Cerebral Palsy and Physical Therapy

Fact Checked

Physical therapy is one of the most important forms of treatment for people living with cerebral palsy. Physical therapists help children with cerebral palsy improve mobility, balance, flexibility, and muscle strength. Most doctors recommend their cerebral palsy patients receive regular physical therapy.

Goals of Physical Therapy for Children With Cerebral Palsy

Children diagnosed with cerebral palsy will have varying degrees of muscle control, balance, and mobility, depending upon how severe the disorder is. Physical therapy helps with these issues by assisting children with balance, posture, crawling, climbing, walking, and muscle strengthening exercises.

In addition, physical therapy helps children with cerebral palsy to:

• Overcome physical limitations and obstacles
• Increase independence
• Help expand the range of motion
• Build muscle tone
• Decrease the chances of bone deformity
• Learn about adaptive equipment and how to use them
• Increase fitness, flexibility, balance, and posture
• Reduce physical discomfort and pain

Physical Therapy Benefits

There are several benefits of participating in physical therapy, especially for children with cerebral palsy. The primary benefits include helping children overcome physical limitations that significantly interfere with their daily lives.

According to a published study by the U.S. National Institutes of Health, physical therapy showed “some effectiveness of upper extremity training.” More studies are needed to demonstrate the full outcome of long-term physical therapy.[1]

Another study indicated that although “altering motor prognosis in cerebral palsy remains limited,” scientists continue to study more “intense and complex training strategies” that have the “potential for adaptive neural plasticity and recovery.”[2]

A physical therapist will construct an in-depth treatment plan according to each child’s strengths and weaknesses. Once the treatment plan is developed, children can benefit from their individualized physical plan, which can help with side effects of cerebral palsy that may include:

• Muscle atrophy
• Limited range of motion
• Loss of joint function
• Muscle spasticity
• Pain in muscles and joints
• Joint inflammation
• Rigid muscles

A Typical Physical Therapy Session for Children With Cerebral Palsy

Before any child starts physical therapy, an in-depth medical history and physical examination are carried out. In addition to the physical examination, a licensed physical therapist will conduct numerous other tests to assess muscle control, functions, and mechanics, such as:

• Range of motion
• Physical strength
• Flexibility and balance
• Endurance
• Joint integrity
• Posture
• Sensory integration
• Cognitive functioning
• Reflexes
• Breathing

Afterward, a care plan is created based on the child’s test results. A physical therapist will then set goals for a child’s progress and work with the child to meet those benchmarks. This typically means the therapist and their assistants manipulate a child’s body while completing stretches, strength exercises, or games with specific movements or purposes.

Therapy often includes instructions for exercises, stretches, posturing, and balance to be performed outside the therapy sessions, at home, school, or work.

Where Does Physical Therapy Take Place?

Physical therapy occurs in several settings, including outpatient medical offices or clinics, inpatient rehabilitation centers, specialized physical therapy centers, skilled nursing centers, hospitals, special education classrooms, and the home.

The number of physical therapy sessions is dependent on several factors. The most important of these is prescribed treatment of the child. Additional considerations include adaptive equipment used in treatment and the abilities of a caregiver to provide additional therapy at home. Insurance coverage can also dictate how often a child attends therapy in a clinical setting.

In many cases, a physical therapist will prescribe exercises to be completed at home. The physical therapist or an assistant will train the individual with cerebral palsy, the parent or caregiver, and the primary caregivers on how to properly perform exercises at home.

Physical Therapy Providers

Physical therapy is performed by licensed, accredited physical therapists, or physiotherapists. Physical therapy assistants often assist these professionals. Some practicing physical therapists have doctorate degrees. Some have a master’s degree in physical therapy or kinesiology.

The coursework a potential physical therapist must complete is extensive and includes:

• Biology
• Physics
• Chemistry
• Anatomy
• Physiology
• Kinesiology
• Human growth and development
• Examination
• Therapeutic practices

Physical therapy assistants, who work under the supervision of a physical therapist, typically complete bachelor’s or associate degree programs focusing on the same topics as the physical therapist.

All states require licensure via state board examination to practice, though the requirements to take the exam vary from state to state. Most states require the therapist to complete the National Physical Therapy Examination.

Most states require licensure for physical therapy assistants. Assistants work under the careful guidance of physical therapists. Assistants may also pursue additional certification in specific therapies, such as aquatics, through the American Physical Therapy Association.

Are There Any Risks to Physical Therapy?

Although physical therapists and their assistants are trained to minimize unforeseen circumstances while carrying out treatment plans with patients, there is some risk associated with therapy. Physical therapy is meant to be restorative. A good therapist will not over-work a patient.

If physical therapy is taken too far in a given session, this can cause injury or unnecessary pain, which is not the goal of therapy. The key to minimizing risks and maximizing results is open communication between the child, their caregivers, and physical therapists.

Talk to your child regularly to discover difficult areas of therapy. Don’t be afraid to mention your concerns to the therapist.