Treatments & Therapies for Cerebral Palsy: Boy with Severe Motor Disorder Stands for the First Time after Aggressive Swimming Therapy

Award-Winning Michigan Cerebral Palsy Lawyers Helping Children Affected by Cerebral Palsy & Other Birth Injuries | Highest Verdicts & Settlements in Michigan For Over 15 Years – Michigan Lawyers Weekly

A Florida doctor recently developed a swimming program for kids with cerebral palsy and special needs.  Children who have problems walking or who spend most of their time in a wheelchair are able to swim, stretch their muscles in in the warm water and even save themselves from drowning.  The swimming instructor, Dr. Harvey Barnett, says that children with special needs are at an especially high risk of drowning and they are often turned away from swimming programs.

One little boy who is coached by Barnett has experienced what his doctors are calling a miracle.  Chance Kern has a motor disorder and spina bifida, which has left his legs partially paralyzed.  After working in the water with Barnett, Chance is able to glide through the water by kicking his legs, a feat which Chance’s doctors had thought was impossible.  Chance can also turn himself over to float so he can save himself from drowning.

Barnett says that creating the program and getting certified to work with special needs kids wasn’t easy.  It took him years to try and figure out how to best help these very special children, but he says we cannot afford water accidents.  Barnett believes that every child can learn to swim – even children with cerebral palsy who are paralyzed from the waist down.  Barnett’s swimming program has brought renewed confidence to so many children with special needs.  Chance’s mother says that seeing what he can accomplish in the water is helping Chance be stronger outside the water.  Chance has finally started standing on his own and his doctors say this miracle is due to the strength Chance developed from swimming.

NATIONALLY RECOGNIZED MICHIGAN CEREBRAL PALSY LAWYERS HELPING CHILDREN FOR ALMOST 3 DECADES

Michigan cerebral palsy lawyers Jesse Reiter & Rebecca WalshThe award-winning cerebral palsy lawyers at Reiter & Walsh ABC Law Centers have helped hundreds of children affected by hypoxic ischemic encephalopathy and cerebral palsy. Attorney Jesse Reiter, president of ABC Law Centers, has been focusing solely on birth injury cases for over 28 years, and most of his cases involve hypoxic ischemic encephalopathy (HIE) and cerebral palsy.  Partners Jesse Reiter and Rebecca Walsh are currently recognized as two of the best medical malpractice lawyers in America by U.S. News and World Report 2015, which also recognized ABC Law Centers as one of the best medical malpractice law firms in the nation.  The attorneys at ABC Law Centers have won numerous awards for their advocacy of children and are members of the Birth Trauma Litigation Group (BTLG) and the Michigan Association for Justice (MAJ).  In fact, Jesse is one of only 2 attorneys in Michigan to have been elected Chair of the BTLG.

If your child experienced a birth injury such as HIE, seizures, cerebral palsy or any other long-term condition, contact Reiter & Walsh today at 888-419-2229.  Our award-winning Michigan cerebral palsy lawyers are available 24/7 to speak with you.

MICHIGAN CEREBRAL PALSY LAWYERS DISCUSS WHY SWIMMING IS SO BENEFICIAL FOR CHILDREN WITH CEREBRAL PALSY.

Part of a child’s normal development is continually moving her arms and legs and exercising as she learns to roll, crawl, move through sitting positions and walk.  This type of spontaneous exercise is often limited in children with cerebral palsy.  These children may be capable of only a few movements and are relatively inactive compared with other children, limiting their amount of exercise.

Exercise is very important for children who have cerebral palsy.  Lack of exercise and stretching, muscle imbalances, and favoring certain muscle groups over others can cause children to develop painful bone, joint, tendon and muscle problems.  Contractures are a serious problem that children with spastic cerebral palsy often experience.  A contracture is permanent shortening of a muscle or tendon, resulting in loss of normal joint movement.  Contractures produce deformities and can be very painful.

Exercise strengthens muscles, increases flexibility, improves respiratory function and it enhances a child’s gross motor function.  Exercise is also fun, and research shows that it is additionally beneficial for a child’s emotional well-being.

Swimming is especially beneficial for children with cerebral palsy.  Being in the water encourages kids to move their limbs and experience the effects of movement on their body.  Warm water helps stiff muscles relax, and children move a lot more easily in water due to the buoyancy.  The buoyancy of water reduces the effects of gravity, poor balance and poor postural control.  Water reduces the level of impact on a child’s joints, providing a gentler environment for children with unstable joints to do exercise and weight-bear.  Indeed water exercise encourages more equal use of all muscles groups.  In the water, children with cerebral palsy have more freedom and a lot less movement limitations.

Water is an excellent opportunity for children to experience a wide variety of sensory feedback.  Kids with feel the warm water, the sounds and sights of splashing and the movement of their limbs.  Movement of limbs that are not normally active is especially important.

For children with cerebral palsy, perceptual and visuomotor skills improve because water slows down movement and gives the child time to react and appreciate how to use their muscles.

Hydrotherapy pools are generally 33 – 34 degrees Celsius, just a few degrees below body temperature, which is 37 degrees.  Warm water has a relaxing effect and can help decrease muscle tone.  For children with spastic cerebral palsy, 35 degrees is the best pool temperature.  Hydrotherapists assess each child and develop tailor made programs.  Pool temperature, type of exercise, assistive devices and how to get the child in the pool are all important issues related to hydrotherapy.

Hydrotherapy programs are designed to accomplish the following:

  • Increase gross motor coordination
  • Maintain or increase range of movement and flexibility
  • Increase muscle strength
  • Improve balance and posture
  • Improve fitness and endurance
  • Promote breathing control
  • Promote water safety and awareness

WHAT ARE OTHER TREATMENTS FOR CEREBRAL PALSY?

As discussed, it is very important to have regular therapy in order to prevent the many problems caused by cerebral palsy, such as contractures, that can get progressively worse.  Listed below are some of the many treatments recommended for children with cerebral palsy.

Physical Therapy

Physical therapyphysical therapy to help treat cerebral palsy and motor disorders (PT) is one of the most important treatments, and there are numerous types of PT that can be given to a child.  Physical therapy can involve water therapy, electrical stimulation of weakened muscles, and taping of certain muscle groups to help reeducate muscles.  Of course, all types of physical therapy must be used in conjunction with range of motion and stretching exercises.

Physical therapy is aimed at promoting motor and developmental skills.  Daily range of motion exercises are important to prevent or delay contractures and to maintain the mobility of joints and soft tissues. Stretching exercises are performed to increase range of motion.  Progressive resistance exercises should be taught in order to increase strength. The use of age-appropriate play and of adaptive toys and games based on the desired exercises are important in order to make the therapy fun.  Strengthening knee extensor muscles helps to improve crouching and stride length.  Postural and motor control training is important and should follow the developmental sequence of normal children.

Occupational Therapy

Occupational therapy focuses on daily life activities, such as feeding, dressing, toileting, grooming, and transfers.  The goal should be for the child to function as independently as possible with or without the use of adaptive equipment.

Children who can follow directions and have spasticity of certain muscles in the wrist, forearm, or muscles that control the thumb may benefit from intensive therapy.  Activity-based interventions such as modified constraint-induced movement therapy (mCIMT) and bimanual intensive rehabilitation training (IRP) can improve the child’s ability to use the impaired upper limb(s) and improve performance in personal care.

Speech Therapy

Some children with cerebral palsy have involvement of the face and upper airway, causing drooling and difficulty swallowing and speaking.  Speech therapy can be used to help improve swallowing and communication.  Some children benefit from assistive communication devices if they have enough motor control and adequate cognitive skills.

Selective Dorsal Rhizotomy (SDR)

Selective dorsal rhizotomy (SDR) is a fairly new, groundbreaking surgery that is performed on the lower spinal cord to reduce spasticity in the legs.  During the surgery, abnormal nerve fibers are cut.  The goal of SDR is to relax the muscles by identifying and cutting only those nerve fibers that contribute to spasticity.  When it is followed by months of rehabilitation, SDR can improve the child’s ability to move and control her muscles.  This provides long-term improvement in muscle tone because the nerves do not grow back together.  SDR may reduce the need for future orthopedic surgeries.

Medications

Many children with cerebral palsy have seizures.  Treatment is based on the type and frequency of the seizures.  Complete seizure control can often be achieved using one medication, but some children have particularly difficult to control seizures.  Medication can have side effects ranging from sedation to hyperactivity.  The drugs can also affect liver function and white and red blood cells, and it is not uncommon to have bone problems.  Side effects are usually not harmful and resolve when the offending medication is discontinued.  The goal of the physician should be for the child to become seizure free with few or no side effects.

Spastic cerebral palsy is by far the most common type of CP.  Numerous medications can be used to decrease spasticity, facilitate movement, and prevent contractures.  Among the most common medications are dantrolene sodium (Dantrium) and diazepam (Valium).  Diazepam is both a muscle relaxant and a sedative.  Baclofen can be taken by mouth or infused continuously with an implanted pump directly in the cerebrospinal fluid (the liquid that bathes the spinal cord and the brain). Baclofen is a muscle relaxant and it is especially useful for children with spasticity in the lower legs.  A muscle-relaxing agent called botulinum toxin (Botox) can be injected into tight muscles to relax them.  When used prudently, this procedure may prevent surgical intervention.

Tendon Release Procedures

Tendon release surgery allows improved range of motion in some cases. The surgery is usually performed on the muscles of the calf or inner thigh.

Tendon release is a procedure to cut through or disconnect a tendon.  The surgery normally involves cutting the tendon and allowing it to retract towards the junction of the muscle and tendon. The purpose of tendon release is to identify and surgically remove the area producing symptoms, while protecting the normal surrounding tissues and their attachments.

Tendon release is commonly done to relieve tightened or shortened muscles (contractures), allow relaxation of joints, and decrease irritation caused by friction.  Sometimes the tendon is re-routed to maintain muscle function.

A femoral osteotomy (also called a hip osteotomy) is a surgical correction done on many children with subluxation (the ball of the hip slowly pulls out of its position in the socket) and dislocation (the ball is completely out of the socket) of the hips due to cerebral palsy.  The thighbone (femur) is typically cut just below the hip joint and redirected back into place.  Many osteotomy procedures involve implanting a plate and pins to hold and fix the osteotomy.  Usually, children are placed in spica casts for 4-8 weeks after surgery.  A splint or brace may then be used for several months after the surgery.  Bracing and therapy schedules must be adhered to. The expectation is that walking will be improved, and for children that are unable to walk, sitting will be improved.

Hip Surgery: Hip Muscle Releases

The adductors are muscles that pull on the bones and bring them closer to the middle of the body.  They are located on the inside of the thighs.  When adductors are too tight, they make the legs scissor, which can pull the ball of the hip out of the socket.  Muscle releases are an attempt to prevent the hips from dislocating.  In a child who is able to walk, this might be done because the feet cross while walking, which often occurs when a child has spastic cerebral palsy.  This is called a scissor gait.

In hip muscle release surgery, selected muscles of the groin are cut and allowed to retract.  The muscles chosen to be cut depend on the exact problems the child is having, the extent of the spasticity, and if the child can walk or not.  Some surgeons transfer the heads of some muscle groups more toward the rear of the body to help extend the hip.

The hamstrings can be lengthened or cut at the same time as the other muscles are cut.  The hamstrings are the large muscle group located on the backside of the thigh.  The two groups of muscles, one on the inside and one on the outside of the thigh, can become tight and contracted.  Children who sit in a wheelchair all of the time are at risk for developing these contractures.  When contractures occur, the child’s legs may be so tight she will not be able to lie down flat.  These tight muscles can contribute to hip subluxation, hunched posture and poor positioning.  Contractures can also lead to serious spinal problems.

MICHIGAN CEREBRAL PALSY LAWYERS HELPING CHILDREN THROUGHOUT THE NATION FOR ALMOST 3 DECADES

If you are seeking the help of a Michigan cerebral palsy lawyer, it is very important to choose a lawyer and firm that focus solely on birth injury cases.  Reiter & Walsh ABC Law Centers is a national birth injury law firm that has been helping children for almost 3 decades.

Award-Winning Michigan Cerebral Palsy Lawyers - Jesse ReiterJesse Reiter, president of ABC Law Centers, has been focusing solely on birth injury cases for over 28 years, and most of his cases involve hypoxic ischemic encephalopathy (HIE) and cerebral palsy.  Jesse is currently recognized as one of the best medical malpractice lawyers in America by U.S. News and World Report 2015, which also recognized ABC Law Centers as one of the best medical malpractice law firms in the nation.  The Michigan cerebral palsy lawyers at ABC Law Centers have won numerous awards for their advocacy of children and are members of the Birth Trauma Litigation Group (BTLG) and the Michigan Association for Justice (MAJ).

If your child was diagnosed with a birth injury, such as cerebral palsy, a seizure disorder or hypoxic ischemic encephalopathy (HIE), the Michigan cerebral palsy lawyers at ABC Law Centers can help.  We have helped children throughout the country obtain compensation for lifelong treatment, therapy and a secure future, and we give personal attention to each child and family we represent. Our nationally recognized birth injury firm has numerous multi-million dollar verdicts and settlements that attest to our success and no fees are ever paid to our firm until we win your case.  Email or call Reiter & Walsh ABC Law Centers at 888-419-2229 for a free case evaluation.  Our firm’s award-winning Michigan cerebral palsy lawyers are available 24 / 7 to speak with you.

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