Chapter 26: Cerebral Palsy

Chapter 26: Cerebral PalsyPages 387-408Melissa EwerthAdapted Physical EducationWest Chester Universityhttp://www.youtube.com/watch?v=ICpl0F6AqdE&feature=youtu.be1ObjectivesDefine Cerebral PalsyIdentify the causes of cerebral palsyUnderstand the diagnosis for cerebral palsyExplain ways to help children with cerebral palsyIdentify useful strategies for teachersWhat is Cerebral Palsy?Cerebral palsy is a movement and posture disorder that is caused by a non- progressive abnormality of the immature brain.Cerebral palsy is a developmental disability that is associated with signs of neurological dysfunction.

3Causes of Cerebral PalsyCerebral palsy is most often caused by a brain injury.In some cases, cerebral palsy is caused by genetic problems with brain development.Birth asphyxia is only the cause of cerebral palsy in a minority of cases.4Causes of Cerebral Palsy:Prematurity-RelatedPremature infants are at increased risk for cerebral palsy.The increased risk comes from the weakness in the white matter of the brain.Two common causes of white matter injury at this stage of life are periventricularleukomalacia (PVL) and intraventricular hemmorage (IVH)Both of these conditions can result from immature brain development.5Causes of Cerebral Palsy:Full-Term InfantsFull-term infants with cerebral palsy are often smaller than average at the time of their birth or have deformities of the central nervous system (CNS) or other body systems.Birth asphyxia can be a cause of cerebral palsy in a full term infant as it can cause severe brain damage at the time of birth.

6Causes of Cerebral Palsy:InfectionInfections are also a known cause of cerebral palsy in both premature and full-term infants.Fetal viruses and other agents of infections such as parasites are an uncommon cause of cerebral palsy.Chorioamnionitis is an intrauterine infection of the mother and is known to be linked with the Cerebral Palsy.7DiagnosisCerebral palsy is diagnosed based on delays in motor development paired with dysfunction in the central nervous system.Cerebral palsy cannot be diagnosed at birth.Severe cerebral palsy is usually diagnosed by age one.Mild cases of cerebral palsy are usually diagnosed by two years of age8Diagnosis:Delayed Motor DevelopmentThe most common cause of motor delay in children is not cerebral palsy.Individuals with motor delays that are related to cerebral palsy tend to have more severe motor delays that are related to signs of upper motor neuron dysfunction.

9Upper Motor Neuron SystemTwo Primary ComponentsPyramidal Tract/Corticospinal PathwaysExtrapyramidal SystemUpper Motor Neuron dysfunction is often characterized by positive and negative signs.

10Persistent Primitive ReflexesPrimitive reflexes are reflexes that are present early in life.Suckling reflex, hand-grasp reflexThese reflexes are controlled by the primitive regions of the nervous systemSpinal cord, lower brain areas, brain stemFor children with cerebral palsy, it is common for primitive reflexes to continue on past infancy.The asymmetrical tonic neck reflex and the tonic labyrinthine response are primitive reflexes that that are helpful in the diagnosis of cerebral palsy.11Persistent Primitive Reflexes Continued

12Persistent Primitive Reflexes Continued

13Involuntary Movements & AtaxiaDyskinesias- atypical, involuntary movementsChorea- rapid, random, jerky movementsAthetosis- slow, writhing movementsDystonia- rigid posturing that is centered in the trunk and neckAtaxia- abnormal voluntary movement when it comes to balance and the spacial position of the limbs and trunk.14Walking and Cerebral PalsyWalkingMaintain upright postureMove forward smoothly with coordinationProtective safety responsesEven those with the mildest forms of cerebral palsy have trouble walking.Scissoring: Increased muscle tone/internal hip rotation.Toe Walking: Tightness of calf muscles and AchillesQuick Fact: Children with better motor skills at a younger age have a better prognosis for walking than those with more underdeveloped skills.15Subtypes of Cerebral PalsySpastic Cerebral PalsySpastic hemiplegiaSpastic diplegiaSpastic quadriplegiaDyskinetic cerebral palsyAthetoid cerebral palsyDystonic cerebral palsyAtaxic cerebral palsyMixed cerebral palsy

16Impairments associated with Cerebral PalsyIntellectual DisabilityVisual ImpairmentsHearing ImpairmentsSpeech and Language DisordersSeizuresFeeding and Growth AbnormalitiesBehavior and Emotional Disorders17Gross Motor Function ClassificationThere are 5 levels of function classification.

Each level is broken into age classification.

Compare and contrast levels 1 and 5.18Helping Children with Cerebral PalsyHabilitationTherapyNeurodevelopmental Therapy (NDT)HippotherapyAquatic TherapyBracing and splintingOrthotic DevicesPositioning DevicesAdaptive EquipmentCrutch, walker, caneWheelchairsCushionsCar seats19Useful Information for TeachersKnow your students!Physical exercise is important and can be modified.Swimming, dancing, horseback ridingBe creative in adaptations!Work with the family and additional resources to best meet the needs of the student as an individual.20Did You know?Most children with CP will live into adulthood, although life expectancy is shorter than the general population.The ability to successful function in society is based more on the cognitive ability than physical ability.Young Adults Study30% lived with parents12.5% lived with a partner32.5% lived alone53% had secondary education36.3% had paid employment

121SummaryCerebral palsy is a disorder resulting from brain damage or dysfunction of the developing brain.There are different types of cerebral palsy that must be taken into account when treating and teaching individuals with the disorder.Physical activity is beneficial in a variety of ways for individuals with cerebral palsy.Contact InformationMelissa Ewerth:ME796843@wcupa.edu

Presentation Link:http://www.youtube.com/watch?v=ICpl0F6AqdE&feature=youtu.be