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People with cerebral palsy: effects of and perspectives for therapy
1Department of Physiology, University College London, United Kingdom. m.mayston@ucl.ac.uk
Insights
Cerebral palsy (CP) therapy shows potential for improving function in children. However, research is inconclusive on the most beneficial therapeutic approaches for this complex movement disorder.
Area of Science:
- Neurology
- Pediatrics
- Rehabilitation Medicine
Background:
- Cerebral palsy (CP) presents diverse motor impairments due to brain injury, complicated by increased survival rates of premature infants.
- Impairments include abnormal muscle tone, weakness, contractures, and altered biomechanics, leading to reduced functional ability.
- Sensory, cognitive, and perceptual deficits also contribute to the motor disorder in children with CP.
Purpose of the Study:
- To review the current understanding of motor disorders in cerebral palsy.
- To explore the effects of various therapeutic interventions on functional outcomes in children with CP.
- To emphasize the need for a holistic approach in therapy, considering multiple interacting systems.
Main Methods:
- Literature review on cerebral palsy, its complexities, and therapeutic interventions.
- Analysis of evidence regarding the efficacy of different therapies for improving function in CP.
- Synthesis of knowledge on the interplay of neurological, musculoskeletal, sensory, cognitive, and behavioral systems.
Main Results:
- Therapy demonstrates potential to enhance functional capabilities in children with cerebral palsy.
- Current evidence is inconclusive regarding the superiority of specific therapeutic approaches.
- Understanding the plasticity of the central nervous system (CNS) is crucial for optimizing therapy.
Conclusions:
- Optimizing functional possibilities for children with cerebral palsy requires a comprehensive understanding of their condition.
- Therapists must consider the interaction of all systems (CNS, musculoskeletal, sensory, cognitive, behavioral) for effective intervention.
- Further research is needed to determine the most beneficial therapeutic strategies for CP.
Abstract:
The movement disorder of cerebral palsy (CP) is expressed in a variety of ways and to varying degrees in each individual. The condition has become more complex over the last 20 years with the increasing survival of children born at less than 28 to 30 weeks gestational age. Impairments present in children with CP as a direct result of the brain injury or occurring indirectly to compensate for underlying problems include abnormal muscle tone; weakness and lack of fitness; limited variety of muscle synergies; contracture and altered biomechanics, the net result being limited functional ability. Other contributors to the motor disorder include sensory, cognitive and perceptual impairments. In recent years understanding of the motor problem has increased, but less is known about effects of therapy. Evidence suggests that therapy can improve functional possibilities for children with cerebral palsy but is inconclusive as to which approach might be most beneficial. The therapist requires an understanding of the interaction of all systems, cognitive/perceptual, motor, musculoskeletal, sensory and behavioral, in the context of the development and plasticity of the CNS. It is necessary to understand the limitations of the damaged immature nervous system, but important to optimize the child's functional possibilities.