Helping Children with Cerebral Palsy To Become More Physically Fit
The symptoms of cerebral palsy (CP) affect children differently, so they face some unique challenges to becoming physically fit. Cerebral palsy is a disorder which occurs before or at birth where the brain is damaged. The symptoms include poor coordination and motor skills, and musculature impairment. Children with cerebral palsy sometimes experience learning and speech difficulties.
Physical exercise, however, provides many benefits such as:
- Managing weight
- Increased bone health
- Increased mobility
- Improving muscle tone and strength
- Promotion of control over spasticity and range of motion
- Reducing the risk of cardiovascular and metabolic disease and other chronic conditions
Experts recommend that people with cerebral palsy begin with regular, short periods of moderate-intensity exercise. People with cerebral palsy tire more quickly during tasks than the non-disabled people, so relaxation breaks and stretching sessions can help to prevent fatigue. Here are some tips to help children with cerebral palsy achieve more range of motion and endurance.
Give the children unstructured playtime
Children with CP often lead very structured lives because of therapy and other medical appointments. They have little down time. They need time to let loose and play on their own terms.
Discourage the w-sitting position
Stacy M. Menz, a pediatric therapist, has observed that children with CP tend to position themselves in a “w-sitting” position. Sitting this way is is potentially harmful. Many children with CP sit on their bottoms with their knees bent and their legs spread out in a “w” position because it provides them with some stability, but this position takes a toll on their muscle development.
Some pediatric therapists say that is w-sitting is harmful because this position:
- Shortens muscles, impacting the children's ability to balance, and their motor skills and coordination
- Hinders their ability to rotate their trunk and develop trunk strength – w-sitting doesn’t require much trunk coordination
- Encourages hamstring tightness
- Causes hip and femur alignment problems
- Creates poor posture
- Hinders the development of balancing skills because the child doesn’t need to work his muscles in order to sit up straight
Ways to encourage children not to sit in the w-sitting position:
- If a child seems to be going into a w-sitting position, tell them to change their legs to another way
- Encourage the child to sit cross-legged, on one side, or with legs stretched out to the front
- Remind children to change their position and praise them when they do
- If the child is on one side, tell them to change sides – this builds bilateral coordination and the use of their hands to support themselves
- use a couch or small table and chair when playing on the floor
- If the child cannot sit, talk to a pediatric therapist about alternatives
Stretch children’s joints
Children with CP have difficulty holding onto a range of motion in the various joints in the body. Growth spurts will cause the muscles to become a little tighter, whether they have high tone or low tone. A reduction in their range of motion will impact their ability to move and do everyday tasks.
Pediatric therapists recommend starting to stretch muscles from an early age and to make a habit of stretching and moving the body into a various positions. Hot packs can help the muscles to be more flexible. Children with CP can benefit from intense pediatric therapy programs to stretch, build muscle strength, and increase flexibility, balance, and endurance.
Work on muscle tone and strength
Strength and tone are different characteristics. Many children with CP have altered muscle tone that can be low tone, high tone, or mixed tone, which combines the two. The weakness in low tone muscles are easier to spot and strengthen through therapy.
High tone is more difficult to address because the muscles tend to be “turned on” and stiffer. Strengthening may seem counterproductive but is necessary. Under the high tone are weak muscles that need to be strengthened. Strength exercises can help children control and regulate their muscle tone. Overall, strengthening muscles provides kids with CP increase their function.
Give kids a therapy vacation
Children with CP need a break from the physical activity. It gives their bodies and minds a chance to merge the new skills that they have been practicing. Children need time to rest and recover. Once they have had a break, they will move up to the next level of the skills they have been practicing.
Promote independence and self-reliance
Many children with CP are dependent on their parents, caregivers and health care aides for interaction and mobility. This situation could foster dependence on others.
Here are some ways to promote independence.
- Encourage them to explore their environment
- Promote communication and interaction with peers
- Encourage self-reliance
- Teach self-directed behavior so that the children are not dependent on parents for step by step instructions
- Provide opportunities for them to enhance their cognitive skills
- Provide mobility or assistive devices while encouraging them to improve their mobility
- Allow children to do tasks independently such as feeding even if they make a mess, self-feeding will given them a sense of accomplishment
Provide a variety of physical activities
Mix harder and easier physical tasks. Children with CP need more time to master simple tasks such as eating a meal or walking. These tasks do become easier with time. Easier tasks in between harder tasks give children a break and lower their frustration levels.
Use video game play that promotes fitness
When children with cerebral palsy spend too much time in front of video games may be at risk of gaining weight or developing muscularoskeletal disorders or diabetes. Some video games, however, do encourage moderate to physical activity in children with CP. Some games that require physical body movements may not be vigorous enough to promote strength or build endurance, but they do encourage repetititive movements and and are enjoyable. Video games can provide a fun way to supplement a therapy plan.
Find ways to be physically active
Children should be active every day. Activity can be unstructured such as a visit to a park, games at home, or community programs. Parents can find ways to help their kids with CP be more physically active and have fun. Many sports can be adapted to the needs of children with CP. Aquatic activities, especially in warm water, can help relax muscles while improving muscle tone. Inner tubes, rafts, and toys can encourage children with CP to become more active.
9 best things to do for a kid with cerebral palsy (that don't feel like work), Love That Max, Stacy M. Menz
W-sitting and Your Child's Growth, North Shore Pediatric Therapy, Marissa Edwards
Kids with Cerebral Palsy May Benefit from Video Game Play, AlphaGalileo