CHILDREN WITH CEREBRAL PALSY (CP)
We care for Cerebral Palsy kids through their adulthood to assure consistency and continuity of care.
Cerebral Palsy Causes
Cerebral Palsy can be linked to a one-time event creating a health effect that will last a lifetime. The immature brain becomes affected — up to a year after birth — and is maybe caused by prematurity, meningitis, stroke, or the brain being deprived of oxygen.
Cerebral Palsy Diagnosis
When doctors diagnose cerebral palsy early, it allows parents to learn how to best care for their children. A Cerebral Palsy diagnosis normally occurs within the first three years of a baby’s life. When parents become suspicious that their child is developing slower than normal, they seek help from their doctor. If your family doctor suspects that your baby or child suffers from CP, the doctor should refer you to us. We can diagnose the condition and determine whether your baby or child exhibits signs of spastic, ataxic, or athetoid cerebral palsy.
When diagnosing people with CP, our doctors will carefully examine the child’s medical history for signs that CP is the root of developmental problems.
Cerebral Palsy Symptoms
Some of the early signs or symptoms of cerebral palsy include:
- Delayed Development, mental health
- Vision problems
- Slow to reach developmental milestones: these include rolling over, sitting, crawling, and walking
- Abnormal muscle tone
- Unusual posture
- Hearing problems
The early symptoms of CP are usually evident by the time a child reaches 18 months of age. Symptoms can vary for each person. CP affects motor skills like coordination, movement, muscles, or posture on a spectrum that varies for each person. Some cases have mild symptoms and others have more severe ones. Normally, the condition doesn’t get worse, but the symptoms can change.
Cerebral Palsy Treatment
Many treatment strategies, from physical therapy to surgery, can help a child live more happily with these conditions. Children with Cerebral Palsy require a team of doctors with different specialties as we offer complex care for them. Our doctors will devise a treatment plan for your child and continue to provide for their needs from infancy throughout their adulthood. We work closely with our colleagues in other health specialties, and our patients have full access to the wide variety of services provided by the Medical City Hospital.
Cerebral Palsy Specialist Doctors
Our team strives to take care of the child emotionally and physically. Also, our doctors take the time to visit and talk with the patient and the patient’s family. Discussions also include the psychological aspects of cerebral palsy. The success of this program relies on the advanced health care we provide. We possess the knowledge, skills, and abilities to take care of people with CP who are often too sick to be treated at other facilities. We know which conditions to screen for as your child may be at an increased risk of:
The success of this program relies on the advanced health care we provide to our patients
“Two broad groups of patients with cerebral palsy are those who walk and those who are wheelchair dependent. The goal is to perform surgeries and tailor treatment plans that keep people walking throughout their lives whenever possible. Our doctors try to perform single event multi-level surgery (SEMLS), one operation that takes care of many issues at once, to avoid a cumulative effect of many surgeries.” Shyam Kishan, M.D.
Our board-certified orthopedic doctors diagnose conditions in children with cerebral palsy. Then the doctors will determine the severity and how that condition will affect the child as he or she grows. Also, our doctors can recommend and provide treatment, including surgery, to help correct problems or improve movement. Our team will take the time to consult with you and your child. We try and help parents learn how to prevent injuries or a worsening of any conditions related to the musculoskeletal system.
While cerebral palsy cannot be cured and does not get worse, living with orthopedic conditions can be limiting and even painful. Several conditions may affect a child with CP, and many can be treated to improve mobility and reducing pain.
Hip dysplasia is a health concern affecting children with CP. It is a deformity of the hip joint. In addition, this often occurs as a result of either over-or-under-toned muscles around the hip. As a result, hip dysplasia causes the joints to become misaligned.
Hip dysplasia can be treated with surgery to realign the hip joint and keep the femur in place. Physical therapy may also help prevent dysplasia by working on the tone of the muscles around the joint. Therapy may also help a child move in a way that prevents further damage to the joint.
Foot Orthopedic Health
Abnormal contractions of muscles in the feet of a child with cerebral palsy can lead to a flat foot. Spasticity or increased muscle tone often causes this. When the tone of muscles in the ankles is too high, a child may develop toe-walking. The contracture of the muscles makes a child walk on his or her toes or on the balls of the feet.
Physical therapy to stretch the muscles or casts along with Botox can help improve the way in which a child walks. If these strategies do not help, surgery can be used to lengthen the Achilles tendon.
Cerebral palsy may cause children to develop scoliosis, an abnormal curvature of the spine. The back muscles affected by cerebral palsy do not support the spine, and this can cause curvature. Scoliosis appears like a C- or S-shaped curve in the spinal column. Although cerebral palsy itself does not get progressively worse, scoliosis can get worse with time. If not treated, wheelchair patients seem to get worse more rapidly.
A back brace is a common treatment to support the spine when the muscles cannot and a brace encourages normal growth. When the curvature becomes severe or impairs a child’s movements, surgery may be recommended. We also have technology such as the MAGEC rod to perform “Growth Friendly” Spine Surgery that helps the child’s spine grow as the correction progresses.
Other Orthopedic Health Concerns
A child with cerebral palsy may have one leg longer than the other, to a degree that makes walking difficult. Surgery can shorten the longer leg, but this is usually only done when the difference is more than two centimeters. Otherwise, a lift in the shoe improves mobility and comfort.
Torsion in the legs is another possible issue. This occurs when the legs either twist in or out, and it can make walking difficult. A surgical procedure can be used to cut the affected bone, usually the femur or tibia, and reposition it with surgical pins and plates. The correction usually improves the gait and ability to walk.
The Importance of Monitoring Orthopedic Health and Using Treatments
and Orthopedic health is important because it affects how a child moves. When movement is compromised, a child may be limited and may even be in pain or discomfort. Cerebral palsy does not get worse with time, but the problems it causes in muscles can cause many problems. These can get worse with time if not addressed and treated.
To give a child with cerebral palsy the best opportunity for a full life, it is crucial to monitor their health, use non-invasive strategies like physical therapy, and resort to surgery only as needed. Due to our expertise and experience, our pediatric surgeons perform procedures with outstanding results. Ongoing physical therapy is especially important, as it helps joints and bones stay in the correct alignment and can prevent problems or keep problems from getting worse.
If you have a child with cerebral palsy, our doctors at Medical City Children’s Orthopedic and Spine Specialists have years of expertise with the challenges associated with your child’s unique condition. In addition, we will treat our cerebral palsy patients through their adult years within the same medical practice.
Children experiencing chronic pain, or in need of constant and consistent doses of medication, may benefit greatly from the insertion of a pump that continuously disperses medication through the spinal column.
- Baclofen pump – this is a very small device implanted in the abdomen. It is connected to the spinal cord with a thin tube that threads under the skin.
The pump must be refilled periodically, usually every six months.
- Selective dorsal rhizotomy (SDR) – a procedure where 30 percent to 50 percent of sensory nerves are cut to decrease spasticity.
Our orthopedic doctors only consider surgery when other less invasive treatments and therapies have been tried without success. Orthopedic surgery can be performed on bones, ligaments, joints, tendons, muscles, and nerves.
Each patient’s condition is unique, and therefore, treatment and surgery for those with Cerebral Palsy do not follow a set protocol. To repeat, every patient is different from any other, but the goal is always the same, and that is to improve the quality of life.
The focus of our practice for Cerebral Palsy patients is to reduce or eliminate pain, improve impairments, optimize independence and self-care, improve movement, balance, and coordination, and thus, improve the wellbeing of the patient. When considering orthopedic surgery options, the benefits are weighed against the risk of surgery. Not all deformities need to be corrected, and our doctors will weigh the risks and benefits with the family.
Surgery is often used to improve:
Orthopedic surgeries focus on improving mobility and body movement, such as:
- Fine motor skills – hand, wrists, finger, foot, ankles, toes, lip, and tongue movements
- Gross motor skills – sitting, standing, crawling, walking, running, wheeled mobility, and adapted mobility
- Balance and coordination – head control, trunk control, posture, and standing
Cerebral Palsy Therapy
Babies and children with Cerebral palsy respond well to different kinds of therapy. And as the child grows older therapy can provide physical, mental, social, and academic benefits. Thus, it’s important to start early with therapy as it can reduce problems and the risk of developing other conditions associated with cerebral palsy.
There are several different kinds of therapy, but not only is therapy beneficial to the child, but it is extremely helpful to parents and caregivers. For example, nutritional therapy can help caregivers understand specific dietary needs, while behavioral therapy can teach parents the benefits of positive reinforcement. Meanwhile, our doctors will work with families to determine the child’s best therapies and develop a sound individualized plan with goals.
Here are some of the therapies that we recommend for children with cerebral palsy.
Physical therapy is one of the most important forms of treatment for children with cerebral palsy. Also, most doctors recommend physical therapy for all children with cerebral palsy, regardless of how minor or severe the disorder is.
Goals of Physical Therapy for Children with Cerebral Palsy
Children with cerebral palsy will have various degrees of muscle control, balance, and mobility, depending upon how severe the disorder is. Physical therapy helps with these issues by assisting children with balance, posture, crawling, climbing, walking, and muscle strengthening.
In addition, physical therapy helps children with cerebral palsy to:
- Decrease the chance of bone deformities
- Overcome physical limitations
- Expand the range of motion
- Use adaptive equipment
- Increase fitness, flexibility, balance, and posture
- Reduce physical discomfort and pain
- Increase independence
- Improve muscle tone
Interaction therapy assists children with cerebral palsy to improve socially while they are at home, at school, and later in life, at work. In addition, this type of therapy helps children carry out social tasks needing to be done each day.
A typical therapy session consists of the child being trained and guided by a therapist to work on exercises that will improve function and help with activities of daily living. Most importantly, the child’s current abilities, as well as limitations, will be used to create a custom plan.
When a child has cerebral palsy, they often have trouble forming words and this is where speech therapy really helps them talk with others. Therefore, a speech and language pathologist can start the child talking with others better by taking into account unique strengths and weaknesses. In some cases, this can be done through sign language, cues, and the use of other tools. With speech therapists, goals are set to help these children communicate much better.
Aqua therapy helps a child with cerebral palsy to improve muscle tone and physical functions. It’s especially good for children with cerebral palsy who are unable to walk without assistance.
This type of therapy takes place in a swimming pool and combines both aerobic and anaerobic exercise in a way that’s easy and fun for kids with cerebral palsy to perform.
Massage therapy is very good for children with cerebral palsy, as it improves muscle tone and function.
Research indicates that massage therapy is a proven way to help children. It can also help children deal with chronic pain due to joint contractures, scoliosis, and spasticity.
Play and Social Therapy
Regardless of disabilities, almost all children enjoy playtime. Although playing is something that comes easily for most children, those with cerebral palsy may find it a bit harder than others.
Play and social therapy give parents, caregivers, and loved ones the time to see how the child interacts socially during play. This can really work, especially for children who do not communicate well.
According to the American Music Therapy Association (AMTA), music therapy helps to establish a relationship between the child in therapy and the instructor. Also, children who get music therapy may experience improvements in learning, motivation, relaxation, and language skills.
Behavioral therapy helps children with emotional problems and who act out through bad behavior. Behavior therapy uses positive reinforcement to help change bad behavior into more desirable and better behavior.
Thoughts, beliefs, and emotions are explored via behavioral therapy, which helps the therapist mediate difficult situations the child has and, in turn, improve confidence and well-being.