Understanding the Limitations of People with Cerebral Palsy

Cerebral palsy (CP) is a group of disorders that can affect a person's posture, balance, and ability to move. It can also have an impact on communication, eating, and sleeping. The parts of the body affected by cerebral palsy, the level of severity, and the combination of symptoms may vary from person to person. Mobility limitations are common among those with CP. The type and severity of cerebral palsy, as well as the location of movement problems, are factors that influence a patient's mobility.

Impaired mobility is the most common issue associated with CP. Mobility issues can range from a slightly abnormal gait to an inability to walk at all. Medications, surgery, physical therapy, and adaptive equipment can help improve mobility and quality of life. All people with cerebral palsy have problems with movement and posture. Many also have related conditions such as intellectual disability, seizures, vision or hearing problems, changes in the spine (like scoliosis), or joint problems (like contractures).

In about 10-20% of cases, cerebral palsy is acquired after birth due to brain damage caused by bacterial meningitis, viral encephalitis, hyperbilirubinemia, motor vehicle collisions, falls, or child abuse. Brain stimulation of the upper medial cerebellar cortex using an implantable controlled-current pulse generator has been found to reduce seizure activity and spasticity of primitive reflexes, increase muscle tone and co-contraction, and reduce athetoid movements in those with CP. Mental health can be affected by chronic pain, social isolation, and the loss of functionality and independence associated with CP. In a representative series of 176 children with CP aged 5-8 years old, the associations between additional neurodeficiencies, activity limitations and restrictions on participation in areas such as mobility, education and social relations were studied according to the International Classification of Functional Disability and Health (ICF). Birth complications such as asphyxiation are estimated to account for about 6% of cases of congenital cerebral palsy.

Those with this type of CP may need to extend their feet well when walking in order to maintain balance. Compared to the general population, those with CP have a higher mortality rate from ischemic heart disease, cerebrovascular disease, and digestive disorders. The most common type of CP is spastic which is characterized by overtoned muscles and spastic movements. Taking a child with CP to regularly scheduled physical therapy sessions can cause significant family stress. The Gross Motor Function Classification System (GMFCS) for CP measures voluntary movements. CP is never curable but surgery to repair a leg deformity for example could help a child walk more easily and achieve greater independence.

Botulinum toxin type A administered through ultrasound-guided injections into the intrasalival glands has been investigated to reduce salivary flow and correct pediatric drooling associated with CP. Currently there is no evidence-based indication for the use of hyperbaric oxygen therapy in the treatment of those with CP.