Cerebral Palsy 101

What is cerebral palsy?

Cerebral Palsy (CP) is the most common physical disability in childhood, affecting approximately 4 infants in every 1,000 born in the US, but what does it mean? Breaking the words down:

Cerebral = of the brain
Palsy = lack of muscle control

It is important to understand that cerebral palsy is an umbrella term that refers to a large group of non-progressive disorders that affect’s an individual’s ability to move. All cases present differently and no two people with CP are affected in exactly the same way!

CP is typically classified under 3 different categories:

1. Body part affected

• Quadriplegiaà affecting all 4 limbs: both arms and both legs. This type can also affect an individual’s face, mouth, and torso.
• Triplegiaà affecting 3 limbs: both legs and one arm. This type can also affect an individual’s face, mouth, and torso.
• Diplegiaà affecting both legs.
• Hemiplegiaà affecting one side of the body: either right-side (right leg and right arm) or left-side (left leg and left arm).
• Monoplegiaà affecting only one limb.

2. Brain injury location

• Spastic (70-80% of individuals)à this type causes muscles to appear stiff and tight as a result to damage of the motor cortex
• Dyskinetic (6% of individuals)à this type causes involuntary movements as a result to damage of the basal ganglia
• Ataxic (6% of individuals)à this type causes shaky movements, poor balance, and inability to sense where certain body parts are in space. This occurs as a result to damage of the cerebellum
• Mixedà injuries to multiple areas of the brain and can present as a combination of the above symptoms

3. Gross Motor Function Classification System (GMFCS) Level 

This is a five-level classification system used to provide families and clinicians with a description of the child’s current motor function and is used to provide an idea of how they will get around as they grow up.

What Do The Levels Mean?

The difference between levels is based on your child’s movement and motor ability, the need for devices like crutches, walkers, or wheelchairs, and the quality of movement. Level 1 means less help is needed and Level 5 means more help is needed. There is a range of ability within each level.

Example for children between ages 6-12 years old:

What causes CP?

CP is caused by damage to the brain that occurs before, during, or up to 2 years after birth. Additional risk factors for cerebral palsy include:

• Prematurity
• Bleeding in the brain (stroke)
• Lack of oxygen to the brain
• Maternal infection or illness
• Traumatic brain injury

How can therapy help?

Therapy for a child with CP can involve a lot of people! A therapy team can consist of physical therapists, occupational therapists, speech therapists, and more. An intensive evaluation is always completed to meet your child’s individual needs. This team creates a coordinated plan and plays a crucial role is managing specific impairments while optimizing mobility and capabilities. Early intervention (treatment while the child is still developing) has been proven to lessen associated impairments and decrease the risk for associated comorbidities and diseases.

Emily Bean, Student Physical Therapist

Allie Stumbo, PT, DPT

Sources:

https://www.apta.org/patient-care/evidence-based-practice-resources/clinical-summaries/cerebral-palsy-cp

https://www.nichd.nih.gov/health/topics/cerebral-palsy/conditioninfo/types

https://www.choosept.com/guide/physical-therapy-guide-cerebral-palsy

https://cparf.org/what-is-cerebral-palsy/types-of-cerebral-palsy/