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Non-Surgical Treatment Options for Cerebral Palsy
This is the list we wish
we had been given when our son was diagnosed with cerebral palsy.
Why? Because medical care for people with cp, as it must be for
anyone with a disability, is fragmented into many specialties: neurology,
orthopedics, physiatry, opthamalogy, to name a few. They all have
a little piece of the whole puzzle, and it remains the patient's
responsibility to put the pieces together. Also, medical technology
and research moves forward and it may be difficult for practicing
physicians to keep up with all the latest news and techniques. This
page lists all the treatment options we've heard of being used for
cerebral palsy.
Keep in mind that not all of these treatments are available everywhere,
nor will they necessarily be effective. Consult with your doctor(s)
and therapist(s), talk to people who have tried the treatment, and
do your own research. As always, remember that health care is a
commodity like any other in the market--caveat emptor! (Buyer beware!)
Physical therapy: NDT-trained (neurodevelopmental treatment),
for gross motor skills. Considered one of the mainstay therapies
for cp, it is used to decrease spasticity, strengthen underlying
muscles, and teach proper or functional motor patterns. A good PT
will also teach the family/care-givers how to help the person with
cp to help themselves.
Visit The Neuro-Developmental Treatment Association
web site for detailed information on the practices.
Occupational therapy, for fine motor skills and daily living
activites. Another mainstay therapy for cp, it is used in much the
same way as PT, primarily focusing on the hands and arms. Consult
these therapists for feeding techniques and adaptations (self-feeding
or otherwise) and for wheelchair driving too.
Speech & language therapy, for spoken and alternative
communication. Some speech therapists have additional training as
oral motor specialists, and these can help with more serious issues
with feeding, breathing, swallowing, and oral sensitivity.
Alicia Courville's Speech
Therapy Home Page offers much information on speech and language
pathology and related fields.
Feldenkrais, a body awareness methodology for learning how
to hold and move the body. Excellent places to learn more are The Feldenkrais Guild and Movement
Educators . For more in-depth information on feldenkrais and
its founder, Moshe Feldenkrais, read Learning
How To Learn , by Dennis Leri.
Swimming, preferably in a warmer-than-average pool. Any exercise
or movement done in the water will be easier and more effective
at exercising muscles. Recreational therapists may be used to teach
your child how to swim. For some people with cp, swimming is their
only independent mobility.
Horseback riding:
hippotherapy , for exercise. Benefits abound in the horse's
movement, bonding with an animal, and it's just flat-out fun. Kids
who can't walk get a sense of what it feels like, and kids with
arm movement learn how to take care of these beautiful beasts as
well as learn to ride. It is also a very effective means of stretching
legs, arms, and the back. This one comes highly recommended by just
about everyone who's lucky enough to have access to it.
Craniosacral therapy , a method
of manipulating the head and lower spine, and thus the cerebrospinal
fluid. May make movement easier or more coordinated. Results, if
any, are generally seen in about two weeks following the initial
treatment.
Also myofacial release, a similar treatment done on "trigger" points
throughout the body.
Electrical stimulation: TES, FES, or NMES. All three types
use very low levels of electrical current to stimulate the muscles
to contract. Electrodes are placed on the skin over the desired
muscle group or groups.
-Therapeutic electrical stimulation (TES) is administered
at night during sleep. It has been proven to actually add more muscle
fiber, but exercise and/or therapy must be used to teach the person
what to do with the strengthened muscle tissue. The Beth
Israel site has a good summary of TES.
See also, the Mayatek Inc. homepage , makers of a Therapeutic
Electrical Stimulation (TES) device. They also list names and addresses
of physical therapists who are trained to set people up with TES.
"The TES program, an adjunct to physical therapy, [...] counteracts
the disuse muscle atrophy associated with a wide range of neurologic
disorders including and especially, cerebral palsy and spina bifida."
Conductive education, (as of 2.23.00, this link is dead) a method of teaching
children with motor disorders; it is widely used in Europe. The method
was developed 50 years ago in Budapest, Hungary, and teaches motor
skills and independence in an educational setting. Conductive educators
are therapists who have been specially trained in CE techniques.
See also, MOVE
International in the USA and Ability Camp , a "year-round facility
that provides five week intensive therapeutic sessions for children
with motor disorders."
More conductive
education information
Patterning, aka the Dolman-Delcato method, a home-based
rehabilitative program that parents and community volunteers implement
in the child's home. This controversial method is available only through
the Institutes for Human Potential and uses, among other techniques,
passive and repetitive movement to teach correct motor patterns.
Botox injections (botulinum toxin) in minute amounts effectively
"paralyze" the spastic muscle giving the nonspastic muscles a chance
to strengthen. A physiatrist usually prescribes and administers botox
to specific muscle groups for a specific functional purpose such as
independent walking.
Botox injections are nerve blockers, similar to phenol injections
but safer in most applications. Because it is reversible (it wears
off in a matter of months), it can be used as a rough predictor of
muscle- and tendon-release surgery. It is not considered a long-term
fix for orthopedic problems but shows promise as a means to delay
or minimize surgery.
Check out Boston
University's Neuropharmacology Lab , a site for botulinum toxin
research and clinical use, with a journal, bulletin board, and other
information.
Also see Botox for Spasticity in CP
, a study being conducted at the University of Washington.
Hyberbaric Oxygen Therapy
, aka HBO, HBOT. Pure oxygen sessions in a pressurized tank. The theory
is that it stimulates or restores function to nerve cells that border
the area of the brain damage.
A good FAQ about hyperbaric oxygen
therapy. There is also an excellent, easy-to-read introduction and review paper with lots
of links included. The Oxytherapy
site has good information on oxygen and ozone therapies for a variety
of conditions, not just cerebral palsy.
Nutritional Supplements
may be used to increase health, alleviate symptoms, and augment the
diet.
Clinics and Organizations on the Web
American Academy of Physical Medicine and Rehabilitation
The national medical society representing 5,600 physicians, called
physiatrists, who are specialists in the field of physical medicine
and rehabilitation.
AACPDM
American Academy for Cerebral Palsy and Developmental Medicine,
a research organization.
Cerebral Palsy
Web Forum
A web-based bulletin board with subjects on all aspects of CP.
MEDEK
Cerebral Palsy
- Hope through Research
A superb overview of cerebral palsy, including history, symptoms,
treatments and current research. If you are new to Cerebral Palsy
Cerebral
Palsy - A Guide for Care
This is a very informative page containing a synopsis of the material
covered in the book
of the same title (also see below), published by Johns Hopkins
University Press. The material is the result of work done in the
Cerebral Palsy Program at The Alfred I. Dupont Institute in Wilmington,
Delaware.
NACD
National Academy of Child Development, a home-based rehabilitative
program that is tailored to suit the child's and family's specific
needs.
Cerebral
Palsy Growth Chart Index
The Kennedy Krieger Institute provides height:weight:age ratio growth
charts for boys and girls ages 0-10. Before believing someone else's
opinion of the height or weight of your child, check these charts.
Multiple Sclerosis and Spasticity
While centered around MS, this site provides a succinct summary
of general anti-spasticity treatments in an FAQ format.
Spasticity Treatments
Good explanations of selective posterior (dorsal) rhizotomy, intrathecal
baclofen, and therapeutic electrical stimulation by the Beth Israel
Medical Center.
Nurses
Protection Group - Cerebral Palsy Links
A small page of links to CP resources on the web.
Cascade Prosthetics & Orthotics
Cascade is an excellent, reasonably priced manufacturer of
AFOs, DAFOs, and other orthotic equipment. While we are not affiliated
in any way with Cascade, we do purchase our son's DAFOs thru them
because of the quality and price of their products.
Cerebral Palsy
Info Central
One of the most complete cerebral palsy index sites around. Anee,
the webmistress of this site, who happens to have cerebral palsy,
also hosts links to epilepsy and visual impairment sites and personal
web pages of people with CP.
MOVE International
QuackWatch Home Page
Check this page before you get any unusual or fad medical treatment.
You may be surprised at what you find.
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