Post on 26-Jan-2017
CEREBRAL PALSY, STROKE, AND TRAUMATIC BRAIN INJURY
Chapter 14
INTRODUCTION Cerebral Palsy, Stroke, and Traumatic
Brain Injury Different causes, similar results: brain
damage Still encouraged to participate in
physical activity
CEREBRAL PALSY Refers to a group of permanent disabling
symptoms resulting from damage to the motor control areas of the brain
Nonprogressive Originates before, during, or shortly after birth Symptoms vary widely, ranging from severe to
mild Other impairments and secondary medical
complications
CAUSES OF CP Pre-natal, Natal, and Post-natal causes Rubella, Rh incompatibility,
prematurity, birth trauma, anoxia, meningitis, poisoning, brain hemorrhages or tumors, and other forms of brain injury
Results from causal pathways rather than any single factor
INCIDENCE Estimated 800,000 children and adults
in the US with CP Only about 10% of those cases are
acquired The number of new cases has
increased by 25% over the last decade 8,000 babies and infants diagnosed
each year 1,200 to 1,500 preschool aged
CLASSIFICATIONS The degree and location of the brain
damage affects the symptoms that are displayed
Because of the variety of symptoms, classification systems have been put in place.1. Topographical2. Neuromotor3. Functional
TOPOGRAPHICAL Based on the body segments affected Typically used by the medical community Classes include:
Monoplegia Diplegia Hemiplegia Paraplegia Triplegia Quadriplegia
NEUROMOTOR American Academy
for CP and Developmental Medicine
Three main types1. Spasticity2. Athetosis3. Ataxia
Characteristics are not distinct
NEUROMOTOR: SPASTICITY Results from damage to motor areas of
the cerebrum Characterized by increased muscle
tone Strong exaggerated muscle
contractions are common Associated with hyperactive stretch
reflex
NEUROMOTOR: ATHETOSIS Caused by damage to the basal ganglia Results in an overflow of motor
impulses to the muscles Also known as dyskinetic CP Muscle tone fluctuates, especially in
muscles that control the head and neck.
Lordotic standing posture Aphasia and articulation difficulties
NEUROMOTOR: ATAXIA Caused by damage to the cerebellum Hypotonicity Usually not diagnosed until child
attempts to walk Wide-based gait is typical Nystagmus is also commonly observed
FUNCTIONAL Used in the field of education Based on ability due to the severity of
the disability Important implications for physical
education and sport
Class
Description
I Severe spasticity or with poor functional range of motion and strength in all extremities
II Severe to moderate spastic or athetoid quadriplegic; poor functional strength in all extremities, and poor trunk control
III Moderate quadriplegic or triplegic; severe hemiplegia; fair to normal strength in one upper extremity
IV Moderate to severe diplegic; good functional strength and minimal control problems in upper extremities and torso
V Moderate to severe diplegic or hemiplegic; moderate to severe involvement in one or both legs; good functional strength; good balance when assistive devices are used
VI Moderate to severe quadriplegic; fluctuating muscle tone producing involuntary movements in trunk and both sets of extremities;
VII Moderate to minimal spastic hemiplegic; good functional ability on nonaffected side
VIII Minimal hemiplegic, monoplegic, diplegic, or quadriplegic; might have minimal coordination problems; good balance
GENERAL EDUCATIONAL CONSIDERATIONS
CP is not a disease. It is not to be treated but managed.
Manage both motor and associated disabilities
In some cases surgery can be done There has been some advanced research
in the use of stem cells Physical therapy is common, especially in
younger patients with CP
FIVE AIMS WHEN WORKING WITH PEOPLE WITH CP
1. Reducing musculoskeletal impairments to improve function and quality of life
2. Enabling children to function optimally given their existing impairments
3. Preventing or limiting development of secondary implications
4. Altering the natural course of the disorder5. Promoting wellness and fitness over the life span
Attention must also be given to the psychological and social development of people with CP.