (e.g. standing frame, walkers, crutches) and training in safe and efficient use of these devices is provided to the child’s parents and carers along with adapting device use for different environments.
- Enhancing strength and fitness: It is very important to also work on building up strength which is an essential component for improving mobility. Strengthening exercises targeting the legs and core muscles, for example, sit-to-stand exercises, using resistance bands where applicable, and aerobic exercises such as cycling, and swimming help enhance and help enhance cardiorespiratory fitness and reduce fatigue. These exercises collectively enhance motor skills, coordination, and overall physical independence.
- Range of Motion and Flexibility: Maintaining and improving joint flexibility and maintaining range of motion in all joints is vital to prevent contractures. It is important to implement stretching exercises for major muscle groups and some may require appropriate orthotics to maintain proper alignment if they are at a higher risk of developing contractures. This improves the quality of life of the child and reduces the risk of further injuries.
- Preventing secondary complications and promoting participation in daily activities: Therapy must be engaging and enjoyable such as incorporating game-based exercises, interactive technology, and group activities with peers, and also monitor the prevention of secondary complications such as pain from musculoskeletal issues, respiratory problems due to swallowing difficulties, seizures, hip subluxation which requires regular monitoring and targeted exercises, osteoporosis addressed through weight-bearing activities and proper nutrition, muscle contractures, managed through stretching and positioning.
The key is a comprehensive, individualised approach that involves the child, family, and a multidisciplinary team of healthcare professionals. This includes occupational therapists and speech therapists for communication and swallowing/feeding issues. And also orthotists for appropriate bracing and orthotics.
Educating and involving the family is crucial for successful outcomes such as teaching parents how to assist with exercises and stretches, providing guidance on home modifications for safety and accessibility, and offering emotional support and resources to help them understand Cerebral Palsy.Â
Please contact your ORS occupational therapist or physiotherapist for further information to receive a tailored individual assessment and intervention plan to assist your child in achieving their goals through allied health services that work!
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Co-authored by Chanel Dunn and Shabreena Mavi
