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Other Treatment on Cerebralpalsy
Physical therapy is one of the most important treatments for cerebral palsy (CP). It usually begins soon after diagnosis and often continues throughout life. Some people with CP may begin physical therapy before being diagnosed, depending on their symptoms.
Special devices and equipment are needed for some people with CP to help them with specific problems. For example:
* A child who develops uneven leg length may need to wear special shoes with a higher sole and heel on the shorter leg.
* Some people who are not able to walk without assistance may need to use canes, crutches, walkers, or wheelchairs.
* Physical therapy and special equipment may be used together, such as for constraint-induced movement therapy, also called shaping. This approach encourages a child to increase movements by presenting interesting activities or objects and giving praise and rewards when a child makes attempts to use the less-functioning muscles. 9
Occupational therapy helps adults adapt to their limitations and live as independently as possible.
Speech therapy helps control the mouth muscles. This therapy can be of great benefit to children with speech or eating problems. Speech therapy often starts before the child begins school and continues throughout the school years.
Nutritional counseling may help when dietary needs are not met because of problems with eating certain foods.
Biofeedback may be useful as part of physical therapy or on its own. During a biofeedback session, people with CP learn how to control their affected muscles. Some people learn ways to reduce muscle tension with this technique. Biofeedback does not help everyone with CP.
Both massage therapy and hatha yoga are designed to help relax tense muscles, strengthen muscles, and keep joints flexible. Hatha yoga breathing exercises are sometimes used to try to prevent lung infections. More research is needed to determine the health benefits of these therapies for people with CP.
Other treatments that vary by age or specific need include:
* Therapies to stimulate learning and sensory development. Babies and young children may benefit from these stimulation or neurodevelopmental therapies. Some of these therapies also help people of other ages. These therapies cannot repair damaged parts of the brain. However, they may be able to stimulate undamaged parts of the brain that the person is not currently using.
* Behavioral therapy. This type of therapy helps some school-age children with CP learn better ways to communicate with others.
Several controversial therapies exist for CP, such as electrical stimulation and special diets. If you are considering these types of treatments, talk to your doctor about any related research or where to find more information.
Surgery for people with cerebral palsy (CP) usually involves either:
* Loosening tight muscles and releasing fixed joints, most often performed on the hips, knees, and ankles. In rare cases, this surgery may be used for people with stiffness of their elbows, wrists, hands, and fingers.
* Cutting nerves on the limbs most affected by movements and spasms. This procedure reduces spasms and allows more flexibility and control of the affected limbs and joints.
A doctor evaluates the person's symptoms, age, and general state of health when considering whether to recommend surgery.
A thorough checkup is needed to help the doctor determine which muscles and nerves are affected and what type of surgery would best treat the condition. A gait analysis is part of the examination if the person is able to walk.
For young children, surgery may be postponed if doing so will likely prevent the need for additional surgery in the future.
Other surgeries related to cerebral palsy
Surgery for various orthopedic problems: Surgery for other problems is sometimes needed for children with CP. These surgeries vary depending upon the specific problems involved. For example, some children may need surgery to correct uneven leg length, dislocation of the hip, curves in the spine (scoliosis), or an eye problem.
Medication-related surgery: A small pump is surgically implanted under the skin in the abdomen for some people with CP. This pump is used to deliver medications, such as baclofen (Lioresal), directly into the fluid surrounding the spinal cord. For more information, see antispasmodics.
The main surgery choices for people affected by cerebral palsy (CP) are:
Orthopedic surgery (for muscles, tendons, and joints). This type of procedure is done to lengthen a tendon to increase a limb's range of motion by cutting through a muscle or tendon (release) and sometimes reattaching it in a different area. 1
Selective posterior rhizotomy (cutting nerves of affected limbs). This procedure is usually considered only for children with severe muscle tightness in the legs.
What To Think About
Health professionals do not agree about the best age for people with cerebral palsy (CP) to have surgery.
* Some surgeons believe that children less than 2 years old with CP benefit most from orthopedic surgeries because it allows them to grow and develop more like other children.
* Some health professionals believe that all surgery should wait until a child is older than age 2; some prefer to wait until sometime between ages 6 and 8 years. They believe that more problems can be corrected during the same surgery if orthopedic surgery is postponed until the child is older.
Surgery is not used nearly as often for the arms as for the legs. Surgery on arm deformities carries more risks related to sensory damage; also, surgery has a more limited impact on functional abilities than on the legs. 8
Sometimes medications or physical therapy are used to postpone or eliminate the need for surgery. Physical therapy is also needed for most children after surgery. The type of therapy and special equipment needed after surgery (such as braces, casts, and splints) depend on the child's specific needs. In general, post-surgical physical therapy usually starts as soon as possible and may continue for as long as 6 months.
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