What is Cerebral Palsy?
Cerebral Palsy (CP) is an umbrella term covering a group of non-progressive, but often changing, motor impairment syndromes secondary to an insult to the brain arising in the early stages of development. CP therefore isn't a particular disease or illness. The term simply means a physical condition that affects movement, as a result of an injury to the brain. Every individual with CP will be affected in a different way and have their own their own pattern of movement difficulties and muscle co-ordination problems, which range from multiple and profound to barely detectable.
CP is the most common cause of childhood physical disability with a total of 2-2.5 in every 1000 live born children in the UK developing the condition. It is estimated that 1800 children are diagnosed with CP in Great Britain each year.
The majority of children with CP are born with it, although it is not usually detected until the first 12-18 months of life when they fail to reach accepted developmental milestones or show differences in motor (movement) development.
There are said to be three main types of CP which are as follows:
Spastic
This is the most common form of CP accounting for nearly 80% of all cases. Children with this type of CP will have one or more tight muscle groups which will limit movement and lead to stiff and jerky movements.
Ataxic
This accounts for 5-10% of CP sufferers. It is characterized by decreased muscle tone (traditionally termed "floppy baby") and poor co-ordination of movement which results in the child appearing very unsteady and shaky.
Athetoid or Dyskinetic
Comprising of 10% of CP sufferers, athetoid CP is caused by damage to the basal gangli or cerebellum areas of the brain. This is characterised by the development of involuntary or purposeless movements as the muscle tone changes from floppy to stiff in an uncontrolled manner. Speech may also be hard to understand.
Some children may also have what is known as mixed type CP. These children may have both the tight muscle tone of spastic CP and the involuntary movements of athetoid CP. This is the most common combination although other combinations are possible.
CP is usually characterised clinically by the parts of the body affected:
- Hemiplegia (Hemiparesis)
- Impairment of the arm and leg on one side.
- Diplegia
- Impairment of the legs (usually with some limited movement of the arms).
- Triplegia
- Impairment of three limbs.
- Quadraplegia (tetraplegia)
- All four limbs, in fact the whole body, are functionally compromised.
Case Studies
Bambach understands the problems associated with Cerebral Palsy
- Loss of selective movement and lack of muscle co-ordination
- Difficulty with fine motor skills
- Tremor
- Increased muscle tone and reflexes (spasticity)
- Abnormal muscle tone
- Assymetric gait (walk)
- Decreased co-contraction of muscle groups
- Musculoskeletal problems such as scoliosis, muscle contracture and hip dislocation
The Bambach design and Cerebral Palsy
The Bambach saddle seat was designed by an Australian Occupational Therapist as a result of her observation following years spent working with 'Riding for the Disabled'.
She found that disabled individuals suffering from neurological conditions such as CP often had great difficulty in maintaining a healthy posture and assumed a 'collapsed' or 'slouched' posture when seated in a conventional wheelchair and required considerable support (or strapping) to remain sitting.
These same individuals when sat on horseback were however capable of sitting independently and unsupported and showed remarkably improved functional abilities as a result of being put on a horse on a saddle.
