Cerebral palsy (CP) is a group of disorders that affects movement and muscle tone caused by damage to the developing brain. It impacts coordination, muscle strength, and gait. The Gross Motor Function Classification System (GMFCS) categorizes CP into 5 levels based on mobility ability from walking without limitations to needing a wheelchair operated by another person. Physiotherapy can help reduce symptoms, improve mobility and flexibility, and prevent deformities. Treatments are tailored to the individual and may include exercises, stretching, equipment, and more.

2. Cerebral Palsy (CP) is an umbrella term that defines a group of disorders that impacts coordination, movement,
muscle strength, and gait. It is caused by abnormal brain development or irreparable damage to the immature
and developing brain (during pregnancy or shortly after birth).
CP can affect the whole body, be limited to one or two limbs, or one side of the body. CP is not a degenerative
disorder. This means its symptoms will not get worse with time. However, timely diagnosis and immediate
treatment can better the person’s ability to be as independently mobile as possible.
Understanding Cerebral Palsy

3. CP affects that part of the brain that is responsible for muscle movement. It can lead to flaccid muscles, poor
motor coordination, impaired reflexes, impaired balance, incorrect posture, involuntary movements, etc. The
extent of mobility issues depends on the type of CP.
How does Cerebral Palsy affect mobility?

4. The Gross Motor Function Classification System (GMFCS) is a system of classifying the severity of CP that
further helps in describing the individual’s abilities and challenges when it comes to mobility. The GMFCS has
ascertained the five levels of mobility as follows:
Level 1: Walking without limitations
Level 2: Walking with some limitations
Level 3: Walking with the help of assistive devices like cane or a walker
Level 4: Mobility with self-operated wheelchair
Level 5: Mobility with wheelchair operated by another person
In order to evaluate the degree of difficulty in mobility, the above classification can help greatly.
The Gross Motor Function Classification
System (GMFCS)

5. Physical therapy will help
● Reduce muscle contractures
● Improve strength and flexibility
● Better coordination and sense of balance
● Increase flexibility
Physical therapy introduced early can also avoid many bone and joint deformities, as well as help children
become more independent. It will also help them improve their social and communication skills, participate
better at home and school, and boost their psychological well-being.
Benefits of physiotherapy for Cerebral Palsy

6. Physiotherapy can be tailored to suit the individual needs of the child and based on the type of CP they have
been diagnosed with. It can benefit different types of CP in different ways, like:
● SPASTIC CEREBRAL PALSY: Reduce muscle tension and jerky movements; relieve stiffness (through
stretching)
● ATHETOID CEREBRAL PALSY: Increase muscle tone, gain control over voluntary movements
● ATAXIC CEREBRAL PALSY: Improve gait, balance, and mobility
Physiotherapy has also proved to be beneficial for other symptoms of CP like scoliosis, lumbar lordosis,
knee/hand deformities, pelvic inclination, and shortened Achilles tendon.
Benefits of physiotherapy for Cerebral Palsy

7. Exercise, stretching, special equipment, and muscle relaxation techniques are all part of physiotherapy for
Cerebral Palsy that address specific needs and limitations.
Let’s take a look at some of the most prescribed physiotherapy activities:
Passive stretching: eases soft tissue tightness, relieves spasticity, enables easier walking, enhances range of
motion
● Manual stretching: use full body weight to induce a good stretch; can help overcome hypertonia
● Weight-bearing exercises: targets tight muscles in the lower body
● Splints: improves resting posture, reduces spasticity, improves flexibility; enables long-duration, low-force
stretching
Static weight-bearing exercises: uses devices like tilt-tables and standing frames to guide children through load-
bearing activities; improves muscle tone and strength
Types of physiotherapy for Cerebral Palsy

8. Functional exercises: combination of aerobics and strength training to improve functionality and fitness in
children who can walk
Apart from being beneficial, these kinds of activities, like static biking, plyometric exercises are thoroughly
enjoyed by children.
Bimanual training: improves coordination of the upper body through play and functional activities that employ
both arms
Types of physiotherapy for Cerebral Palsy

9. Body weight supported treadmill training: develops stepping reflex that is essential for regular perambulation
Electric stimulation: improves muscle strength and nerve function through stimulation; these are safe and non-
invasive techniques; can be done at home (guided by the therapist)
Massage therapy: relaxes muscles and gives the child a break from physical strain; also helps with pain relief
Types of physiotherapy for Cerebral Palsy

10. 1. Choose a physiotherapist who has worked with children who have CP
2. Cover slippery floors and remove sharp objects from to make a safe environment for your child
3. Start slow with new exercises and equipment, gradually increase intensity
4. Use assistive devices like brace, guard rails, anti-slip gloves, etc. wherever necessary
5. Always supervise therapy sessions.
6. Encourage your little one to speak up if they’re uncomfortable. Stop the exercise immediately if there’s any
pain or discomfort.
7. Ensure you have a stretching routine before beginning physical therapy.
8. Encourage and motivate small wins.
9. Speak with your doctor about corrective surgeries that could fix bone or joint deformities.
Things parents and caregivers should keep in
mind

11. Children learn through play too. You do not have to always follow an exercise program, per se. You can
incorporate physical activity into your child’s daily routine through simple play and games.
Play is a child’s work

12. At Plexus, we offer the best treatment for CP through our rehabilitation program that helps children learn
suitable coping mechanisms, and live their best lives. The earlier a rehabilitation program begins, the greater
the physical, cognitive, and psychological benefits will be
Treatment for CP includes:
● Physiotherapy
● Occupational therapy
● Speech and language therapy
● Cognitive therapy
● Developmental therapy
● Reflex integration therapy
● Early intervention therapy
● Postural training
● Gait training
● Activities for daily living training
Treatment and care
● Pre-academic skills training
● Hand function training
● Stem cell therapy
● Medication and/or surgery
● Mirror therapy
● Contracture release therapy
● Constraint-induced movement therapy
● Corrective splinting
● Mobility aids