Cerebral Institute of Discovery

Non-Surgical Treatment Options for Cerebral Palsy

This is the list I wish we had been given when our son was diagnosed with cerebral palsy. Why? Because medical care for people with cp, as it must be for anyone with a disability, is fragmented into many specialties: neurology, orthopedics, physiatry, opthamalogy, to name a few. They all have a little piece of the whole puzzle, and it remains the patient's responsibility to put the pieces together. Also, medical technology and research moves forward and it may be difficult for practicing physicians to keep up with all the latest news and techniques. This page lists all the treatment options we've heard of being used for cerebral palsy.

Keep in mind that not all of these treatments are available everywhere, nor will they necessarily be effective. Consult with your doctor(s) and therapist(s), talk to people who have tried the treatment, and do your own research. As always, remember that health care is a commodity like any other in the market--caveat emptor! (Buyer beware!)

Physical therapy: NDT-trained (neurodevelopmental treatment), for gross motor skills. Considered one of the mainstay therapies for cp, it is used to decrease spasticity, strengthen underlying muscles, and teach proper or functional motor patterns. A good PT will also teach the family/care-givers how to help the person with cp to help themselves.
Visit The Neuro-Developmental Treatment Association web site for detailed information on the practices.

Occupational therapy, for fine motor skills and daily living activites. Another mainstay therapy for cp, it is used in much the same way as PT, primarily focusing on the hands and arms. Consult these therapists for feeding techniques and adaptations (self-feeding or otherwise) and for wheelchair driving too.

Speech & language therapy, for spoken and alternative communication. Some speech therapists have additional training as oral motor specialists, and these can help with more serious issues with feeding, breathing, swallowing, and oral sensitivity.
Alicia Courville's Speech Therapy Home Page offers much information on speech and language pathology and related fields.

Feldenkrais, a body awareness methodology for learning how to hold and move the body. An excellent place to start to learn more is The Feldenkrais Guild.

Swimming, preferably in a warmer-than-average pool. Any exercise or movement done in the water will be easier and more effective at exercising muscles. Recreational therapists may be used to teach your child how to swim. For some people with cp, swimming is their only independent mobility.

Horseback riding: hippotherapy, for exercise. Benefits abound in the horse's movement, bonding with an animal, and it's just flat-out fun. Kids who can't walk get a sense of get a sense of what it feels like, and kids with arm movement learn how to take care of these beautiful beasts as well as learn to ride. This one comes highly recommended by just about everyone who's lucky enough to have access to it.

Craniosacral therapy, a method of manipulating the head and lower spine, and thus the cerebrospinal fluid. May make movement easier or more coordinated. Results, if any, are generally seen in about two weeks following the initial treatment.

Also myofacial release, a similar treatment done on "trigger" points throughout the body.

Electrical stimulation: TES, FES, or NMES. All three types use very low levels of electrical current to stimulate the muscles to contract. Electrodes are placed on the skin over the desired muscle group or groups.

-Therapeutic electrical stimulation (TES) is administered at night during sleep. It has been proven to actually add more muscle fiber, but exercise and/or therapy must be used to teach the person what to do with the strengthened muscle tissue. See the Mayatek Inc. homepage, makers of a Therapeutic Electrical Stimulation (TES) device. They also list names and addresses of physical therapists who are trained to set people up with TES. "The TES program, an adjunct to physical therapy, [...] counteracts the disuse muscle atrophy associated with a wide range of neurologic disorders including and especially, cerebral palsy and spina bifida."

Conductive education, (as of 2.23.00, this link is dead) a method of teaching children with motor disorders; it is widely used in Europe. The method was developed 50 years ago in Budapest, Hungary, and teaches motor skills and independence in an educational setting. Conductive educators are therapists who have been specially trained in CE techniques.

See also, MOVE International in the USA and Ability Camp, a "year-round facility that provides five week intensive therapeutic sessions for children with motor disorders."
More conductive education information

Patterning, aka the Dolman-Delcato method, a home-based rehabilitative program that parents and community volunteers implement in the child's home. This controversial method is available only through the Institutes for Human Potential and uses, among other techniques, passive and repetitive movement to teach correct motor patterns.

Botox (botulinum toxin, the one that gives us trichanosis), injections of this toxin in minute amounts effectively "paralyzes" the spastic muscle, giving the underlying "good" muscles a chance to strengthen. A physiatrist usually prescribes and administers botox to specific muscle groups for a specific functional purpose, such as independent walking.

Botox injections are nerve blockers, similar to phenol injections but safer in most applications. Because it is reversible (it wears off in a matter of months), it can be used as a rough predictor of muscle- and tendon-release surgery. It is not considered a long-term fix for orthopedic problems but shows promise as a means to delay or minimize surgery.

Check out Boston University's Neuropharmacology Lab, a site for botulinum toxin research and clinical use, with a journal, bulletin board, and other information.

Hyberbaric Oxygen Therapy, aka HBO, HBOT. Pure oxygen sessions in a pressurized tank. The theory is that it stimulates or restores function to nerve cells that border the area of the brain damage.
A good FAQ about HBO. There is also an excellent, easy-to-read introduction and review paper with lots of links included.

Amino acids, a series of supplements that provide the brain with essential amino acids.

Nutritional Supplements. While some prescription medications (such as Valium and baclofen) are available, these may not be the best choice for spasticity reduction. The addictive qualities of Valium, for instance, as well as the sedating side effects may interfere with movement and walking and thereby increase the chances of a fall, making these drugs undesirable for people who have a lifelong need for anti-spasticity substances.

Clinics and Organizations on the Web

American Academy of Physical Medicine and Rehabilitation
The national medical society representing 5,600 physicians, called physiatrists, who are specialists in the field of physical medicine and rehabilitation.

AACPDM, American Academy for Cerebral Palsy and Developmental Medicine, a research organization.

Cerebral Palsy Web Forum
A web-based bulletin board with subjects on all aspects of CP.

MEDEK

Cerebral Palsy - Hope through Research
A superb overview of cerebral palsy, including history, symptoms, treatments and current research. If you are new to Cerebral Palsy, Start Here.

Cerebral Palsy - A Guide for Care
This is a very informative page containing a synopsis of the material covered in the book of the same title (also see below), published by Johns Hopkins University Press. The material is the result of work done in the Cerebral Palsy Program at The Alfred I. Dupont Institute in Wilmington, Delaware.

NACD, National Academy of Child Development, a home-based rehabilitative program that is tailored to suit the child's and family's specific needs.

Multiple Sclerosis and Spasticity , while centered around MS, this site provides a succinct summary of general anti-spasticity treatments in an FAQ format.

Spasticity Treatments, good explanations of selective posterior (dorsal) rhizotomy, intrathecal baclofen, and therapeutic electrical stimulation by the Beth Israel Medical Center.

Nurses Protection Group - Cerebral Palsy Links
A small page of links to CP resources on the web.

Cascade Prosthetics & Orthotics
Cascade is an excellent, reasonably priced manufacturer of AFOs, DAFOs, and other orthotic equipment. While we are not affiliated in any way with Cascade, we do purchase our son's DAFOs thru them because of the quality and price of their products.

Cerebral Palsy Info Central
One of the most complete cerebral palsy index sites around. Anee also hosts links to epilepsy and visual impairment sites and personal web pages of people with CP.

Cerebral Palsy Association of Western Australia
We sure wish there had been a site like this for our state when we first received our son's diagnosis. If you are from Australia, this site is a comprehensive list of programs and services available to you.

MOVE International

QuackWatch Home Page. Check this page before you get any unusual or fad medical treatment. You may be surprised at what you find.

Researchers

DANIEL B. DRACHMAN
Nerve Muscle Interactions in Health and Disease. Botox research.

Books of Interest

Click on the image or title to read a summary or order the book

	Handling the Young Cerebral Palsied Child at Home by Nancie R. Finnie, Nancy Finnie Our Price: $14.95 Availability: This title usually ships within 4-6 weeks. Please note that titles occasionally go out of print or publishers run out of stock. We will notify you within 2-3 weeks if we have trouble obtaining this title. Paperback 2nd edition (January 1991) New American Library Trade; ISBN: 0452266580 ; Dimensions (in inches): 0.99 x 8.26 x 5.26
	Cerebral Palsy : A Complete Guide for Caregiving by Freeman Miller, Steven J. Bachrach List Price: ~~$18.95~~ Our Price: $15.16 You Save: $3.79 (20%) Availability: Usually ships within 24 hours. Paperback - 488 pages Reprint edition (April 1998) Johns Hopkins Univ Pr; ISBN: 0801859492 ; Dimensions (in inches): 1.28 x 9.91 x 6.99
	Keys to Parenting a Child With Cerebral Palsy by Jane Faulkner Leonard, Margaret E. Myers, Sherri Lynn Cadenhead List Price: ~~$6.95~~ Our Price: $5.56 You Save: $1.39 (20%) Availability: Usually ships within 24 hours. Paperback (September 1997) Barrons Educational Series; ISBN: 0764100912 ; Dimensions (in inches): 0.52 x 8.25 x 5.20
[ No picture ]	Children With Cerebral Palsy : A Parents' Guide by Elaine Geralis (Editor) List Price: ~~$16.95~~ Our Price: $13.56 You Save: $3.39 (20%) Availability: Usually ships within 24 hours. Paperback 2nd edition (September 1998) Woodbine House; ISBN: 0933149824 ; Dimensions (in inches): 1.02 x 8.54 x 5.50
	Mine for Keeps by Jean Little Availability: This title is out of print. Although it is no longer available from the publisher, we'll query our network of used bookstores for you and send an update within one to two weeks. ASIN: 0670859672
	On Being Sarah by Elizabeth Helfman, Lino Saffioti (Illustrator), Judith Mathews (Editor) Our Price: $13.95 Availability: This title usually ships within 2-3 days. Reading level: Ages 9-12 School & Library Binding - 172 pages (October 1992) Albert Whitman & Co; ISBN: 0807560685 ; Dimensions (in inches): 0.71 x 8.34 x 6.32
	Uncommon Voyage: Parenting a Special Needs Child in the World of Alternative Medicine by Laura Shapiro Kramer, Seth Kramer List Price: ~~$14.95~~ Our Price: $11.96 You Save: $2.99 (20%) Availability: Usually ships within 24 hours. Paperback - 224 pages (October 1997) Faber & Faber; ISBN: 0571199283 ; Dimensions (in inches): 0.70 x 9.02 x 6.00
	Caring for Children With Cerebral Palsy: A Team Approach by John P. Dormans (Editor), Louis Pellegrino (Editor) Our Price: $41.95 Availability: On Order; usually ships within 1-2 weeks. Paperback - 496 pages (March 1998) Paul H Brookes Pub Co; ISBN: 155766322X ; Dimensions (in inches): 1.15 x 8.98 x 6.16
	The Cerebral Palsies: Causes, Consequences, and Management by Geoffrey Miller (Editor), Gary D. Clark (Editor) Our Price: $75.00 Hardcover (April 1998) Butterworth-Heinemann Medical; ISBN: 0750699647
[ No picture ]	Orthopaedic Management in Cerebral Palsy (Clinics in Developmental Medicine, No 99/100) by Eugene E. Bleck Our Price: $95.00 Availability: This title usually ships within 4-6 weeks. Please note that titles occasionally go out of print or publishers run out of stock. We will notify you within 2-3 weeks if we have trouble obtaining this title. Hardcover (June 1987) Lippincott Williams & Wilkins Publishers; ISBN: 0521412188

Wednesday, 23-Feb-2000 18:24:31 EST