Adapted Equipment for Cerebral Palsy
By: Judlande Guervil

Everyone (whether they realize it or not) is affected by disability. Although the person themselves may not have a disability, they may have a friend or family member with a disability. Disabilities rage from learning disabilities, physical impairments, mental illness, and sensory impairments. As individuals age the odds increase that disability will enter their lives. The Wikipedia defines disability as a condition or function judged to be significantly impaired relative to the usual standard of an individual or their group.

Finding out that a child has cerebral palsy may cause a produce a lot of concerns for parents. Many parents think that because of this disability their child's opportunities for fun and recreation will be forever limited. It is a horrible thing to allow a child with cerebral palsy to be cooped up in a hospital room while his or her friends are playing outdoors. Thanks to many different therapeutic options, children with CP can enjoy the same kind of thrills and adventures that any normal child would enjoy.

Although history lacks written proof, it is said that cerebral palsy has existed from the time women began to give birth. Finally in 1861 a breakthrough happened when Dr. William John Little wrote the first medical description of a crippling disorder which made children's muscles stiff, weak, and prone to twitch. He noted that the children had trouble grasping, crawling, or walking. He termed their condition, "Little's Disease (1)."

In 1897, psychiatrist Sigmund Freud disrupted the conclusion that Dr. Little came up with. Freud stated that because children had other medical problems (mental retardation, seizures, visual impairment, etc), the disorder could begin before birth.

Freud wrote, "Difficult birth, in certain cases, is merely a symptom of deeper effects that influence the development of the fetus" (1).

About 500,000 people in America have some form of CP. Each year 8,000 infants and nearly 1,500 preschool-age children are diagnosed with CP (7). Cerebral palsy is more of a state rather than a condition. Cerebral palsy refers to the brain, and palsy means weakness or lack of muscle control. About 90 percent of all cases are caused by brain injury before labor begins. It is caused by damage to the brain cells which control the movement of muscles. The individual with CP can have mild to severe physical disabilities (1).

At birth the symptoms of Cerebral Palsy aren't noticeable. Previously, it was assumed that it was caused by fetal distress, such as lack of oxygen at birth. Motor deficits are usually unnoticeable before four to six months of age. There are certain factors that can occur during life that can cause cerebral palsy. These factors include viral infections, lead poisoning, or head injuries. The most common type is spastic cerebral palsy. This is a condition, in which there is too much muscle tone. Cerebral palsy is not a progressive condition, which means that it does not progress over time (1). There are other factors that can cause cerebral palsy which include infections, Rh incompatibility, prematurity, birth trauma, and metabolic disorders such as maternal diabetes (8).

There are three major types of cerebral palsy. Some individuals may have more than one symptom. The three types are spastic, athetoid, and ataxic.

Spastic cerebral palsy affects 70 to 80 percent of individuals. Spastic diplegia is when both legs are affected. The child may have difficulty walking because the muscles are tight in the hips and legs, this causes the legs to turn inward and cross at the knees (called scissoring). Spastic hemiplegia is when one side of the body is affected. The most severe is known as spastic quadriplegia, all four limbs and the trunk are affected; this often occurs with muscles controlling the mouth and tongue. Children with spastic quadriplegia often have mental retardation and other problems (2).

Athetoid cerebral palsy affects about ten to 20 percent of individuals with cerebral palsy, which affect the entire body. This condition is characterized by fluctuations in muscle tone and at times with uncontrolled movements. Many children have a difficult time learning how to control their bodies well enough to sit and walk. There can also be difficulties with sucking, swallowing, and speech because the muscles in the face and tongue can be affected (2).

The third type is known as ataxic cerebral palsy, which affects 5 to 10 percent of individuals with cerebral palsy. Individuals with this condition walk with an unsteady gait with feet far apart; they also have difficulty with motions that require precise coordination such as writing (2).

Children with cerebral palsy may develop eating difficulties, bladder and bowel control, breathing problems, and learning disabilities. They have limited use of their arms because of the dysfunction of their neural motor control and stiffness of their joints (1). Baby's or toddler's with cerebral palsy have problems learning to roll over, sit, crawl or walk. When evaluating a child with cerebral palsy doctors check the child's muscle tone. Their muscle tone can appear floppy. For those with increased muscle tone, the muscles may appear stiff. The doctors will check the child's reflexes to determine whether or not the baby has developed a preference for using his right or left hand (3).

There are a team of specialists who helps maximize and coordinate movement, minimize discomfort and pain, and prevent long-term complications. Counseling and behavior therapy are used because the symptoms of cerebral palsy can cause behavioral and emotional problems. Individuals with cerebral palsy can also benefit from drug therapy. This is used to reduce the effects and prevent complications. Other treatments include physical, speech, and occupational therapy (3). Physical therapy helps the child develop stronger muscles such as the legs and trunk. The child is able to work on skills like walking, sitting, and keeping his or her balance. Occupational therapy helps the child develop fine motor skills when it comes to feeding, dressing, writing, and other daily living task. Speech-language pathology helps the child develop communication skills. They can work on speaking skills, which might be difficult because of muscle tone of the throat and tongue (6).

Children with cerebral palsy are not physically able to do the things that a child without cerebral palsy may be able to do. The child will sit, walk, and use their body in a unique kind of way. Household items like dining furniture my not be practical or comfortable for a child with cerebral palsy. Because of modern engineering there are adaptive equipments. That way the child will be able to explore the environment around them and be safe while doing it.

Since children who have cerebral palsy have muscle problems, there is special adaptive equipment that is available for them to help them get around or do everyday activities. The child can use a wheelchair which will allow them to move from one place to another. Although most children with cerebral palsy have no problems using their arms to roll the wheels of their wheelchair, there are wheelchairs that are available that are motorized (5). Some children with cerebral palsy are able to walk but they have poor balance. These types of children would benefit from using a walker. A walker is a piece of equipment usually made out of light metal. Most of the time it will have four legs with a height adjuster (4).

Children with cerebral palsy may have a difficult time using utensils for eating because of their fine motor problems. There are special handles or grips available such as a fork or spoon. They can be curved or bent. For those children who have a difficult time writing, there are pen and pencils with special grips and handles (4).

For children who have a difficult time understanding, or have a difficult time talking with others, there are communication aids available. The communication aids vary from a book or poster that shows what the child might want, or it can even be an alphabet board that the child can use to spell out what they are trying to communicate. There are also computers available that are used as communication aids that will talk to the kids (4). Other adaptive equipment include: car seats, stroller and push chairs, tricycles, gait trainers, toilet chairs, sleeping aids, bathing aids, and swings (5).

Adapted toys can be purchased to help the child manipulate or control play. The One touch Remote Car is a type of car that has one very large remote device. The child only has to hit it once and the car will drive forward; a second hit and the car will drive around in circles. If the child wants to stop the car, all they have to do is lift their hand off the control. Another good toy is Soft Mr. Potatohead. All of the accessories are attached by Velcro. Therefore the child is allowed to place the pieces anywhere on the head and it will stick. This is a good way for the child to play if they are having difficulty with their motor skills and precision. Some children with cerebral palsy find it frustrating if they are unable to take pieces out of a puzzle. There are wooden puzzles available that have extra large knobs to make it easier to get the pieces in and out. This does not only enhance motor skills but it also increases self esteem and confidence (6).

Children with cerebral palsy should definitely exercise. The type of exercises that the child will be able to do will depend on his or her physical limitations. An example is aerobic movement which will help the child keep their heart in good condition, and their weight will also be under control. Yoga is a slow moving exercise that eases stress and improves mobility, flexibility, and muscle tone. Horse back riding is a fun and relaxing way to help the child enjoy the outdoors. "As warm water loosens tight muscles and supports full body weight, many children with CP have more freedom of movement in the water than anywhere (10)." If the child with CP loves water, swimming, kicking, and splashing in a warm pool is a great way to relieve stress and stay in shape. Kicking and throwing a ball is good for the child's coordination and is a sure way to enjoy a few laughs (5).

An alternative to exercise is hippotherapy. Hippotherapy is when horses aid the child in achieving more normal balance and improving posture, movement, and muscle strength. A trained therapist sits behind the child on the horse, should support be needed for the head or any other body part. If the child is able to sit in the saddle without support, the therapist instead walks beside the horse. The child rides the horse for approximately thirty minutes at a time. Researches have found that the rhythmic stride of a horse is much like the gait of the child when he or she walks. The horse's movements give the child the sensation of walking and motion. While doing this the child can easily forget about all the pain and struggles of cerebral palsy. The child can smile, laugh, and feel a sence of freedom and pride (5).

"As researchers continue to explore new treatments for cerebral palsy and to expand our knowledge of brain development. We can expect significant improvements in the care of children with cerebral palsy and many other disorders that strike in early life (9)."

WORKS CITED

1. Chandler, David. Types of and Causes Cerebral Palsy. 2005 August 14. www.childrensdisabilities.info

2. Stanford, Anee. General Information about Cerebral Palsy and Typed of Cerebral Palsy. Accessed 2007 March 20. www.geocities.com/aneecp/cptypes.htm

3. Pellegrino Louis .Cerebral Palsy. Accessed 2007 March 20. www.marchofdimes.com

4. Adapted Equipment for Cerebral Palsy. 2003 October 9. Cerebral Palsy. www.aboutcerebralpalsy.org

5. The Greatest Gift to Your Child is Independence. Accessed 2007 March 22. www.cerebralpalsy.org

6. Miller, F., & Bachrach, S.J. (1998). Cerebral palsy: A complete guide for caregiving. Baltimore, MD: Johns Hopkins University Press. www.press.jhu.edu

7. Geralis, E. (1998). Children with cerebral palsy: A parents' guide (2nd ed.). Bethesda, MD: Woodbine House. www.woodbinehouse.com

8. Stopka Christine. Applied Special Physical Education and Exercise Therapy. University of Florida. P.37

9. "Cerebral Palsy: Hope Through Research," NINDS. Publication date July 2006. http://www.ninds.nih.gov/disorders/cerebral_palsy/detail_cerebral_palsy.htm

10. Children’s Hemiplegia and Stroke Association. “Swimming and hemiplegia” Accessed 2007 March 22. http://www.chasa.org/swimming.htm

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