No products in the cart.

No products in the cart.

Flaccid Cerebral Palsy: How to Identify and Improve Low Muscle Tone

understanding flaccid cerebral palsy symptom

Low or flaccid muscle tone (hypotonia) is a secondary effect of cerebral palsy that can make it challenging for individuals to perform a variety of movements and everyday functions. While it is much more common for individuals with cerebral palsy to experience high muscle tone than low muscle tone, it is also possible for individuals to experience a mix of both. With a personalized management plan, individuals with cerebral palsy can learn to effectively manage abnormal muscle tone and improve their functional abilities.

To help you understand flaccid muscle tone in individuals with cerebral palsy, this article will discuss:

What Causes Flaccid Muscle Tone in Individuals with Cerebral Palsy?

Cerebral palsy is a motor disability that affects a person’s movements. Our muscles create movement by contracting and relaxing. Individuals with flaccid muscle tone lack muscle tension at rest, which increases their risk of injury and makes it difficult to coordinate movements.

Abnormal (high or low) muscle tone is one of the most common effects of cerebral palsy. It is caused by damage to the areas of the developing brain responsible for regulating movement including the motor cortex, basal ganglia, thalamus, and cerebellum.

Depending on the location of brain damage, individuals may experience a wide range of secondary effects. Low muscle tone is most commonly associated with damage to the cerebellum that results in ataxic cerebral palsy. However, it can occur in individuals with spastic, dyskinetic, and mixed types of cerebral palsy as well.

Most children with flaccid muscle tone due to cerebral palsy will be diagnosed by the time they’re 6 months old. However, milder forms of hypotonia may go unnoticed until the child is older. The following section will discuss the various signs of flaccid muscle tone in individuals with cerebral palsy.

Signs of Flaccid Cerebral Palsy

flaccid cerebral palsy muscle tone

Every case of cerebral palsy is unique. As a result, even individuals with the same type of CP may have completely different signs and symptoms.

Symptoms of flaccid cerebral palsy include:

  • Limp or flaccid limbs
  • Minimal or no neck control (head tilting to the side while sitting or inability to raise head when lying on stomach)
  • Developmental delays
  • Frequent falls and clumsiness
  • Extreme flexibility
  • Slow movements and reflexes
  • A soft or weak voice
  • Feeding difficulties
  • Wide-based stance when walking, sitting, or standing
  • Fatigue

While the brain damage that causes cerebral palsy will not worsen over time, secondary effects such as flaccidity can progress and significantly affect an individual’s quality of life. Therefore, proper management of abnormal muscle tone is essential for long-term functional independence.

Management of Flaccid Cerebral Palsy 

physical therapy for children with cerebral palsy and low muscle tone

Early management of cerebral palsy and its secondary effects is crucial to maximizing your child’s mobility. In fact, many individuals with flaccid muscle tone are capable of building muscle tone and improving their overall mobility through repetitive, task-specific practice.

Improvements in muscle tone and mobility are possible because the brain is capable of utilizing neuroplasticity. Neuroplasticity refers to the central nervous system’s ability to make adaptive changes and reorganize its neural circuitry.

As a result, functions affected by brain damage, such as muscle tone, often have the potential to be rewired to unaffected regions of the brain and improved.  Below, we’ll discuss several therapeutic interventions that can help individuals with flaccid muscle tone improve their functional abilities.

Physical Therapy

Physical therapy for flaccid muscle tone often consists of targeted exercises that build muscle strength and improve coordination. 

Muscle tone refers to the amount of tension a muscle has at rest. In contrast, muscle strength helps you perform movements when the muscles aren’t at rest. By exercising to build strength, individuals with flaccid muscle tone may improve the speed and coordination of their movements.

The more you practice targeted exercises, the better the brain gets at perceiving demand for functions that utilize that muscle. Consequently, the repetitive stimulation will help promote adaptive changes in the brain and help strengthen the new connections. Continuing to practice physical therapy exercises at home can even further promote neuroplasticity and improvements.

Occupational Therapy

Occupational therapy for flaccid muscle tone generally focuses on improving an individual’s functional independence by practicing everyday activities such as eating, grooming, and dressing. Working on functional tasks teaches individuals with cerebral palsy how to be independent at home and promotes active movement.

Depending on the severity of the individual’s hypotonia, an occupational therapist may also teach your child how to use adaptive equipment or recommend positioning devices and strategies to increase functional independence.

Speech Therapy

Flaccidity can affect muscle tone throughout the entire body, including the muscles around the mouth. To manage speaking or feeding difficulties, individuals with hypotonia may benefit from treatments with a speech-language pathologist.

During speech therapy, individuals with flaccidity may practice activities focused on strengthening the oral motor muscles so that they can eat and/or communicate more effectively.

Additionally, those with severe oral motor impairments that are unable to produce speech may learn to use alternative forms of communication such as tablets or voice generators. Speech therapists may also recommend softer diet textures or thickened liquids if needed.

Orthotic Devices

Because children are constantly growing, poor posture caused by flaccid muscle tone in the trunk may affect the way the body develops. This can cause distorted growth, scoliosis, and pain.

Wearing orthotic devices such as braces or casts promotes proper body alignment and form. For example, a trunk brace can help prevent slouching caused by weak core muscles and promote better upright sitting balance. Similarly, if a child has more severe cerebral palsy and needs to use a wheelchair, lateral supports or a contoured backrest may also encourage better posture.

While orthotic devices won’t change flaccid muscle tone, they provide the structural support necessary to reduce injuries and promote proper musculoskeletal alignment.

Caring for a Child with Flaccid Cerebral Palsy

cerebral palsy flaccid tone management

Now that you understand what flaccid muscle tone is and how to manage it, here are some tips to consider when caring for a child with hypotonia:

  1. Before lifting your child, always make sure that one hand is supporting the back of their head to prevent neck injury.
  2. Avoid lifting your child by their arms or legs because children with low muscle tone are more likely to dislocate a joint.
  3. Select clothes that are comfortable, easy to put on, don’t restrict movement, and won’t get caught on nearby objects. 
  4. Encourage your child to perform activities of daily living independently (or as independently as developmentally appropriate) and only assist them when they ask for it to promote active movement and body awareness.
  5. Be patient. Because children with flaccid muscle tone struggle to coordinate their movements, they’ll likely need more time to carry out tasks and activities.

With the right care and enough practice, individuals with hypotonia can learn to significantly improve their mobility and overall quality of life.

Flaccid Cerebral Palsy: Key Points

Flaccid muscle tone can make it challenging for individuals with cerebral palsy to maintain their balance and coordinate movements. With a personalized management program that targets their specific weaknesses, individuals can improve their muscle tone. Additionally, there are effective ways to compensate for low muscle tone such as learning how to use adaptive tools and alternative forms of communication.

We hope this article helped you gain a better understanding of flaccidity in individuals with cerebral palsy and how to manage it.

Keep it going: Don’t leave behind this free ebook with 19 pages of helpful tips for cerebral palsy

illustration of cerebral palsy tips ebook with example pages

Get our free 19-page PDF full of helpful tips for cerebral palsy by signing up below! If you liked this article, you’ll LOVE our free ebook.

When you sign up, you’ll also receive our popular emails that share more tips for life with cerebral palsy — you can opt out anytime.

We will never sell your email address, and we never spam. That we promise.

More Ways to Recover with Flint Rehab:

Free CP Tips Ebook

illustration of cerebral palsy tips ebook with example pages

Discover Award-Winning Neurorehab Tools

You're on a Roll: Read More Popular Articles About Cerebral Palsy

You’re Really on a Roll: Discover a Program for CP That’s Actually Fun to Do!

At Flint Rehab, we understand that doing physical therapy at home can become tedious and repetitive. But when repetition is critical to recovery, it’s important to stick with a repetitive regimen. But that doesn’t mean it has to be boring.

Flint Rehab is the leading manufacturer of motion-sensing, gamified rehabilitation devices. Our bestselling recovery tool, FitMi, transforms full-body rehab exercises into an interactive experience.

See what individuals with CP are saying about FitMi:

“The FitMi and MusicGlove have done wonders for my son with hemiparesis from cerebral palsy and stroke. It motivates him to do his exercises. It does not seem like therapy for him since it is fun. FitMi monitors his progress so it is a great reinforcement for him. Music is a motivator for him. He has been using it on his arm and we will try the leg exercises soon.”


While FitMi is a recovery tool for the full-body, our other device, MusicGlove, helps target the hand to improve fine motor skills and dexterity.

See what others have said about MusicGlove:

“My granddaughter has right-side hemiplegia from Cerebral Palsy / stroke at birth. She states that this is a great product for anyone who has issues with the use of their hand(s), and that is has helped her tremendously. She also finds the music quite catchy (surprisingly!). Our occupational therapist has been impressed as well. I can say that it has arguably been the best tool of all our therapy resources.”


Together, FitMi and MusicGlove make a powerful home therapy regimen for individuals with cerebral palsy. Best of all, you can save money when you bundle them together.

To learn more, click the button below:

ebook cover with the title "Helpful tips for managing cerebral palsy"

Do you have these 19 pages of helpful tips for CP?

Get a free copy of our ebook Helpful Tips for Managing Cerebral Palsy. Click here to get instant access.