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What a Diagnosis of Cerebral Palsy Means for Your Child

For new parents whose children are diagnosed with Cerebral Palsy (CP) and parents whose children with CP are nearing school age, understanding the diagnosis, prognosis, and the interventions available is often their top priority.  Being a first-time parent is challenging enough, and for many parents looking for answers, a medical diagnosis provided by a doctor often leads to more questions.

What having Cerebral Palsy means for your child:

Cerebral Palsy is a broad term used to describe a neurological condition that impacts physical functioning in children. The presentation of CP in individuals affected is highly varied in terms of severity, symptoms, and deviation from typical development.  The condition itself is explained by a brain lesion that occurred in utero or around the time of birth (such as an in-utero stroke, brief oxygen deprivation before birth, or a birth trauma to the young brain).   The neuromuscular system is affected, leading to motor impairments that hinder a child’s voluntary muscle control. Put simply, a child’s ability to control his trunk and move his body parts become limited.

Muscles and our brain’s ability to control them are a huge part of our physical function, from our vision and speech, to our sense of balance. This impaired control and coordination of voluntary muscles affects children in a variety of ways, depending on the location, timing, and severity of the brain lesion.  Much like a brain injury can affect a mature individual’s ability to control his limbs, a lesion in the immature brain often leads to decreased postural control and delayed physical development.  The lack of motor control is not always, but is often correlated with cognitive delays and learning disabilities, speech delays, visual or auditory impairments, and seizure disorders.

There are many misconceptions in the general community about children with CP.  Many people think CP is associated with mental delays and poor independent functioning. This is simply not the case for everyone with cerebral palsy.  Cerebral Palsy is often classified in different ways based on the movement disorder (stiffness, rigidity, low tone, uncontrollable movement, etc) observed. No matter the diagnosis or presentation, a team of healthcare professionals is absolutely essential to improve the lives of children and families affected with cerebral palsy.  It is important to begin a treatment program as early as possible to ensure a child develops to his or her full potential.  Sometimes, a child with CP may need surgery, orthotics, assistive technology, early intervention therapy, or medications, to improve their function and independence.

The role of the physical therapist:

One of the first steps to take after receiving a diagnosis of cerebral palsy is to discuss with your pediatrician and your child’s medical team about the interventions currently available and the interventions needed long-term. Often times, physical therapy becomes an indispensable part of a child’s medical care. Physical therapists will develop a plan of care based on the child’s abilities.

Our goal as physical therapists is to improve a child’s independence by doing the following:

  • Teaching him to move and play while protecting his joints from abnormal movements/postures
  •  Helping him strengthen muscles that are weak, keep stiff joints mobile, and stretch out muscles that are tight
  •  Fitting him for special equipment to help him stand, walk, and participate in school and life activities as needed
  •  Working with his family and caregivers on adaptive techniques and changes to their home or school environment, to allow him to interact with other children and participate in daily tasks
  •  Addressing his limitations and movement disorders by improving his posture, walking mechanics, endurance, and pain
  •  Accommodating for his changing needs as he matures and as new challenges arise, and
  •  Providing the child and his family emotional support, healthcare references, and professional insight to help him transition into adulthood.

Every child with cerebral palsy develops differently. The importance of early therapy is to help a child live up to his full potential with this neurological condition.

Reference: Olney SJ, Wright MJ. Cerebral palsy. In: Campbell SK, eds 3. Physical Therapy for Children. Philadelphia, Pa: WB Saunders Co, 2004 :625-664.

The Rewards of Adaptive Bicycles for Children

Bicycle or tricycle riding is an important component of childhood. For certain children with medical complexities, there are special equipment that enable them to explore the world just like any other child.

When I was working as a physical therapist on the pediatric floor of a rehabilitation hospital, I encountered many children and families impacted by debilitating conditions and circumstances. From cerebral palsy and brain injury, to spinal injury, or cancer, many of the children I met proved that being physically and cognitively limited did not keep them from participating in stimulating play activities.

Adaptive tricycles are designed to provide less able-bodied children a way to exercise their limbs, practice their skills and encourage their participation. 

They often come with various features and accessories such as extra wide frames, trunk reinforcement, head support, leg straps, hand straps, steering assist, etc. They make it possible for children who have low muscle tone, motor control, coordination, or cognitive function to engage in locomotion.

How Can an Adaptive Bicycle Help?

For children with diagnoses that reduce their trunk control, adaptive bikes provide a safe environment where they can work on coordinating their limbs while having their back fully supported or strapped in.  For children who fatigue easily due to their medical conditions, adaptive bikes offer the option of having an adult help steer from behind.  For children who lack the motor control to alternately pedal their legs, foot straps and connected pedals make the reciprocal motion easier by putting muscles and joints through those much needed ranges. Depending on the type of bike, adaptive handles can also accommodate all kinds of grip. So when a child with upper body weakness has a hard time grasping or holding the handlebars to steer a regular bike, an adaptive bike allows them more control of their locomotion.

Durable wheels and a parking brake make adaptive bikes safe for children with a wide range of physical abilities and conditions.  Children with medical complexities who are restricted to a wheelchair can still benefit from rides in an adaptive bike.  Aerobic training and upright posture, as well as limb movements (facilitated or self-initiated), are an essential part of the growth and rehabilitation process for children of all different capabilities. All of this is made easy by special equipment such as the adaptive bike. Being outside and being able to participate in activities with other children promote emotional health and create positive environments for mental and physical growth.

The Rewards of Using Adaptive Bicycles

I have watched many children blossom behind the wheel of an adaptive bicycle. Taking part in that transition is such a rewarding process.  Children who were unable to move certain parts of their bodies after an injury were eventually able to transfer what they learned during cycling to standing and walking tasks. Toddlers who were never able to stand on their own were able to experience, for the first time, limb movements and self-propulsion locomotion. Seeing the smiles on their faces, and hearing the laughter of their parents and siblings… Those moments definitely made my job worthwhile.