Cerebral palsy encompasses a wide range of motor impairments caused by damage to the developing brain. Depending on the severity of that damage, motor impairments can affect various areas of the body. For some, CP only affects one side of the body. This article will focus specifically on right-side cerebral palsy by discussing:
- What Causes Cerebral Palsy That Affects the Right Side?
- Effects of Right-Side Cerebral Palsy
- How to Manage Right-Side Spastic Hemiplegia
What Causes Cerebral Palsy That Affects the Right Side?
When cerebral palsy only affects the right side of the body, it is called right-side spastic hemiplegia.
The brain consists of 2 hemispheres: left and right. The left hemisphere affects movement on the right side of the body and the right hemisphere affects movement on the left side of the body.
Therefore, when motor impairments occur on the right side of the body, it is due to damage on the left hemisphere of the brain, specifically the motor cortex.
While spastic hemiplegia is one of the most common types of cerebral palsy, individuals may experience a wide variety of secondary effects. As a result, even amongst individuals with right-side spastic hemiplegia, everyone experiences cerebral palsy differently.
A common characteristic of this type of cerebral palsy is that individuals often experience more severe motor impairments in the affected upper body than lower body. In the next section, we’ll discuss other potential effects of right-side hemiplegia.
Effects of Right-Side Cerebral Palsy
One major concern regarding right-side spastic hemiplegia is neglecting to use the unaffected side of the body. This is known as developmental disregard.
While it is completely normal to have a dominant side, becoming overly dependent on one side of the body can result in poor bilateral coordination and make everyday tasks much more difficult to perform.
Spastic cerebral palsy is primarily characterized by high muscle tone (spasticity). When only one side of the body experiences spasticity, excess strain on the joints and muscles can affect growth, posture, and overall functional abilities.
Common effects of right-side motor impairments include:
- Stiff movements
- Difficulties performing fine motor skills like writing and using silverware with the affected side
- Abnormal gait (walking pattern)
- Poor posture/ scoliosis due to excess strain on the affected side
- Asymmetric growth
To effectively manage spasticity and its secondary effects, individuals with right-side spastic hemiplegia should seek personalized care. Up next, we’ll discuss management interventions for right-side motor impairments.
How to Manage Right-Side Spastic Hemiplegia
Spasticity is generally referred to as a “reversible type of muscle stiffness” because it often can be temporarily reduced through the use of medications, therapies, and surgeries.
However, in order to permanently reduce spasticity, individuals must stimulate the brain’s ability to reorganize itself (neuroplasticity). Remember, cerebral palsy-related motor impairments are caused by damage to the developing brain. Therefore, by stimulating the brain to make adaptive changes in its neural circuitry, motor functions affected by spasticity may be rewired to healthy areas of the brain.
The brain is always adapting based on your behaviors, so by practicing highly repetitive and task-specific movements with their affected side, individuals with right-side spastic hemiplegia can help promote permanent improvements.
Commonly used management interventions for right-side cerebral palsy include:
Participating in physical therapy is one of the most effective ways to manage right-side motor impairments.
A physical therapist assesses the severity of the individual’s motor impairments and develops a customized exercise regimen to:
- stretch tight muscles
- strengthen underused muscles
- maintain or expand range of motion
- practice new movement patterns
PTs help guide client’s through exercises and make sure that they’re targeting the right muscles.
Constraint-Induced Movement Therapy
To avoid developmental disregard, individuals with right-side spastic hemiplegia must properly continuously practice using their weaker side. Constraint-induced movement therapy focuses on promoting the use of the non-dominant arm by discouraging use of the dominant arm.
Typically, the therapist instructs the individual to wear a glove or mitt on their unaffected hand to discourage its use. Then, the affected arm undergoes intensive training. The goal is to promote neuroplasticity through repetitive stimulation.
Occupational therapy helps individuals with right-side spastic hemiplegia become more independent by practicing activities of daily living like using silverware, getting dressed, and brushing teeth.
Especially because individuals with spastic hemiplegia often experience more severe motor impairments in the affected arm and hand, these tasks help develop precision and coordination.
Occupational therapists can also assess whether individuals may benefit from using adaptive equipment and teach them how to use it to maximize their indpendence.
Medications like baclofen and Botox can help temporarily reduce spasticity. They help block signals that cause muscle contractions.
Depending on the severity of an individual’s motor impairments, different medications may be recommended. For example, the effects of oral baclofen generally last several hours while the effects of Botox can last months. Because medications will not permanently relieve spasticity, it’s crucial to take advantage of the period reduced muscle tone and repetitively practice right-side movements to promote neuroplasticity.
Orthotics like braces, casts, splints, and compression garments help support proper musculoskeletal alignment.
Because CP occurs in early childhood, high muscle tone of the right side of the body can restrict growth or cause body distortions. Wearing orthotics helps provide structural support and subtly stretches spastic muscles.
Surgery is generally only recommended when all other forms of spasticity management prove ineffective.
The most common types of surgeries performed for right-side spastic hemiplegia involve manual lengthening and realignment of the muscles or making incisions at the nerve roots to denervate hyperactive contraction.
Right-Side Cerebral Palsy: Key Points
Right-side motor impairments in individuals with cerebral palsy are the result of damage to the left side of the brain. Fortunately, the brain is capable of making neuroadaptive changes through highly repetitive, task-specific stimulation.
By managing spasticity and consistently training the right side of the body, individuals with right-side spastic hemiplegia can stimulate neural adaptations in the brain and boost their overall mobility.
Image credits: ©iStock.com/wavebreakmedia/yacobchuk/Jovanmandic