Cerebral Palsy

Question 1

Demographics:

Answer 1

• Incidence 1.5 – 5 per 1000 live births
• Prevalence 2.4 per 1000 children starting school age 6
• M:F - 1.33:1

Question 2

Aetiology - 2 main lesion types

Answer 2

• Periventricular leukomalacia – preterm babies – drugs, alcohol, infection, blood disorders
• Stroke – in term babies – infection, blood coagulation disorders

Question 3

Pathophysiology

Answer 3

Periventricular leukomalacia - White mater around ventricles ends up being soft and starts dying off in patches. The more damaged patches the more dramatic the signs and symptoms

Question 4

Factors for perinatal stroke:

Answer 4

• Drug Abuse
• Infection
• Thrombophilia in mother
• Labour and delivery complications

Question 5

How does PVL affect the development of the motor system?

Answer 5

PVL disrupts the connection between the thalamus and the cortex - causing motor deficits. Evidence that this disruption had a stronger correlation to motor deficits compared to damage to the corticospinal tract.

Question 6

How does perinatal stroke affect the development of the motor system?

Answer 6

• Uni-lateral Lesion causes competitive withdrawal – This is when the non-infarct side compensates for the deficits in the infarcted side.
• Bilateral lesion does not cause competitive withdrawal – because both sides of the brain is damaged.

Question 7

Signs and Symptoms of CP:

Answer 7

• Deficits of motor control
• Excessive Muscle tone – UE flexors and LE Extensors (30% athetoid and 70% spastic)
• Hyperactive reflexes
• Characteristics of movement deficit – (changes in gait all the time) high variability in movement patterns
• Dysarthria
• Low IQ (

Question 8

Conventional therapy of CP:

Answer 8

• • Treat motor symptoms as they appear

- • Treat other comorbidities

Question 9

Role of exercise in CP:

Answer 9

• improvements in walking, jumping, or running
• improvement in psychological variables such as self-perception of physical appearance, athletic competence, and self-worth
• improvement in gait efficiency

Question 10

Exercise for CP:

Answer 10

Short Intervals

Small progressions

Question 11

What are the benefits of Exercise?

Answer 11

• increased participation in individual and community activities
• improved sense of well-being
• increased and maintained heart and lung efficiency
• maintained strength, flexibility, mobility and coordination
• improved and maintained bone structure
• assisted weight control
• reduced risks of chronic disease