CHRYS QUIROZ

HOT SHEET

CE R E BR A L
FIELDWORK OBJECTIVE #3

PA LSY

RELATED DISORDERS STRABISMUS/ NYSTAGMUS

DESCRIPTION AND ETIOLOGY

Cerebral Palsy is characterized by neurological, motor and postural deficits often involving injuries that occur as abnormalities to the brain. The onset is typically between birth to the 2nd year of life of an individual. There are multiple ways that cerebral palsy may occur such as hypoxia, bleeding in the brain, infections (maternal or child), injury, birthing complications, and jaundice. There are a variety of classifications with cerebral palsy. For example, quality of tone (athetosis, flaccid, ataxia), disorder of distribution (hemiplegia, quadriplegia, diplegia), ROM, etc. If the child is not identified to have cerebral palsy upon birth, parents may notice that their child is developmentally delayed when performing activities such as sitting, rolling, crawling, or walking. Often times, it is hard for children with cerebral palsy to maintain and gain weight. Therefore, there are multiple secondary complications that occur such as gastro esophageal reflux, obesity, and delayed growth. (MedicineNet.com)

HYDROCEPHALUS

SEIZURES

DYSARTHRIA

PRECAUTIONS
It is important to supervise any activity that involves a child with cerebral palsy. They are often prone to falling and may further injure themselves. Also, keep surrounding environment free of obstructions. Ensure that there are protective devices available such as helmets and a slip-proof flooring, if possible. Do not let children with CP handle sharp objects. (EverydayHealth.com)

URINARY INCONTINENCE

PHYSIOLOGICAL CHANGES
Possible scoliosis -Abnormal gait Arms tucked in Knees crossed or touching Legs scissor Walk on toes -Joint contractures -Hemiparesis (PubMedHealth.com)

LEARNING DISABILITIES

TREMORS

PREVALENCE & POPULATION Cerebral Palsy affects approximately 1 to 3 out of every thousand children that are born. There is a higher prevalence for infants who are born prematurely or are of low birth weight.

RECOVERY PROCESS/PROGRESSION
Cerebral palsy is nonprogressive but the individuals function does become more limited over time. There are often motor, language, cognitive, visual, auditory and feeding complications. Therefore, treatment is typically for the symptoms of Cerebral Palsy and not for the actual causes of the disorder. Though some individuals with CP may have a shortened life span, some will have a normal life expectancy. Typically, life expectancy is largely dependant on the complications that are associated with each individual case. About 1/4 of the CP cases have minimal limitations, 2/4 have moderate impairments and the remaining 1/4 have severe disabilities.

Long term care is expected and CP is considered a lifelong disorder. Individuals can become a functional and independent individuals but it is necessary to seek appropriate therapy and treatment. (VirtualMedicalCentre.com)

CEREBRAL PALSY

Evidence Based Interventions

REHABILITATIVE
The rehabilitative approach can be used to implement strategies to improve daily function for those with cerebral palsy. This intervention mainly focuses on the use of adaptive equipment to allow for independent functioning for the individual. Two examples of activities that can demonstrate the rehabilitative intervention approach are using a walker while playing a sport such as baseball or basketball. Another example would be using an adaptive feeding device if the individual does not have full range of motion to reach a spoon to their mouth. A sippy cup would also benefit a child with cerebral palsy because if they are increasingly spastic, the sippy cup would decrease the amount of spillage during meal times.

NEURODEVELOPMENTAL TREATMENT
The Neurodevelopmental treatment (NDT) approach is known for being a hands-on intervention strategy. It is extremely beneficial for those with cerebral palsy because it allows for them to understand what typical movement is which is facilitated by the therapist going through a normal flow of movement. Two activities that can be done using the NDT approach is having the child go in quad to imitate their favorite type of animal. Often times, children that are spastic will have their fingers flexed. Therefore, the Occupational Therapy can practice hand expansion while in quad. Another activity could be practicing handing the therapist their favorite round toy. This exercise or activity can show the child what a normal movement pattern would be to handing a toy to another individual during their everyday activities.

BIOMECHANICAL
The Biomechanical Approach is built upon the principle that the client will be able to restore some use of their body. Because it is a remediation approach that attempts to regain a prior level of function, it may not see appropriate for an individual with CP. However, it does have goals aimed at increasing range of motion, strength, and endurance. tion, they can also work on proper gait patterns to work and improve the endurance portion of the biomechanical intervention approach.

There are two activities that can be done to strengthen a child with CP. They can practice reaching for a desired object at increasingly difficult levels in order to work on their range of motion. In addi-