There are three different types of cerebral palsy which in short are summarised as follows:
- Spastic cerebral palsy - associated with muscle stiffness and tightness.
- Dyskinetic cerebral palsy - affects body movement due to the muscles being stiff and floppy.
- Ataxic cerebral palsy - causes co-ordination problems and shaky movements.
A person may have multiple types of cerebral palsy. For example, they may have a floppy torso which means they are unable to sit up and also have stiff limbs. This is known as mixed cerebral palsy.
There are many associated and co-existing disorders or difficulties that a person with cerebral palsy may face. The most common is mobility issues. How limited a person’s mobility is depends on the type of cerebral palsy and the severity of the condition.
Body parts can also be affected differently in each case. For example, hemiplegia is where a person may only be affected down one side of the body. Quadriplegia is where all four limbs and usually the whole body are affected. The fine motor skills can also be affected i.e. the hands and fingers, making it difficult to hold a spoon or pen which causes other problems with feeding and writing.
Some people with cerebral palsy are not diagnosed until a few years after birth. It is not until the baby/young child fails to meet milestones, such as being able to crawl, when parents and professionals start to notice warning signs.
My brother has quadriplegic cerebral palsy and one of the first signs we noticed was his poor head control and lack of ability to hold his head up. It then progressed to him not being able to sit up unaided or walk.
It is not just walking that can be limited for someone with cerebral palsy. Associated issues with mobility are wide ranging. For example, not being able to roll over in bed or walking with a limp.
There are many ways to help and manage people with cerebral palsy. Modern laws, technology and medicine have massively benefited those who struggle with mobility (and their carers).
Physiotherapy helps to encourage movement by strengthening the muscles, increasing flexibility and easing the pain. Certain exercises and stretching can improve physical function, and in some cases lead to more mobility. There are various mobility aids that exist such as walking sticks, walking frames, leg braces (called orthoses) and powered wheelchairs to support the legs. Walking sticks help people whose gait is awkward or who lack good balance.
Medications assist in many ways to ease muscle stiffness. This can be through muscle relaxants that are used to reduce muscle spasticity such as baclofen or botulinum toxin injections which are done under general anaesthetic at the hospital and require an intensive physiotherapy program for several weeks thereafter. Relaxing the muscles in a hot tub can ease the spasticity in some cases to some extent.
Surgery is sometimes needed to restore movement in parts of the body. My brother needed hip surgery to prevent it from dislocating due to the strain it was under in its natural position.
Occupational therapy also plays a huge part in facilitating mobility issues as it involves a therapist identifying problems that the person has in relation to carrying out everyday activities such as toileting and dressing. This allows for more independence. This also involves house adaptations such as widening doors for wheelchairs, ramps for access, ceiling hoists, shower chairs and lifts for getting upstairs.
In many countries it is the law for public buildings to be accessible. This has been the case in England & Wales since 1995 and other countries are catching up.