Treatments

Can Cerebral Palsy be cured?

There is no cure for Cerebral Palsy. Not in the traditional sense, that is, in the medical sense. It can, however, be managed. Management implies a partnership between doctor, therapist, educationalist, parent and child.

The fact that Cerebral Palsy cannot be cured has led to a number of different methods of management of the disorder evolving over the years, each method having its dedicated proponents.

While there is no panacea in the management of Cerebral Palsy , much can be done for each individual. Abilities and problems need to be clearly identified. Short-term goals must be clearly defined.

Treatments

There are many different approaches to the management of Cerebral Palsy, and a decision to opt for one treatment rather than another can significantly alter the life of the child and family.

If children are lifted, held and positioned well from a young age, and encouraged to play in a way that helps them to improve posture and muscle control, they can learn a lot, and lead fulfilling lives.

Most therapists favour early intervention and there is general agreement that the younger the child the greater the effect of the treatment.

The reasons for this are:

• Massive myelination (growth) is occurring. It is no doubt easier to form correct movement habits before incorrect ones are established
• The majority of parents have an expectation that their time will be devoted to their baby, especially in the first two years, so it is easier to involve them in treatment
• Treatment does not impinge on the education and social life of the child
• During this time parents need close contact with people who understand their problems, can help them to remain positive and can assist them in learning about their child’s difficulties.

Overall it is important to remember that in order for your child to achieve some degree of independence, they must be given every opportunity and encouragement to accomplish basic tasks, especially when there is the possibility of success.

Types of Treatments

Cerebral Palsy originates from damage to cerebral tissue – this central nervous system damage leads to a loss of control, especially in the limbs where the result of the damage appears. It is not possible, at present, to repair the damage within the brain. However, this is not to say that motor control cannot be improved with training and therapy.

Bobath

The Bobath approach to the management of children with Cerebral Palsy was pioneered and developed by Dr Karel and Mrs Berta Bobath in the 1940s.

The main aim of treatment is to encourage and increase the child’s ability to move and function in as normal a way as possible. More normal movements cannot be obtained if the child stays in a few positions and moves in a limited or disordered way. The aim of management is to help the child to change his abnormal postures and movements so that he or she is able to comfortably adapt to the environment and develop a better quality of functional skills.

Find out more at: www.bobath.org.uk

For more information contact your nearest School of Physiotherapy (attached to a Technical University or Institute):

• School of Physiotherapy at Auckland University of Technology
• School of Physiotherapy at University of Otago
• Or Physiotherapy New Zealand 

Botox

Botulinum toxin type A, or Botox, is a therapeutic muscle-relaxing agent that reduces the rigidity of muscles or unwanted spasms in a specific muscle. Botox is produced from the bacteria that causes food poisoning and provides relief for muscle stiffness at the injection site. Over the past 10 years, Botox has been used to treat spastic muscles in children with Cerebral Palsy. The injection stops the signal between the nerve and the muscle, effectively relaxing the muscle and reducing stiffness. Once the muscles are relaxed intensive therapy is required to maximise the benefits of treatment. This is not a cure for spasticity, and to maintain the effect injections need to be repeated every three to six months.

For more information contact a Children’s Hospital.

Conductive Education – Maximising the Ability in Disability

Conductive Education is a unique form of education and rehabilitation based on the concept of human potential – meaning that everyone has the capacity and capability to learn and develop, irrespective of their starting point. Conductive Education is beneficial for children and adults with a range of disabilities, particularly involving physical coordination (motor disorders), such as Cerebral Palsy. 

Conductors (specialists trained in Conductive Education) work as part of a skilled team to cater for all areas of development – gross motor (rolling, crawling, walking, climbing stairs); hand skills; cognitive; communication/social skills and life skills.

Conductive Education has more than 25 years of history behind it in New Zealand and centres are available which cater for pre-schoolers, school age and adults in a number of locations.

Early intervention is a very important aspect of Conductive Education – early access to a programme will result in better outcomes. Please visit the NZ Foundation for Conductive Education website for locations and further details.

www.nzfce.org.nz

Cranial Osteopathy

Despite nearly 20 years of research Dr William Garner Sutherland, an osteopath from Missouri, USA, had to wait until 1940 to have his ideas accepted. Cranial Osteopathy deals with the movements of the cranial bones (there are 29 bones that make up the head), the movement of the membranes that surround the brain and contain the cerebral spinal fluid, and the movement of the brain itself. These small movements of the body structure affect every part of the body and can be felt and manipulated from almost any part of the body being worked on. It is very gentle (most people don’t feel themselves being worked on), and is often the treatment of choice for the very young, the infirm and the elderly.

To find practitioners in your area search the internet for Osteopaths and contact them to find out whether they practice Cranial Osteopathy.

Physiotherapy

Physiotherapy is a health profession concerned with maximising mobility and quality of life by using clinical reasoning to select and apply the appropriate treatment. Physiotherapists interact with patients and families, as well as other health professionals, in order to assess movement potential and establish goals for the patient. Physiotherapy extends from health promotion to injury prevention, acute care, rehabilitation, maintenance of functional mobility, maintenance of the best achievable health in people with chronic illness, patient and carer education, and occupational health.

• School of Physiotherapy at Auckland University of Technology
• School of Physiotherapy at University of Otago
• Physiotherapy New Zealand 

Surgical Intervention

It is very difficult to predict complex individual systems, they are like weather systems; it is even more difficult to predict the reliability of intervention. Orthopaedic surgery addresses several different areas: gait abnormalities, correction of hip deformity, upper limb and scoliosis surgery. Short muscles cannot be lengthened but surgery can alter the length of the tendons, redirect the tendons and, in some cases, divide the tendons to remove an abnormal force. Bones can also be divided and realigned and unstable joints fused. Lengthening tendons reduces tension in the muscle in the short term. Performing surgical correction at an early stage runs the risk of recurrence throughout growth, with the potential for repeat surgery. Perioperative and postoperative care is critical in ensuring that the treated abnormalities do not re-occur due to pain, lack of therapy and poor provision of orthotics.