treatment of cerebral palsy

1. Treatment
OF CEREBRAL PALSY

2. - No treatment to cure cerebral palsy.
- Brain damage cannot be corrected.
• Crucial for children with CP:
–Early Identification;
–Multidisciplinary Care; and
–Support

3. “The earlier we start,
the more improvement can be made”
-Health worker
I. Nonphysical Therapy

4. A. General management
- Proper nutrition and personal care
B. Pharmacologic
Botox, Intrathecal, Baclofen
- control muscle spasms and seizures,
Glycopyrrolate -control drooling
Pamidronate -may help with osteoporosis.

5. Baclofen
• Delivered directly to
the spinal fluid
• Using a pump
• To avoid brain effects

6. C. Surgery
-To loosen joints,
-Relieve muscle tightness,
- Straightening of different twists or
unusual curvatures of leg muscles
- Improve the ability to sit, stand, and
walk.

7. Selective posterior rhizotomy

8. How it Works
• A major operation, takes approximately four hours
to complete.
• The sensory nerve fibers in the spinal cord,
usually between the bottom of the rib cage and
the top of the hips are divided
• The nerve fibers are then stimulated and the
responses of the leg muscles are observed.
• Those that have an abnormal or excessive
response are severed.
• Those with a normal response are left intact.
• Intensive rehabilitation is required after the
surgery, usually up to six weeks, followed by
physical therapy on an ongoing basis

11. D. Physical Aids
Orthosis, braces and splints
- Keep limbs in correct alignment
- Prevent deformities.
Positioning devices
-Enable better posture
Walkers, special scooters, wheelchairs
- make it easier to move about.

13. E. Special Education
- To meet the child's special needs
- Improve learning.
- Vocational training can help prepare
young adults for jobs

14. F. Rehabilitation Services- Speech
and occupational therapies may
improve the ability to speak, and
perform activities of daily living and to
do some suitable works to have their
own income.

15. G. Family Services
- Professional support helps a patient
and family cope with cerebral palsy.
- Counselors help parents learn how to
modify behaviors.
- Caring for a child with cerebral palsy
can be very stressful.
- Some families find support groups
helpful.
.

16. H. Other Treatment
- Therapeutic electrical stimulation,
- Acupuncture,
- Hyperbaric therapy
- Massage Therapy might help

17. 'The ultimate long-term goal is realistic independence. To
get there we have to have some short-term goals.
Those being a working communication system, education to his potential,
computer skills and, above all, friends'.
- Parent of boy with CP
II. Physical Therapy

18. A.Sitting
- Vertical head control and
control of head and trunk.
B. Standing and walking
- Establish an equal distribution of
weight on each foot, train to use steps
or inclines

19. C. Prone Development
D. Supine Development
o Head control on supine and positions

20. NURSING
RESPONSIBILITIES

21. NURSING RESPONSIBILITIES
A. Functioning as a member of the
health team

22. B. Providing counseling and education
for the parents and promote optimal
family functioning
- Encourage family members to express
anxieties, frustrations and concerns
- Provide emotional support and help with
problem solving as necessary.
- Explore support networks. Refer them to support
organizations

23. C. Promoting physical and psychological
health
- Administer prescribed medications
- Encourage self-care by urging the child to participate
in activities of daily living (ADLs) (e.g. using utensils
and implements that are appropriate for the child’s
age and condition).
- Provide rest periods to foster relaxation. Provide safe
& appropriate toys
- As necessary, seek referrals for corrective lenses
and hearing device to decrease sensory deprivation
related to vision and hearing losses

24. D. Assisting with feeding management
and toilet training
- Promote adequate fluid and nutritional intake.
 Position upright after meals
- During meals, maintain a quiet, unhurried atmosphere
with as few distractions as possible. The child may need
special utensils and a chair with a solid footrest
- Teach him to place food far back in his mouth to facilitate
swallowing.
- Encourage the child to chew food thoroughly, drink
through a straw, and suck on a lollipop between meals to
develop the muscle control needed to minimize drooling.

25. E. Assisting with rehabilitation therapies
(physical, occupational and speech)
- Promote mobility by encouraging the child to
perform age-and condition-appropriate motor
activities
- Inform parents but their child will need considerable
help and patience in accomplishing each new
task.
- Encourage them not to focus solely on the child’s
inability to accomplish certain

26. - Explain the importance of providing positive
feedback.
- Facilitated communication. Talk to the child
deliberately and slowly, using pictures or sign
language to reinforce speech when needed
- Technology such as computer use may help
children with severe articulation problems.

27. F. Providing counseling for educational
and vocational pursuits
G. Preventing child abuse
H. Providing care during hospitalization
- Prepare the child and family for
procedures, treatments, appliances and
surgeries if needed. Assign the child a
room with children in the same age-
group.

28. I. Prevent physical injury by providing the
child with a safe environment, appropriate
toys, and protective gear (helmet, kneepads)
if needed.
J. Prevent physical deformity by ensuring
correct use of prescribed braces and other
devices and by performing ROM exercises.

29. K. Promote a positive self-image in the
child:
- Praise his accomplishments
- Set realistic and attainable goals
- Encourage and appealing physical appearance
- Encourage his involvement with age and
condition appropriate peer group activities.

30. THANK YOU FOR PATIENTLY
LISTENING!!!
"Time and gravity
are enemies of very aging body,
especially mine." - Adult with CP

32. Werner, David. Disabled Village Children: A
guide for community health workers,
rehabilitation workers, and families
http://www.dinf.ne.jp/doc/english/global/davi
d/dwe002/dwe00201.html
http://www.unescap.org/esid/psis/disability/d
ecade/publications/z15005s3/z1500520.htm
ECONOMIC AND SOCIAL COMMISSION FOR
ASIA AND THE PACIFIC
Production and distribution of assistive
devices for people with disabilities:
Supplement3
- Chapter 5&6 -
ST/ESCAP/1774
UNITED NATIONS PUBLICATION
Sales No. E.98.II.F.7
Copyright © United Nations 1997
ISBN: 92-1-119775-9