What Is Cerebral Palsy?
Cerebral palsy (CP) is a group of movement disorders that appear in early childhood and result from brain damage occurring before birth, during birth or shortly afterward. It affects a person's ability to control their muscles, posture and movement. Although it is a lifelong condition, it is not progressive; that is, the damage in the brain does not get worse over time. With appropriate orthotic devices and therapy, mobility, comfort and independence can be supported at any age.
The exact cause often cannot be determined. Known risk factors include premature birth, low birth weight, infections during pregnancy and complications during birth.
Symptoms and Types
The symptoms of CP vary from person to person depending on the severity of the brain damage. Common findings are the following:
- Spasticity: An abnormal increase in muscle tone; the muscles appear stiff and controlled movement becomes difficult. It is the most common finding.
- Paralysis (paresis/paralysis): Classified as monoplegia, hemiplegia, diplegia or quadriplegia depending on the affected area.
- Dyskinesia: Involuntary, uncontrolled, writhing movements (athetosis and dystonia subtypes).
- Ataxia: Difficulty with balance and coordination, a wide-based and unsteady gait.
- Faulty posture and contractures: Problems such as equinus (toe-walking) deformity, scoliosis and hip dislocation.
- Gait disorders, pain and accompanying difficulties such as with learning, vision and hearing.
The most common form is spastic cerebral palsy. Dyskinetic, ataxic and mixed forms may also be seen.
GMFCS: Classifying Mobility
Physicians describe the severity of the condition according to an examination of motor skills and daily mobility. The Gross Motor Function Classification System (GMFCS) is widely used for this purpose and includes five levels: at Level I, the person walks without limitation, while at Level V, even maintaining head and neck posture may be difficult. This classification helps record which movements are possible in daily life.
The Role of Orthotic Devices and Therapy
In cerebral palsy, the aim is to preserve and support joint function and overall mobility. By holding the joints in an appropriate position, orthotic devices can help prevent muscle shortening and contractures. For example, while lower limb orthoses (AFO (ankle-foot orthosis)) support correcting gait, for more complex needs microprocessor-controlled leg orthoses or neurostimulation/functional electrical stimulation (FES) applications targeting spasticity may be considered.
These devices are not used on their own but as part of a multifaceted approach:
- Physiotherapy: Preserves range of motion and develops motor skills.
- Occupational therapy: Supports daily activities such as eating, dressing and washing, as well as fine motor skills.
- Medication and, when necessary, surgery: In managing spasticity and pain, these depend on the physician's decision based on a benefit-risk assessment.
Orthosis selection and all interventions are planned individually for each person in line with the specialist physician's examination, prescription and medical report, with orthotists, physiotherapists and occupational therapists working as a team. Early intervention may be decisive in preserving mobility and independence.
This content is for informational purposes only; you should consult your physician for diagnosis and treatment.
