What is Cerebral Palsy?

Cerebral Palsy (CP) is a non-progressive neurological disorder defined by loss or impairment of motor function. (6)

The disorder is caused by a brain injury or abnormal development of the brain, that occurs while the child’s brain is still developing: before, during or within the first years after birth. Abuse, negligence, infections, medical malpractice, accidents and injury are some known risk factors, which, when happening during pregnancy, may cause CP. Even though CP is defined as one disorder the severity of the symptoms vary and the disorder doesn’t define the person. Some people with CP experience low impairments and no significant disabling, whereas others need full-time care. The disorder doesn’t necessarily affect a person’s cognition and a person with CP should therefore not be mistaken as unintelligent due to the physical impairments (6)(7).

The disorder is primarily affecting body movement and muscle coordination (6):

  • muscle control;
  • muscle tone/posture;
  • muscle coordination;
  • reflex;
  • fine and gross motor skills;
  • oral motor functioning;
  • balance. (6)

People who have CP may also have audio, visual, intellectual and visual impairments, as well as epilepsy and spasms. The variety of CP, the symptoms and areas of the body affected (e.g. image below) depends on which areas of the brain that has been damaged. Hereby, the functional status of people with CP can vary from experiencing slight physical impairments to be needing a wheelchair, have saliva control problems, stiffness and strong spasms, difficulty speaking etc. (2),(6),(7)

Image result for assistive devices cerebral palsy

There is no cure for CP, but medicine and surgery may be prescribed, and a team of physiotherapists, speech therapists and occupational therapists can help deal with problems, prevent symptoms and support enhancement of the life-quality of the person.

How can an Occupational Therapist help?

Occupational Therapy (OT) is a client-centred and holistic form of therapy. Therefore, the OT focus on all parts of the clients life and work with the clients engagement in and satisfaction of Activities of Daily Living (ADL). An OT cooperating with a person with CP has their perspective on habilitation. Habilitation differs from the term rehabilitation by emphazising the learning of new skills, whereas rehabilitation is about regaining old skills.  The OT interventions will always have the client’s meaningful ADL as goal or means of the intervention, can be done as individual or group therapy, take place on many different levels, settings and during the whole life-span. In the habilitation process, the OT will look upon the need of adapting environment, activities and routines in the client’s daily life in order to focus on the person’s abilities in stead of limitations. Some people with CP need more help than others and, therefore, may the OT need to advocate authorities for assistive devices (1) such as a lift, special cutlery (picture on the right), writing tools, wheelchairs, toilets etc.

Image result for assistive device for cerebral palsy              Image result for assistive writing tools               Picture

Though there is no cure for CP, it is still possible to work with neuro-plasticity, which means that the brain, through a lot of therapy, can be changed. The younger a person is, the more plastic is the brain. (4) Therefore will interventions targeting the brain plasticity have the biggest effect with younger clients (hereby not said that it is not possible to work with older clients as well). Working with plasticity in people with CP can, for example,  be done through constrained induced movement therapy, task-oriented training, passive and active movement therapy and sensory integration to improve motor function and the ability to process sensory input. The goal with neuro-plastic intervention is to create a connection between the different body parts and the brain so the person with CP gets a body awareness and slowly, with a lot of training, is able to improve bodily control. (3)

How can a person with CP benefit from yoga therapy?

Yoga is a form of sensory integration and movement therapy, which creates a body awareness and, hereby, integrates body and mind. Since some people with CP are not able to control their body movements at all, it may be difficult to imagine how doing yoga with such difficulties is even possible. But I can tell you that it indeed is, and the earlier you get started the better. Yes, it is possible to start practicing yoga with babies too.

The asanas (yoga poses), pranayama (yogic breathing), eye exercises and meditation should be adapted to the individual’s physical ability and need. If a person’s CP is so severe that there is no or little movement, the therapist will provide the movement for the client to move passively. While moving, it is effective to describe what is happening. E.g.: “Your leg is bending and pressing against your stomach, while your head is lifting up until your nose touches your knee.” Deep tactile pressure (sense of touch), slow proprioceptive (movement sense) stimulation and time for rest  is important for the signals to arrive and settle in the brain.

The yoga program and the active vs. non active performance will vary greatly depending on the client and should always be adapted accordingly. (5)

Please, feel free to contact me for questions regarding occupational therapy, cerebral palsy and yoga 🙂

References:

Litterature:

  1. Brandt, Å & Jensen, L (2011) At muliggøre aktivitet og deltagelse – hjælpemidler og tilgængelighed In: Basibog i ergoterapi 2. edition, publisher: Munksgaard D,anmark
  2. Blicher, J., U. & Kristensen, H., K (2013) Neuroanatomi, neurofysiologi og neuropsykologi In: Neurologi og Neurorehabilitering, 2nd edition, publisher: Ergo/Fys Munksgaard
  3. Lindahl, M., Schmidt, N., H. & van Tongeren, H. (2012)Læring og genlæring af bevægelse og funktion, In:Neurorehabilitering i praksis, 1st edition, publisher: Gads Forlag
  4. Lorentzen, J. & Nielsen, J., B. (2012) Den foranderlige hjerne, In:Neurorehabilitering i praksis, 1st edition, publisher: Gads Forlag
  5. Sumar, S. (2013) Yoga for the Special Child 11th edition, publisher: Yoga for the Special Child LLC, Florida, United States
  6. Stern, K. A.: Definition of Cerebral Palsy: Last visited: 05.10.16 at: cerebralpalsy.org: http://www.cerebralpalsy.org/about-cerebral-palsy/definition
  7. Webmed: Cerebral Palsy – Topic Overview: last visited 03.10.16 at: www.webmed.com: http://www.webmd.com/children/tc/cerebral-palsy-topic-overview

 

Images:

bblc- Dealing With Health Problems No One Wants to Ask About: Last visited: 05.10.16 at: bblc.tv:

Cerebralpalsy.org.uk: Last visited: 05.10.16 at: cerebralpalsy.org.uk: http://www.cerebralpalsy.org.uk/disabled-stair-lift.html

Medcitynews: Last visited: 05.10.16 at: Medcitynews.com: http://medcitynews.com/2013/09/entrepreneurs-arthritic-grandmother-inspires-a-medtech-fork-9500-indiegogo-campaign/

Neurofit: www.neurofit360.com: last visited: 05.10.16 at: http://neurofit360.com/

Teacher’s Gateway to Sepcial Education: Last visited: 05.10.16 at: teachspeced.ca: http://www.teachspeced.ca/fine-motor-skills

 

This page should only be used for informational purpose and is NOT intended to provide medical advice. Before seeking any form of treatment, the reader must seek direct information from his/her certified health care provider.

A Few Facts about Cerebral Palsy, Occupational Therapy and Yoga!

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