Cerebral Palsy (CP) is a non-progressive condition that
results from a lesion in the brain that occurs either before, during, or
shortly after birth, resulting in the abnormal development of the brain.
Failure of the brain to develop properly can occur during the first or second
trimesters of pregnancy and can be caused by genetic disorders or limited blood
supply. A lesion may also develop as a result of injury to the brain before,
during, or after birth, such as a traumatic blow
to the head or bleeding in the brain.
Depending on the severity of the lesion and the part of the
brain affected, individuals with CP will present with varying degrees of
disability. However, the general characteristic features of CP are limited mobility,
poor coordination, and a limited ability to maintain posture and balance. These
individuals may be wheelchair bound, unable to walk at all, or may be able to
walk, but with an abnormal gait, or walking pattern. They will also often present
with spasticity in the hands and arms, and a misshapen mouth, resulting in
drooling and slurred speech. Their cognitive function is usually not affected,
therefore, it is important not to treat them as cognitively impaired simply
because they drool and have a slurred speech.
Because of the varying degrees of disability in CP patients,
every person must be assessed and treated as an individual according to his/her
goals and degree of disability. Adaptations to the assessment and management of
these individuals will need to be made to accommodate each individual’s needs
and goals. Any medications that the individual is taking must be considered, as
these may alter his/her response to exercise. It is important to realize that
the lesion in the brain cannot be reversed or changed by exercise; however,
exercise therapy can help to improve the symptoms of spasticity, poor balance
and muscle weakness associated with CP. It is also important to note that a
person with CP may experience increased spasticity and decreased coordination
shortly after exercise, but this is not uncommon and will return to normal.
Individuals with CP are often sedentary, due to their lack
of mobility. This increases their risk of developing sedentary diseases, such
as cardiovascular disease and stroke. It is, thus, important that they embark
on an appropriate, regular exercise programme in order to reap the
physiological and psychological benefits of regular exercise. Improvements in
mood and self-esteem are also associated with exercise, which the CP patient
will benefit from. The exercise programme should incorporate all the major
muscle groups (if still functional) and should be aimed at improving
cardiovascular fitness, muscles strength and flexibility, thereby increasing
one’s independence to carry out his/her daily activities and, in turn,
improving one’s sense of self-worth. A biokineticist can assist in the design,
implementation and adaptation of such an exercise programme.
References
ACSM’s Exercise Management for Persons with Chronic
Diseases and Disabilities
