| l therapy is one of the most important | | | | wrists, hands, and fingers. |
| treatments for cerebral palsy (CP). It usually | | | | * Cutting nerves on the limbs most affected by |
| begins soon after diagnosis and often continues | | | | movements and spasms. This procedure reduces |
| throughout life. Some people with CP may begin | | | | spasms and allows more flexibility and control of |
| physical therapy before being diagnosed, | | | | the affected limbs and joints. |
| depending on their symptoms. | | | | A doctor evaluates the person's symptoms, age, |
| Special devices and equipment are needed for | | | | and general state of health when considering |
| some people with CP to help them with specific | | | | whether to recommend surgery. |
| problems. For example: | | | | A thorough checkup is needed to help the doctor |
| * A child who develops uneven leg length may | | | | determine which muscles and nerves are affected |
| need to wear special shoes with a higher sole and | | | | and what type of surgery would best treat the |
| heel on the shorter leg. | | | | condition. A gait analysis is part of the examination |
| * Some people who are not able to walk without | | | | if the person is able to walk. |
| assistance may need to use canes, crutches, | | | | For young children, surgery may be postponed if |
| walkers, or wheelchairs. | | | | doing so will likely prevent the need for additional |
| * Physical therapy and special equipment may be | | | | surgery in the future. |
| used together, such as for constraint-induced | | | | Other surgeries related to cerebral palsy |
| movement therapy, also called shaping. This | | | | Surgery for various orthopedic problems: Surgery |
| approach encourages a child to increase | | | | for other problems is sometimes needed for |
| movements by presenting interesting activities or | | | | children with CP. These surgeries vary depending |
| objects and giving praise and rewards when a | | | | upon the specific problems involved. For example, |
| child makes attempts to use the less-functioning | | | | some children may need surgery to correct |
| muscles. 9 | | | | uneven leg length, dislocation of the hip, curves in |
| Occupational therapy helps adults adapt to their | | | | the spine (scoliosis), or an eye problem. |
| limitations and live as independently as possible. | | | | Medication-related surgery: A small pump is |
| Speech therapy helps control the mouth muscles. | | | | surgically implanted under the skin in the abdomen |
| This therapy can be of great benefit to children | | | | for some people with CP. This pump is used to |
| with speech or eating problems. Speech therapy | | | | deliver medications, such as baclofen (Lioresal), |
| often starts before the child begins school and | | | | directly into the fluid surrounding the spinal cord. |
| continues throughout the school years. | | | | For more information, see antispasmodics. |
| Nutritional counseling may help when dietary needs | | | | Surgery Choices |
| are not met because of problems with eating | | | | The main surgery choices for people affected by |
| certain foods. | | | | cerebral palsy (CP) are: |
| Biofeedback may be useful as part of physical | | | | Orthopedic surgery (for muscles, tendons, and |
| therapy or on its own. During a biofeedback | | | | joints). This type of procedure is done to lengthen |
| session, people with CP learn how to control their | | | | a tendon to increase a limb's range of motion by |
| affected muscles. Some people learn ways to | | | | cutting through a muscle or tendon (release) and |
| reduce muscle tension with this technique. | | | | sometimes reattaching it in a different area. 1 |
| Biofeedback does not help everyone with CP. | | | | Selective posterior rhizotomy (cutting nerves of |
| Both massage therapy and hatha yoga are | | | | affected limbs). This procedure is usually |
| designed to help relax tense muscles, strengthen | | | | considered only for children with severe muscle |
| muscles, and keep joints flexible. Hatha yoga | | | | tightness in the legs. |
| breathing exercises are sometimes used to try to | | | | What To Think About |
| prevent lung infections. More research is needed | | | | Health professionals do not agree about the best |
| to determine the health benefits of these | | | | age for people with cerebral palsy (CP) to have |
| therapies for people with CP. | | | | surgery. |
| Other treatments that vary by age or specific | | | | * Some surgeons believe that children less than 2 |
| need include: | | | | years old with CP benefit most from orthopedic |
| * Therapies to stimulate learning and sensory | | | | surgeries because it allows them to grow and |
| development. Babies and young children may | | | | develop more like other children. |
| benefit from these stimulation or | | | | * Some health professionals believe that all |
| neurodevelopmental therapies. Some of these | | | | surgery should wait until a child is older than age |
| therapies also help people of other ages. These | | | | 2; some prefer to wait until sometime between |
| therapies cannot repair damaged parts of the | | | | ages 6 and 8 years. They believe that more |
| brain. However, they may be able to stimulate | | | | problems can be corrected during the same |
| undamaged parts of the brain that the person is | | | | surgery if orthopedic surgery is postponed until |
| not currently using. | | | | the child is older. |
| * Behavioral therapy. This type of therapy helps | | | | Surgery is not used nearly as often for the arms |
| some school-age children with CP learn better | | | | as for the legs. Surgery on arm deformities |
| ways to communicate with others. | | | | carries more risks related to sensory damage; |
| Several controversial therapies exist for CP, such | | | | also, surgery has a more limited impact on |
| as electrical stimulation and special diets. If you are | | | | functional abilities than on the legs. 8 |
| considering these types of treatments, talk to | | | | Sometimes medications or physical therapy are |
| your doctor about any related research or where | | | | used to postpone or eliminate the need for |
| to find more information. | | | | surgery. Physical therapy is also needed for most |
| Surgery | | | | children after surgery. The type of therapy and |
| Surgery for people with cerebral palsy (CP) usually | | | | special equipment needed after surgery (such as |
| involves either: | | | | braces, casts, and splints) depend on the child's |
| * Loosening tight muscles and releasing fixed | | | | specific needs. In general, post-surgical physical |
| joints, most often performed on the hips, knees, | | | | therapy usually starts as soon as possible and |
| and ankles. In rare cases, this surgery may be | | | | may continue for as long as 6 months. |
| used for people with stiffness of their elbows, | | | | |