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Cerebral palsy (CP) is a group of movement disorders that appear in early childhood. Signs and symptoms vary among people and over time, but include poor coordination, stiff muscles, weak muscles, and tremors. There may be problems with sensation, vision, hearing, and speaking. Often, babies with cerebral palsy do not roll over, sit, crawl or walk as early as other children of their age. Other symptoms include seizures and problems with thinking or reasoning, each of which occur in about one-third of people with CP. While symptoms may get more noticeable over the first few years of life, underlying problems do not worsen over time.
Spasticity is a feature of altered skeletal muscle performance with a combination of paralysis, increased tendon reflex activity, and hypertonia. It is also colloquially referred to as an unusual "tightness", stiffness, or "pull" of muscles.
Scope is a disability charity in England and Wales that campaigns to change negative attitudes about disability, provides direct services, and educates the public. The organisation was founded in 1952 by a group of parents and social workers who wanted to ensure that their disabled children had the right to a decent education. Originally focused on cerebral palsy, Scope now embraces all conditions and impairment. Scope subscribes to the social model of disability rather than the medical model of disability – that a person is disabled by the barriers placed in front of them by society, not because of their condition or impairment.
Spastic diplegia is a form of cerebral palsy (CP) that is a chronic neuromuscular condition of hypertonia and spasticity—manifested as an especially high and constant "tightness" or "stiffness"—in the muscles of the lower extremities of the human body, usually those of the legs, hips and pelvis. Doctor William John Little's first recorded encounter with cerebral palsy is reported to have been among children who displayed signs of spastic diplegia.
Diplegia, when used singularly, refers to paralysis affecting symmetrical parts of the body. This is different from hemiplegia which refers to spasticity restricted to one side of the body, paraplegia which refers to paralysis restricted to the legs and hip, and quadriplegia which requires the involvement of all four limbs but not necessarily symmetrical. Diplegia is the most common cause of crippling in children, specifically in children with cerebral palsy. Other causes may be due to injury of the spinal cord. There is no set course of progression for people with diplegia. Symptoms may get worse but the neurological part does not change. The primary parts of the brain that are affected by diplegia are the ventricles, fluid filled compartments in the brain, and the wiring from the center of the brain to the cerebral cortex. There is also usually some degeneration of the cerebral neurons, as well as problems in the upper motor neuron system. The term diplegia can refer to any bodily area, such as the face, arms, or legs.
A selective dorsal rhizotomy (SDR), also known as a rhizotomy, dorsal rhizotomy, or a selective posterior rhizotomy, is a neurosurgical procedure that selectively cut problematic nerve roots of the spinal cord. This procedure has been well-established in the literature as a surgical intervention and is used to relieve negative symptoms of neuromuscular conditions such as spastic diplegia and other forms of spastic cerebral palsy. The specific sensory nerves inducing spasticity are identified using electromyographic (EMG) stimulation and graded on a scale of 1 (mild) to 4. Abnormal nerve responses are isolated and cut, thereby reducing symptoms of spasticity.
Spastic quadriplegia, also known as spastic tetraplegia, is a subset of spastic cerebral palsy that affects all four limbs.
Scissor gait is a form of gait abnormality primarily associated with spastic cerebral palsy. That condition and others like it are associated with an upper motor neuron lesion.
ADAPT – Able Disabled All People Together is an Indian non-profit and non-governmental organization, working to help people with neuro-muscular and developmental disabilities. It was started on 2 October 1972 by Mithu Alur, to provide education and treatment services for the "spastics".
Over time, the approach to cerebral palsy management has shifted away from narrow attempts to fix individual physical problems – such as spasticity in a particular limb – to making such treatments part of a larger goal of maximizing the person's independence and community engagement. Much of childhood therapy is aimed at improving gait and walking. Approximately 60% of people with CP are able to walk independently or with aids at adulthood. However, the evidence base for the effectiveness of intervention programs reflecting the philosophy of independence has not yet caught up: effective interventions for body structures and functions have a strong evidence base, but evidence is lacking for effective interventions targeted toward participation, environment, or personal factors. There is also no good evidence to show that an intervention that is effective at the body-specific level will result in an improvement at the activity level, or vice versa. Although such cross-over benefit might happen, not enough high-quality studies have been done to demonstrate it.
Cerebral Palsy Alliance is an Australian nonprofit organisation helping babies, children, teenagers and adults living with cerebral palsy and other neurological and physical disabilities. Its therapy teams work with individuals and families to maximise their participation in the community.
Upper motor neuron syndrome (UMNS) is the motor control changes that can occur in skeletal muscle after an upper motor neuron lesion.
Spastic cerebral palsy is the type of cerebral palsy characterized by spasticity or high muscle tone often resulting in stiff, jerky movements. Cases of spastic CP are further classified according to the part or parts of the body that are most affected. Such classifications include spastic diplegia, spastic hemiplegia, spastic quadriplegia, and in cases of single limb involvement, spastic monoplegia.
Spastic hemiplegia is a neuromuscular condition of spasticity that results in the muscles on one side of the body being in a constant state of contraction. It is the "one-sided version" of spastic diplegia. It falls under the mobility impairment umbrella of cerebral palsy. About 20–30% of people with cerebral palsy have spastic hemiplegia. Due to brain or nerve damage, the brain is constantly sending action potentials to the neuromuscular junctions on the affected side of the body. Similar to strokes, damage on the left side of the brain affects the right side of the body and damage on the right side of the brain affects the left side of the body. Other side can be effected for lesser extent. The affected side of the body is rigid, weak and has low functional abilities. In most cases, the upper extremity is much more affected than the lower extremity. This could be due to preference of hand usage during early development. If both arms are affected, the condition is referred to as double hemiplegia. Some patients with spastic hemiplegia only experience minor impairments, where in severe cases one side of the body could be completely paralyzed. The severity of spastic hemiplegia is dependent upon the degree of the brain or nerve damage.
Mithu Alur is the founder chairperson of The Spastic Society of India – now rechristened ADAPT – Able Disable All People Together. She is an educator, disability rights activist, researcher, writer and published author on issues concerning people with disability in India.
Spastic Society of Gurgaon covers within its scope the programs on occupational therapy, counseling, vocational training and psychotherapy of the children with autism, cerebral palsy, intellectual disability and multiple disabilities in Haryana, India. It is India's first non-profit disability sector organization which was awarded ISO certification by United Kingdom Accreditation Service: United Registrar of Systems for quality of services rendered by it. It also works in the field of imparting counseling and psychotherapy to the parents and guardians of the disabled children. Mass camps are conducted for welfare of children with disabilities. Multiple single window services like assistance in issuance of disability certificates, NIRAMAYA cashless insurance cards, medical check ups, distribution of medicines and medical aids are rendered to disabled people in such camps. Being sponsored by Haryana Government it undertakes disability audits of organizations for assessing accessibility compliance by them.
scosa was a South Australian organisation providing a range of supports to children and adults with disabilities. Initially it focused on people with cerebral palsy. In August 2019, it was announced that scosa was to merge into Novita.
Isabella Lombardo is an Australian child with spastic quadriplegic cerebral palsy who underwent a selective dorsal rhizotomy procedure at age four and a separate stem cell surgery at age six. Her story was profiled on an episode of 60 Minutes in 2018, and a feature-length documentary film, The Unknown Upside, about her surgeries and subsequent treatments which premiered in March 2019.
Diane Louise Damiano is an American biomedical scientist and physical therapist specializing in physical medicine and rehabilitation approaches in children with cerebral palsy. She is chief of the functional and applied biomechanics section at the National Institutes of Health Clinical Center. Damiano has served as president of the Clinical Gait and Movement Analysis Society and the American Academy for Cerebral Palsy and Developmental Medicine.
Multi-level fibrotomy is a conservative minimally invasive surgical procedure that consists in the exhaustion of the bands and muscle fibers affected by spasticity, in case these are due to difficulties in the physiological movement of a joint.
References
- ↑ Mitsiokapa, EA; Mavrogenis AF; Skouteli H; Vrettos SG; Tzanos G; Kanellopoulos AD; Korres DS; Papagelopoulos PJ. (Apr 2010). "Selective percutaneous myofascial lengthening of the lower extremities in children with spastic cerebral palsy". Clin Podiatr Med Surg. 27 (2): 335–43. doi:10.1016/j.cpm.2009.12.005. PMID 20470962.
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