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Physical Therapy for Cerebral Palsy

Cerebral palsy is the most common physical disability in children, and represents the most frequent diagnosis in children who receive physical therapy. The severity of limitations in gross motor function among children with cerebral palsy varies greatly, as some can walk with or without assisting devices while others must use battery-powered wheelchairs. Physical therapists help children learn better ways to move and balance, as well as learn to walk, use their wheelchair, stand up without assistance, or go up and down stairs safely.

Physical therapy for cerebral palsy patients consists of activities and education to improve flexibility, strength, mobility, and function. A physical therapist also designs, modifies, and orders adaptive equipment. Physical therapy can take place in clinics, hospitals, schools, and should carry on in the home through an exercise program. Physical therapy for cerebral palsy patients will not be successful without an ongoing daily home program.

A physical therapy program should consist of a number of exercises that include stretching, strengthening, and positioning. To stretch the muscles, the arms and legs must be moved in ways that produce a slow, steady pull on the muscles to keep them loose. Because of the increased muscle tone of the cerebral palsy patient, they tend to have generally tight muscles. Therefore, it is extremely important to perform daily stretches to keep the arms and legs limber, allowing the child to continue to move and function. Strengthening exercises work specific muscle groups to enable them to support the body better and increase function. Positioning requires the body to be placed in a specific position to attain long stretches. Some positions help to minimize unwanted tone. Positioning can be done in a variety of ways. Bracing, abduction pillows, knee immobilizers, wheelchair inserts, sitting recommendations, and handling techniques are all part of positioning techniques used in physical therapy for cerebral palsy patients.

New techniques of physical therapy for cerebral palsy patients have taken to the water. Aquatic-based rehabilitation uses the physical properties of water to resist or assist in the performance of exercises. Cerebral palsy patients experience muscle shortening in most of their involved extremities and it becomes a difficult task to lengthen the affected musculature with regular stretching while having to deal with the affects that gravity has on the spastic arm or leg. In the past, there was clinical prejudice against strengthening activities for this population. However, recent research findings are revealing that children with cerebral palsy can benefit from strengthening programs and that strength is directly related to motor function. Some of the documented benefits are optimization of neuromuscular responses, improved motor unit contraction synchrony and facilitation of maximal muscle contraction along a joint's available range of motion.

Physical therapy for cerebral palsy patients does not cure spasticity but can improve impairments and limitations. Physical therapy for cerebral palsy patients is an important step towards an independent lifestyle. If these changes happen only in the therapy gym, the disability remains unchanged. Therapy must improve abilities to perform meaningful tasks in everyday life. Changing the level of disability is the ultimate goal of physical therapy for cerebral palsy

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