Dr. Tom Novacheck, of Gillette Children's, describes the characteristics of the 4 types of unilateral, otherwise known as hemiplegic gait, and how the use of clinical instrumented gait analysis can help with treatment decision making.
Dr. Tom Novacheck, Gillette Children's, describes what to look for in each of the 4 different gait patterns seen for those with bilateral cerebral palsy and considerations for each type.
Understanding different gait patterns is important because it can determine what interventions will potentially be the most effective.
Though the initial insult or injury to the brain that causes cerebral palsy is non-progressive, aging with cerebral palsy and lack of physical activity during critical periods of development can impact biologic and metabolic function for adults with cerebral palsy.
There are multiple factors that impact bone health, including birth weight, nutrition, medications for seizures and/or reflux, genetics, and physical activity. Targeted exercise to improve bone health in childhood can be sustained into adulthood, and childhood is the best time to promote bone health.
A person’s gait is dependent on the interaction between the nervous, musculoskeletal, and cardiorespiratory systems and has many influences.
Learn about Ava's journey with gait analysis and surgery at Gillette Children's.
As we all know, becoming a teenager means significant upheaval, not only physically, but in terms of friendships, in terms of learning, and life outlook. This is also true for adolescents with cerebral palsy and other developmental disabilities. We know that whilst we may of spent a lot of time focusing on their physical abilities and other difficulties it is not the only part of their life.
Around the age of six all children are going off to school. Children move from explorative play, which is fairly informal to a much more formal day. That can be a lengthy day and it's quite structured. There are a lot of challenges faced by children with cerebral palsy throughout the school year.
When treating a child with CP, part of a pediatrician’s job is assessing and treating children with abnormal tone difficulties, as well as other muscular-skeletal problems. From around the age of two years, kids start to develop difficulties with muscle tone that can have an impact on their hip development.
Cerebral Palsy affects body movement, muscle control, muscle coordination, muscle tone, reflex, posture and balance. Depending on the part of the brain that is injured depends on how someone’s muscle tone will be effected. For people with spastic CP they have increased muscle tone because of the part of the brain that's injured. If causes very tight muscles which in turn effects the movement of the joints and of the limbs. For others who have dyskinetic CP they lose the ability to have voluntary control over their muscles, and they can have jerky and uncontrolled movement patterns.
Upper limb therapies and interventions have been well studied in cerebral palsy. Different interventions that have good evidence are Constraint Induced Movement Therapy (CIMT) and Bimanual Therapy. CIMT has been shown to be successful in children with hemiplegic cerebral palsy (CP). CIMT uses a splint to physically constrain the uninvolved arm and encourage them to use the more involved or affected arm.