Physical therapy for children with cerebral palsy

Kayla Gallegos, DPT

This article will define Cerebral Palsy (CP), help parents and caregivers prepare for a physical therapy initial evaluation, and discuss ongoing treatment options.

What is Cerebral Palsy? 

Cerebral Palsy (CP) is defined as a non-progressive neurological insult that occurs in the developing fetal or infant brain that affects the development of movement and posture and can lead to limitations in activity (Palisano, 2017). Cerebral palsy can be categorized as Spastic, Dyskinetic, Ataxic, or Hypotonic. Each can present very differently, but in general, physical therapy can help to address muscle tone, postural stability, motor coordination, range of motion, endurance, and other impairments associated with CP. 

What to Expect at a Physical Therapy Initial Evaluation

At an initial evaluation, your physical therapist may gather information about your child’s past medical history, developmental milestones, and functional skills. They will also evaluate your child’s reflexes, posture, balance, coordination, strength, range of motion, tone, gait, and joint alignment. There are many tests and measures that can be used to evaluate children with CP. One commonly used test is the Gross Motor Functional Measure (GMFM). This standardized test has five sections that include: Lying & Rolling, Sitting, Crawling & Kneeling, Standing, and Walking, Running & Jumping. This assessment can assist physical therapists in determining a baseline and monitoring progress throughout the course of treatment. 

Physical Therapy Treatment

After the initial evaluation, a plan of care and goals will be formed between the physical therapist, child, and family. In general, treatment sessions may include strengthening, stretching, postural education, gait training, and other activities to facilitate typical movement patterns and promote independence. Cerebral palsy can look very different between patients depending on the classification, so the PT treatment may look different as well. The Gross Motor Function Classification System (GMFCS) is generally used to determine the level of severity ranging from Level 1, walks without limitations, to Level 5, transported in a manual wheelchair. The interventions utilized in the physical therapy treatment session will depend on the child’s GMFCS level, age, and functional ability. No matter the level, the overall goal of PT treatment is to improve functional mobility and promote independence. Physical therapists may also assist in obtaining assistive devices or orthotics when appropriate. At Ability Innovations, we utilize play-based therapy so interventions are intertwined into the child’s play to make therapy more fun and effective!

References:

Palisano RJ, Orlin MN, Schreiber J.  Campbell’s Physical Therapy for Children.  5th ed.  St. Louis, MO: Elsevier, Inc; 2017.