Physiotherapy for Cerebral Palsy

Cerebral palsy can have profound impacts on many aspects of people’s lives which, if not properly managed, can threaten the independence, social lives, and overall quality of life for those affected. So, I hope today to shed some light on the ways in which physiotherapy can help in the management and care of cerebral palsy.

You may or may not already know this, but cerebral palsy is defined as a group of neurological disorders affecting movement and posture. Therefore, put simply, physiotherapy primarily aims to improve movement and posture. In doing so, physiotherapy can improve someone’s functionality, independence, comfort, mobility and quality of life. How we aim to achieve this can be done in a number of ways, but first let’s understand the impacts of cerebral palsy.

Common symptoms of cerebral palsy include high and low tone, dystonia, impaired balance, and impaired coordination – please visit here and here to learn more about low tone, high tone, and dystonia! There are then secondary effects of these which can include postural variation, walking issues, pain and discomfort, and difficulty carrying out daily tasks. So how does physiotherapy combat these?

Physiotherapists love to make everything functional! Especially for cerebral palsy, it is crucial to practice functional movement patterns to help the brain to build better instructions and pathways for how to perform tasks – we call this neuroplasticity. For example, a physiotherapist will make sure to facilitate the legs being in the optimal position when practicing walking so that the brain builds a stronger picture of what walking should feel and look like. This means that the individual is more likely to be able to walk with an improved movement pattern independently. Another example of a well-supported therapy technique is constraint induced movement therapy (CIMT) which in a nutshell aims to improve the functional ability of an arm that has been affected by cerebral palsy so that the brain improves its’ ability to use that arm, rather than getting into a habit of neglecting and not using it. Visit here for more information on CIMT.

The repeated practicing functional tasks can also be used to target reduced balance and coordination too. Balance and coordination can be impaired either because of abnormal muscle tone (meaning muscles needed for balance are not working as they should be) or because areas of the brain responsible for balance and coordination have been damaged. However, this functional approach works for either cause, as neuroplasticity helps rewire the damaged areas of the brain and repeated practice can also help improve the tone and strength of muscles required for balance and coordination tasks.

Postural care is massively important because of the risk people with cerebral palsy face of developing postural differences. Please visit here to learn more about the causes and impact of postural variations such as scoliosis, hip dysplasia, and contracture. Physiotherapists will develop a postural care plan for people with cerebral palsy that often includes implementing pieces of equipment such as sleep systems, standing frames, and ankle-foot orthoses. The previous web link also includes information on some of these devices, but they all ultimately – while having their own unique purposes – aim to maintain good alignment and comfort.

Cerebral palsy also affects mobility levels and again this impact can differ greatly. Some people will be fully capable of walking, some may need a walking aid just for long distances, and others may need a wheelchair all the time. A physiotherapist will help someone to maximise their own walking ability by managing tone in the legs, strengthening the legs and helping to practice optimum walking patterns. Again, this involves practice, practice, practice!

Parents, family members and carers are clearly at the heart of the care of someone with cerebral, and this is why healthcare and non-healthcare professionals involved in this care have to work as a team to best support the individual and their family and carers. A great example of this is in school; occupational therapists and physiotherapists will work with teachers to provide an environment where someone is best able to participate in the school environment both socially and academically.

Cerebral palsy presents challenges that vary and are uniquely impactful for each person it affects, but this article has introduced you to some of the ways physiotherapists ensure people with cerebral palsy maximise their independence and function, ultimately aiming to improve people’s ability to engage in the world and lead a high quality of life.

For some more information and some of the wider effects of cerebral palsy, the causes, and other non-physiotherapy treatments, please visit:

NHS Inform - some great information on some of the causes and symptoms of cerebral palsy and an overview of different treatments available.

Scope - Scope is the UK’s main cerebral palsy charity. Here you can find information on cerebral palsy and what support may be available to you, including information on medical negligence.

Flint Rehab – here you can find some information on how cerebral palsy can be linked to learning difficulties and support that can be offered in those cases.