Scoliosis, pelvic obliquity, and windswept hip deformity are examples of postural abnormalities that can develop in children with cerebral palsy as they become older, even if they may not have any at birth. This could impair respiratory function and impact survival in more extreme situations. Children with cerebral palsy are thought to benefit from postural treatment in terms of their health and quality of life. An overview of the causes and therapeutic congenital hip dislocation treatment of postural deformity in children with cerebral palsy is given in this article.
Understanding Cerebral Palsy
Cerebral palsy (CP) is an umbrella term for illnesses affecting a person’s movement that arise in the developing fetus or infant brain rather than referring to a single condition. Even though children with cerebral palsy typically have normal musculoskeletal status at birth, postural abnormalities can gradually emerge as they grow.
In children with cerebral palsy, postural deformity significantly affects both their mortality and quality of life—lung compression results from severe scoliosis and a malformed chest cage. Patients with cerebral palsy frequently experience respiratory issues, which are a significant cause of death.
Avoid these secondary issues, as they may result in functional decline. The source of the malformations and ways to prevent them have been the subject of numerous investigations, although certain questions remain. This review gives an outline of the causes and clinical congenital hip dislocation treatment for postural abnormalities in children with cerebral palsy.
Posture and Control of Posture
The attitude that the body adopts when it is moving or stationary is known as posture. Postural control refers to the ongoing adjustments to body posture required to carry out functional tasks. Intricate interactions between the musculoskeletal and neural systems produce these adjustments.
Postural control includes maturing postural reactions (righting, protective, and equilibrium reactions), integrating primitive reflexes (asymmetrical tonic neck reflex, symmetrical tonic neck reflex, and tonic labyrinthine reflex), maintaining normal muscle tone and postural tone, and making deliberate voluntary movements. These components necessitate reaching normal developmental milestones.
Positioning’s Objective
To experience and develop more typical ways of moving and to avoid secondary issues, children with cerebral palsy require external postural support in various positions, called placement. It is generally acknowledged as standard practice for the general seating and positioning goals to include the following, as supported by clinical and research evidence:
- Restoring normalcy to tone or lessening its aberrant impact on the body.
- Keeping the skeleton in alignment.
- Preventing or allowing for skeletal abnormalities.
- Supplying a solid foundation to encourage function.
- Encouraging greater tolerance for the intended position.
- Encouraging ease and rest.
- Controlling pressure or stopping pressure sores from forming.
- Reducing weariness.
- Improving the autonomic nervous system’s respiratory, digestive, and cardiac functions.
- Promoting optimal function while minimizing pathology.
- Additionally, proper placement promotes social engagement, kid communication, and eye contact.
The Impact of Cerebral Palsy on Posture
Muscle imbalances and altered muscle tone are the main reasons for poor posture in people with cerebral palsy. Muscle tone can be either high or low or a combination of both. If your tone is too high or too low, it could be difficult to control motions and maintain posture. For instance, it could be challenging to maintain seated equilibrium if you have low trunk muscle tone. As a result, those who have unstable trunks may begin to slant to one side.
In a similar vein, excessive muscle tone can cause the body to adopt strange positions. The longer a person stays in a particular posture, the more likely they are to acquire contractures. Long-term postural disorders may develop due to the body growing acclimated to continuously impaired posture.
Hazards Linked to Bad Posture in People with Cerebral Palsy
Cerebral palsy-related compromised posture can result in a variety of other motor deficits. People with CP who have poor posture management are typically at higher risk for:
- Scoliosis pain
- Breathing issues
- Heart issues
- Unstable balance
- Additional limitations on mobility
- Inequitable growth
- Dislocation or subluxation of the hip
- Unbalances in the musculoskeletal system put undue strain on the bones and joints. Therefore, improper posture management may eventually impair function.
How to Handle Posture Compromise
The main goals of treatment for postural problems in people with cerebral palsy are improving functional capacities and preventing further posture imbalances.
Poor posture can occur at any age if it is not adequately addressed. Although the underlying brain injury that causes cerebral palsy will not worsen, symptoms like altered muscle tone may persist throughout a person’s lifetime.
Among the methods used to control and enhance posture are:
- Control of spasticity- Targeting spasticity may relax the muscles and lessen muscle imbalances because lousy posture is mainly caused by abnormal muscle tone. To address spasticity, people usually take drugs that temporarily lower muscular tone (Botox, baclofen, etc.) and then engage in rigorous physical activity.
- Physical treatment- Increasing functional range of motion, gently stretching tense muscles, and performing exercises that target underutilized muscles are all part of physical therapy. This could enhance posture control and lessen musculoskeletal strain.
- Orthopedics- By stabilizing the spine in an upright position, wearing a trunk brace frequently postpones surgery.
- Adjustments for wheelchairs- Wheelchair seat molds minimize tilting to one side and stabilize the trunk.
- Compression garments- Compression garments could be a good substitute for braces. They also give the body steady pressure, which promotes better circulation and activates the sensory neurons.
- Hippotherapy- Improving posture and stability requires regular core engagement. Hippotherapy is a fun kind of physical rehabilitation that incorporates riding horses. It is a multi-sensory experience that enhances postural control and standing and sitting balance.
- Electrical stimulation that works- Electrode arrays are applied to the skin to promote neural activation through functional electrical stimulation. Research on people with cerebral palsy shows that FES and rehabilitation together enhanced postural alignment more than rehabilitation alone did.
- Surgery- Cerebral Palsy Orthopedic surgery is typically necessary for more severe postural issues. For instance, spinal fusion surgery, which uses metal rods, screws, and hooks to fuse the spine and create better spinal alignment, may be necessary for those with scoliosis.
Conclusion
One motor disability that can have a significant impact on posture is cerebral palsy. Thankfully, We have best pediatric orthopedic doctor in india that have numerous efficient strategies to enhance motor abilities and stop posture deterioration to enhance your quality of life with congenital hip dislocation treatment.
