PHYSICAL / BODY TREATMENTS
All CP treatments that require physicality and/or controlled exercise/training. It also includes all treatments that deal with body manipulation. In alphabetical order.
Bobath is a type of physiotherapy treatment used in the habilitation of cerebral palsy and other neurological conditions. Its goal is to promote sensory and motor pathway to better facilitate motor control and movement. The idea behind Bobath Therapy is to encourage quality movement patterns, correct posture and sitting standing and lying. Strength building is discouraged however.
Cage / Spider
Also known as the Universal Exercise Unit, the Spider Cage is a large piece of equipment used during physiotherapy sessions. Wearing a Therasuit or Adeli Suit, the cage allows for exercises such as jumping and flipping which improve balance sensory motor integration and coordination.
Spider cage therapy can be used to help children perform many gross motor activities, such as sitting, sit-to-stand, high-kneeling, jumping, walking, as well as help with proper posture.
Depending on the activity to be performed, the child is attached to the cage in various different ways. A harnessing belt with carabiners is attached to the bungee cords which themselves are attached to the cage to help support the child. The child touches the ground but is supported by the cords. It is called ‘spider’ because the bungee cords supporting the child with the cage resemble spider’s legs.
As a pure exercise unit, a series of pulleys are attached from the cage in various locations to the child to enable targeted exercise. It provides low level resistance using weights attached to the pulley system to focus on isolated muscle groups.
The cage has many uses. It can be used for jumping, strength building and learning balance, while being partially suspended it removes the need for total support or weight-bearing control.
It can be used for strengthen as well as improve flexibility and tone.
The spider cage is used to increase strength building and prevent atrophy. It also increases the range of joints, improves balance and coordination as well as muscle flexibility.
Because the child is partially supported there is a greater feeling of confidence and safety by the child.
Spider cage can be used for therapy sessions by both physiotherapist as well as occupational therapist.
A chiropractor’s main objective is in the care of a person’s neuro-musculoskeletal system. Dealing mainly with the nerves, muscles, ligaments and bones of the spine. The chiropractor helps manage neck and back pain. To maintain a patient’s good, postural alignment, the chiropractor will perform spinal adjustments.
Constraint Induced Movement Therapy is a neurological habilitation used to help children with hemiplegia. It is a treatment used to improve upper limb motor function. The treatment involves restricting, or constraining, the non-affected arm or hand thus forcing the child to use the affected side. The constraints used can either be splints, slings, mitts or even non-removable casts on the non affected arm.
Conductive education is a learning method developed for children with mobility difficulties caused by cerebral palsy. The main goal of conduct of education is to reduce a child's dependence on artificial aids thus resulting in greater independence. It focuses on the positive potential of a child’s ability rather than the usual assessment of what the child is unable to do.
Here's the conductive education school Julian went to for 4 years. I can safely say that without it, Julian would be in a wheelchair today. Not only did they give Julian a better understanding of his potential, but more importantly, they taught us how to help Julian.
Cuevas Medek Exercise
CME is a physio therapy approach that attempts to recover motor function for children with motor delay complications. The main concept behind this form of therapy deals with gravity. The further that the therapist supports the child from his or her centre of gravity the more effort is required to maintain the position. The child’s brain and body must work harder to maintain posture and respond to the gravitational challenge. There are more than 3000 different exercises included in CME therapy.
A type of therapy called “The Feldenkrais Method” uses assisted gentle movements to help the body adapt a more correct posture. The method takes advantage of the brains power of neuroplasticity. Through the gentle movements the nervous system is retaught. The method can increase the person’s range of motion as well as improving flexibility and coordination.
“What I’m after isn’t flexible bodies, but flexible brains.”
Developed in the later part of the 19 century Dr Frenkel created a series of exercises aimed at establishing better control of movement by the use of all senses. Thus compensating for the lost kinaesthetic sensation. (i.e. the person’s proprioceptive awareness and the movement of body parts.) Exercises are done either line, sitting standing or while walking.
Goal Directed Training
Goal directed training is a process by which a child with cerebral palsy is taught to achieve specific tasks of daily life. Activities such as using cutlery, doing up buttons, opening doors etc. These individual tasks are the goals for therapy. Other goals can include self-care, communication, school based activities as well as gross motor achievements.
MAES therapy is a form of treatment used to help babies and children with various neuro-developmental conditions, such as cerebral palsy. It is a therapy that guides the child away from following a typical course of development. Through gentle, continuous asymmetrical movements, MAES therapy challenges the brain, and prevents it from reverting to bad, repeated habits that the child has developed. Simply put, during MAES treatment, the brain is forced to leave its comfort zone and learn new skills.
MAES Therapy looks at what is influencing a child’s movements. This includes looking from the child’s perspective and how they’ve learnt to understand, experience and interact with the world around them. A MAES Therapist analyses the child’s movements and identifies what may be influencing their development now and in their future.
Current mainstream physiotherapy addresses the child’s physical limitation head-on to achieve a certain result. To attain that result, mainstream physiotherapy involves stretches, balancing challenges, coordination skills, and strength building. This approach only addresses the effect of a certain movement and totally disregards the cause. The mainstream physiotherapy style of treatment, by itself, is therefore bound to repeatedly hit a CP brick wall as the child grows.
MAES therapy on the other hand takes a massive step outside of the traditional physiotherapy mode of thought. It has a much more ingenious approach to dealing with a physical limitation. It does this by NOT even addressing the limitation itself. Instead, it addresses the underlying reason for that limitation. In many ways, I suppose you could say that MAES therapy is a purely cerebral form of physiotherapy—challenging the brain’s neuroplasticity instead of simply trying to patch up poorly controlled muscles.
Early intervention is beneficial when considering the future development of babies and very young children with neuro-developmental conditions or developmental delay. It is never too late to intervene, however the earlier you do so, the more you can influence the child’s future development for the better.
Myofascial Release Therapy
Myofascial release therapy is the type of deep tissue massage, performed by an osteopath and is used to treat musculoskeletal issues. It is done by plane slow, deep strokes over the muscles and connective tissues. It promotes increased blood flow but more importantly it softens the fascia. Fascia is the thin layer of connective tissue that surrounds the muscle. Myofascial release therapy relieves the muscle tension relaxing it.
Occupational therapy deals with the challenges an individual might have at home, at school or work. Occupational therapy is a type of physiotherapy that deals with managing any daily task. Ultimately leading to a more independent future.
Osteopathy deals with your body’s well-being. Through a variety of techniques, an osteopath manually manipulates your body, skeleton, muscles, ligaments and connective tissue to ease spasticity and the pain caused by it. Using touch, an osteopath physically manipulates, deep massages and stretches muscles to release tension, as well as myofascial release. This all results in better blood flow and nerve supply to the tissues, not to mention the reduction in pain. Osteopathy also treats the mechanisms of posture.
It is my firm belief that osteopathy is fundamental in the treatment of cerebral palsy. There is no doubt in my mind that it should go hand-in-hand with physiotherapy.
Since finding out about it 4 years ago, and realising how indispensable it was to Julian’s physical and mental well-being, he has seen an osteopath every week for four years. After every session, Julian will say something to the effect of “Wow! I feel better!” Osteopathy has proven an absolute must for Julian.
Phyiotherapy / Physical Therapy
Physiotherapy is the single most important treatment for cerebral palsy. It’s main purpose is to improve muscle activation and control with the ultimate goal of improving the person’s functional ability.
Just a few of physiotherapy’s objectives are to…:
Increase muscle strength and mobilisation
Improve postural alignment
Improving balance, mobility and proprioception.
Reduce muscle stiffness, spasms and general pain
Ultimately aiming for increased independence.
Speech & Language Therapy
Because proper control of facial, tongue, throat and neck muscles is necessary for speech. Cerebral palsy can greatly affect a person’s speech. About 1 in 4 individuals with CP have speech difficulties.
Speech therapy is the process used to treat communication, speech and language disorders. Exercises are performed to train the brain to learn, pronounce, understand and interpret words, sound and numbers.
Speech and language therapy can also involve exercises for improving the function of the mouth, jaw and throat.
Speech therapy involves addressing many aspects related to speech such as: pronunciation, word formation, language and vocabulary, word-object associations, as well as mouth and throat coordination and strength exercises.
If a child is non-verbal, a therapist can I identify can determine other means to substitute limitation to permit interaction. These communication aids might include: writing, adaptive equipment, signing, gestures, picture boards, voice synthesisers or a multitude of computer-based aids.
Until very recently strength building was discouraged because it was believed believed to increase spasticity. More recent studies however have shown that many forms of strength building improve body structure and functional ability. Exercises such as weight training, treadmill, cycling, resistance training, and swimming all improve the body’s endurance and ability.
Beginning with the all-important core strength, strength building helps a person with CP improve in balance, flexibility, posture and general strength.
Similar to goal direct training, targeted training is a movement directed physiotherapy to help children with cerebral palsy become more independent.