Physicians typically recommend medical procedures as a way for cerebral palsy (CP) patients to improve their quality of life. While these treatments are very important, there are many additional approaches that can be extremely beneficial.
CP, which manifests as a range of posture and motor impairments, is a common cause of disability in childhood. It is caused by damage to areas within the brain, and often results from an injury that occurred at birth.
People with CP experience a lot of physical limitations, some more severe than others. This can cause them to feel overwhelmed at times due to the challenging nature of everyday life activities. It may be easy for people with CP to feel depressed and apathetic. They may develop learned helplessness and give up on trying to do many daily activities.
Children with CP have multiple symptoms for which there is no curative treatment. Thus, therapies from a variety of sources can provide many benefits.
COMPLEMENTARY AND ALTERNATIVE THERAPIES FOR CEREBRAL PALSY
One of the mainstays of holistic treatment is healthy eating. In this approach, a diet is tailored for the CP patient. The diet emphasizes fresh fruits, vegetables, whole grains and legumes, and discourages processed and sugary foods and soft drinks. A healthy diet can go a long way towards mitigating or reducing symptoms of CP. The advice of an allergist may also help decrease symptoms.
Equine-Assisted Therapy (Hippotherapy)
Therapeutic horseback riding has been used with children who have disabilities for over 60 years. Recently, it has become increasingly popular as a treatment for children with CP. Theoretically, riding a horse can improve posture, balance and overall function by mobilizing the pelvis, lumbar spine, and hip joints, decreasing muscle tone, improving head and trunk postural control, and developing equilibrium reactions in the trunk.
A number of studies have shown benefits from horseback riding in children with CP. Some studies found improvements in specific aspects of the GMFM, such as walking, running and jumping, as well as the total GMFM score. One study found significant improvement in symmetry of muscle activity in muscle groups that had the most asymmetry prior to hippotherapy.
Indeed, there seem to be many positive effects of hippotherapy. In addition, riding a horse is fun and increases social participation in a community activity of the child with CP, a concept supported by the World Health Organization’s view of health. Some research notes that adapted skiing and hydrotherapy also should be engaging, enjoyable, and increase social participation in recreational activities.
In acupuncture, fine needles are inserted into precisely defined, specific points on the body to correct disruptions in harmony, or to restore the normal flow of energy. In theory, it restores internal balance and health.
Acupuncture has been used to treat children with CP for over 20 years, and it has achieved some astonishing success. According to an article in the Journal of Neurology, Neurosurgery and Psychiatry, traditional Chinese medicine is a successful form of treatment for CP. In a test on 33 randomly chosen children with CP, the clinical outcome using the gross motor function measure (GMFM) showed a significant improvement in the motor function of those who had undergone the treatment. Indeed, several controlled and uncontrolled studies show improvements in people with CP.
There are many yoga centers around the world designed especially for handicapped children. Through their exercise and meditation regimens, they claim success in alleviating some of the symptoms of CP. The benefits of yoga include the following:
- Enhancing the natural development of the child through a series of gentle and therapeutic exercises;
- Increasing body awareness, flexibility and strength;
- Reduction of hyperactivity and improvement of concentration by utilization of unique breathing exercises and relaxation techniques.
In addition to conventional occupational and physical therapy, there are other approaches that can make a big difference. These include Rolfing (realignment of neck and head), the Alexander Method (training the body to work more efficiently), and reflexology (a form of massage).
According to Ruth Werner, author of A Massage Therapist’s Guide to Pathology, “As long as sensation is intact and the patient is able to communicate with the therapist in some way, massage is appropriate and potentially very useful for persons with CP, as they work to maintain muscular elasticity and improve motor skills.”
Dr. Kalyani Premkumar is a vocal advocate for the use of massage in caring for CP patients. She points out that the goal of health team therapists is to support the patient, given that there is no cure for CP. Their job is to find ways to reduce stress and spasticity, prevent contractures, improve posture, and improve circulation to the skin and muscles that are not being used. She writes, “Since any form of stress increases the symptom, a relaxing massage helps reduce the spasms and involuntary movements. Passive movements and range-of-motion exercises of joints prevent contractures of muscles.”
She points out that it is important to keep detailed notes on CP clients, “as their spasticity and postural changes can vary from day to day. Keep a meticulous record of physical disability, massage strokes used and duration of treatment for every individual treated, in order to help them maximally.”
Conductive Education was created in the 1940s to help children with motor dysfunction participate and function in society. One of its main goals is to avoid learned helplessness by having students identify new achievable goals. In the program, the “conductor” acts as teacher and therapist. Interventions include promoting independent functioning using repetition and verbalization by the child. The use of adaptive equipment such as splints, walkers and wheelchairs in the classroom is discouraged.
The main theory behind this treatment is that problems with motor skills are problems of learning; new abilities are created out of teaching. Conductive education is implemented in many different ways, making generalizations from a single program difficult. Uncontrolled research trials show benefit in this therapy, but controlled trials have shown mixed results.
Threshold Electrical Stimulation
Several types of electrical stimulation have been used to treat children who have CP. In neuromuscular electrical stimulation, electrical current actually elicits muscular contraction. It may be applied on the top of the skin or through the skin. If a muscle is stimulated when it should be contracting during a functional activity, the stimulation is called functional electrical stimulation (FES). The theory behind functional neuromuscular stimulation is that increased muscle contraction will improve strength and function. The evidence for FES stimulation is somewhat more positive than for TES (discussed below).
In threshold electrical stimulation (TES), the current does not cause visible muscular contraction, and there are no side effects. The theory underlying TES is that the stimulation increases the flow of blood to the muscles, which increases muscle strength and bulk. TES is usually applied at home while the child sleeps.
Some controlled trials show subjective improvements with this type of therapy. One study found an improvement in GMFM score at 1 year, and a recent review of 12 studies noted improvements in muscle function and / or strength.
Inspiration and encouragement
There are many ways to encourage people with CP to lead independent lives, and to overcome the challenges of performing everyday tasks. One way is to invest in occupational therapy, which is a type of therapy that focuses on how to perform everyday responsibilities, such as making a phone call or loading a dishwasher. By providing the tools to actively participate in normal activities of daily living, occupational therapy adds to the person’s concept of self worth.
Another important concept of helping a person with CP to live a positive life is to teach those around them how to interact and engage without treating the person like a disease rather than someone that simply has a physical limitation. It is very important to help those who have daily interactions with person’s inflicted with CP – such as teachers, friends and family members – to discover ways to interact normally and positively. This can include taking someone aside after witnessing an awkward or potentially insulting exchange and explaining that it is important to engage normally, without staring or shouting, and simply treating the person the same way anyone else would be treated.
It always is important to have an awareness of what people are thinking, especially when it comes to those who have a disability that makes physical activity more challenging. Being patient and taking the time to engage in an activity in a way that helps the person with CP learn how to perform the activity is of utmost importance. Providing encouragement and patiently doing activities together can make a huge difference. When people learn how to do activities themselves, it can greatly reduce the person’s feeling of helplessness and apathy. The power of patience and positive encouragement can greatly improve the lives of persons with CP.
It would be very beneficial for practitioners of traditional medicine to be more inclusive in counseling regarding treatment options for persons that have CP. Complementary and alternative therapies should be reviewed and considered, and families and friends need to become active participants in the healing process, encourage peer support, encourage the relationship between the entire health care team and family, encourage the unity between mind, body and spirit, and promote a positive view of life with CP.