Physical Therapy for Cerebral Palsy

If you or a loved one has cerebral palsy (CP), then you understand the functional limitations and impairments that may come with the condition. You may have difficulty with walking, standing, or moving around in bed. Sometimes weakness or muscular spasms may cause difficulty with basic tasks.

Many people with CP benefit from working with a physical therapist. Physical therapy can help improve strength and coordination, decrease and manage spasms, and improve safe functional mobility.

So what does physical therapy for CP entail, and how does a physical therapist help improve function for someone with CP?

What Is Cerebral Palsy?

Cerebral palsy is a blanket term for a collection of neurological signs and symptoms that occur as a result of damage to the brain during gestation, birth, or within the first few years after birth. "Cerebral" refers to the brain's cerebrum, and "palsy" refers to paralysis of voluntary movement.

Impairments associated with cerebral palsy may vary in intensity and severity, and they often affect people differently. The condition often causes various functional impairments, including:

• Difficulty maintaining posture
• Difficulty with walking and gait
• Changes in muscle tone
• Impaired coordination

CP may also cause other problems not related to movement. These may include difficulty with vision, hearing, speaking, managing bowel and bladder function, and learning.

The motor impairments commonly seen with CP can change over time; things may slowly worsen or get better. The role of physical therapy in the management of CP is to ensure that you attain and maintain appropriate functional mobility so you can engage in the activities you want to do.

Physical Therapy Across the Continuum

People with CP often work closely with many healthcare professionals to manage their condition. You may work with physical therapists, occupational therapists, speech therapists, nurses, social workers, and physicians to ensure you get the best care for your condition.

Your physical therapist will often communicate with these professionals during your treatment, and many times various therapists will work together in a co-treatment model to provide the best care.

Your symptoms and impairments from CP may change over time, and you may have different needs as you grow older. As you age and manage your CP, you may work with different physical therapists who specialize in various treatment areas.

Therapists may be wheelchair or assistive device experts who can help you move around better. Other physical therapists may specialize in school-based needs, ensuring you have appropriate access to educational opportunities.

Some therapists are orthotic experts who can use their skills to provide bracing and orthotics to ensure you are positioned properly during functional tasks.

Physical Therapy for Cerebral Palsy

When meeting a physical therapist for treatment for CP, the first session will be an initial evaluation. During this session, the therapist will gather information about your condition. They will ask about your diagnosis, symptoms, and the care and treatments you have received thus far.

The physical therapist will review your medical history in general and ask questions about your current functional status and goals. The main goal of physical therapy for CP is to help improve functional mobility and prevent problems with movement, such as joint dislocations or contractures.

Your physical therapist should offer strategies that improve your self-reliance and your ability to interact independently in your community and environment.

Physical Therapy in the Home

Home physical therapy for CP is often centered around the needs of the patient in the home. Are there stairs to negotiate? How are you able to move in bed? Can you get to the kitchen table for meals, or do you need assistance?

If your child has CP, most therapy begins in the home setting, and specialized exercises and movements will ensure proper development and functional mobility. Your child's physical therapist will teach you strategies and exercises that you can do with your child.

The benefits of home therapy for CP may include:

• Increased safety in the home
• Improved strength
• Decreased spasm
• Improved balance
• Improved flexibility
• Improved gait and walking

A physical therapist who comes to your home can assess your living situation and make recommendations that improve your (or your child's) ability to move in your home environment independently.

School-Based Physical Therapy

When your child is in school, they should have access to all of the educational resources that are available to everyone; CP should not be a barrier to learning. A school-based physical therapist may work with your child when they are in school.

The goal of school physical therapy is to ensure that your child can participate as fully as possible in all educational programming.

Some physical therapy sessions for your child in school will be "pull-out." This means that your child will leave their normal learning environment and work in the therapy room with the physical therapist. Other times, the school physical therapist may "push-in," meaning they will work with your child in their typical classroom environment.

Most children who receive physical therapy (or other rehab services) in school have an individualized education plan (IEP). The IEP is a roadmap for your child's education, and it will set specific goals and timeframes for your child's progress while in school.

Your child's physical therapist should meet regularly with you and other care team members to assess progress and make changes as the needs of your child change.

Outpatient Physical Therapy

Some people with CP benefit from working with a physical therapist in an outpatient clinic. There, your therapist can provide specialized treatments to help improve mobility, decrease pain, and improve strength and endurance.

Treatments that may be used in the outpatient clinic include:

• Heat
• Ice
• Taping techniques
• Splinting for hands, arms, or legs
• Strengthening exercises
• Stretching exercises
• Exercises to improve endurance
• Postural control exercises
• Balance and coordination exercises

The goal of outpatient physical therapy for CP is the same as in other settings—to help you improve mobility, decrease pain and muscle spasm, and prevent worsening of the impairments that limit your function. Interventions should be chosen that address your specific impairments and help meet your specific goals.

How Long Should PT Last?

CP is a neurological disease process, and often the outcomes associated with it are varied. Some people with CP experience progressively worsening mobility, and others can maintain independent functioning with the help of rehab professionals.

Most people with CP have several different episodes of care with physical therapists, depending on their current life situation:

• You can expect home physical therapy for a child to be ongoing for several months or years, addressing your child's needs as they develop.
• School-based physical therapy episodes of care will also last for several months, as long as the services are meeting the needs of the child (and reaching the goals set forth in the IEP).
• Outpatient physical therapy episodes of care for CP typically last for six to eight weeks.

A Word From Verywell

If you have CP, you may experience various symptoms that prevent you from moving effectively and enjoying independent mobility. Working with a physical therapist may be beneficial to helping you improve mobility, decrease spasm, and improve strength and function.

Your therapist can give you (and your family) strategies to ensure you are able to enjoy maximum functional mobility with minimal barriers.