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Understanding Spastic CP and How to Manage Its Symptoms

child with spastic cp using walker due to abnormal gait

Spastic CP is the most common type of cerebral palsy, making up about 80% of all cases.

It’s caused by damage to the motor cortex, which is the part of the brain primarily responsible for controlling voluntary movement.

To help you understand what to expect if your child has spastic CP, this article will cover potential symptoms and the best ways to manage them.

Symptoms of Spastic CP

As its name suggests, spastic CP is mostly characterized by spasticity (involuntary muscle contractions).

Spasticity occurs because damage to the brain disrupts the transmission of signals to the muscles.

The sensory and motor fibers within the central nervous system work together to regulate the tightening and relaxing of muscles.

Damage to the brain or spinal cord can disrupt this system and cause muscles to involuntarily contract.

As a result of high muscle tone, individuals with spastic CP may experience a wide variety of symptoms, including:

  • Scissor gait (a walking pattern characterized by knees bent together and feet pointed inwards)
  • Crouch gait (a walking pattern characterized by continuously bent knees, hips, and ankles)
  • Tip-toeing (walking on the balls of the feet with the heels raised)
  • Stiff, exaggerated movements
  • Slow movements
  • Chronic pain
  • Curling of the fingers or toes
  • Chewing, swallowing, or speaking difficulties

Spastic CP doesn’t have to affect the entire body. Depending on the severity of damage to the brain, it might only affect one arm or one side of the body.

In the following section, we’ll review the various types of spastic cerebral palsy.

Types of Spastic CP

diagram showing different types of spastic cp

While spastic CP is the most common type of cerebral palsy, it can be further categorized by which areas of the body are affected.

Generally, the more severe one’s cerebral palsy is, the more areas of the body will be affected.

The 5 types of spastic CP are:

  1. Spastic hemiplegia affects one side of the body
  2. Spastic monoplegia affects one limb (usually an arm)
  3. Spastic diplegia affects both legs (can also mildly affect the arms)
  4. Spastic triplegia affects three limbs (typically both legs and an arm)
  5. Spastic quadriplegia affects all four limbs (can also affect the muscles around the mouth)

While spastic hemiplegia, diplegia, and quadriplegia are prevalent, spastic monoplegia and triplegia are rare.

Regardless, management for any type of spastic CP involves minimizing the impact of spasticity and practicing normal movement patterns.

Now that you understand the symptoms and various types of spastic CP, let’s go over the various ways to manage them.

Methods for Spastic CP Management

To improve motor functions, individuals with spastic CP must promote neuroplasticity.

Neuroplasticity is the brain’s ability to rewire itself. While damaged parts of the brain cannot heal, affected functions can be reassigned to healthy areas of the brain through consistent stimulation.

The more repetitions a person performs, the stronger the neural pathway for that function become.

It is ideal to start management for spastic CP as early as possible because children’s brains have higher levels of plasticity than those of adults. As a result, it is usually easier for children to acquire new skills to replace abnormal movement patterns.

Some of the most effective ways to manage the symptoms of spastic CP include:

1. Physical Therapy

stretching exercises for spastic cp

Physical therapy for spastic CP will focus on improving an individual’s mobility through exercise.

Typically, physical therapy will consist of:

By continuously stimulating the muscles and moving the joints, individuals with spastic CP can expand their range of motion and reduce the excitability of spastic muscles.

2. Occupational Therapy

Occupational therapy involves practicing activities of daily living like brushing one’s teeth or getting dressed to improve overall mobility.

By practicing everyday activities, individuals with spastic CP can develop the skills necessary to optimize their independence.

Generally, occupational therapy activities involve using the hands, which will help individuals improve their fine motor skills.

3. Orthotic Devices

child with cerebral palsy using orthoses to manage spasticity

Orthotic devices like braces, splints, and casts can be extremely helpful for managing spastic CP.

While the brain damage that caused cerebral palsy will not progress, symptoms like spasticity can.

The more severe one’s spasticity becomes, the more difficult it becomes to move. This is why some individuals with cerebral palsy lose the ability to walk as they get older.

Orthotic devices help promote proper form and musculoskeletal alignment. They’ll also mildly stretch spastic muscles and help support underused muscles.

4. Botox

Botox is a nerve blocker that gets directly injected into spastic muscles to relieve high muscle tone.

However, it’s important to understand that Botox is only a temporary spasticity treatment and its effects typically last between 3-6 months.

To promote long-term spasticity relief, individuals should take advantage of the effects of Botox and pursue intensive physical therapy to stimulate neurological adaptations.

5. Muscle Relaxants

Baclofen is a muscle relaxant that helps reduce spasticity by regulating the release of neurotransmitters that cause muscle contractions.

It can be taken orally, by injection, or through a pump. Depending on what type of spastic CP your child has, different forms of Baclofen will be ideal.

For example, Baclofen in pill-form is more ideal for individuals with spastic quadriplegia because it will affect the entire body.

In contrast, individuals with more localized forms of CP like spastic monoplegia will benefit from injections because they allow for more targeted spasticity relief.

Like Botox, the effects of muscle relaxants are temporary and may not be ideal for long-term use. Generally, muscle relaxants do not last very long and will need to be administered more regularly than Botox.

6. Speech Therapy

young girl with spastic cerebral palsy at speech therapy

Individuals with motor impairments around the mouth can benefit from speech therapy.

There, a speech-language pathologist will guide your child through exercises to strengthen their oral motor muscles and improve their ability to eat and speak.

Speech therapy can also help children who are non-verbal learn how to use augmentative and alternative communication devices like communication boards or voice generators to better communicate with others.

7. Surgery

Surgery for spastic CP is generally only recommended if other methods of management prove ineffective.

Similarly, it is often recommended to put off surgery for as long as possible.

The most common surgery for spastic cerebral palsy is selective dorsal rhizotomy. It involves cutting nerve roots at the spinal cord to relieve severely spastic muscles.

Other commonly performed surgeries for spastic CP include muscle and tendon lengthening surgeries and baclofen pump implantation.

Understanding Spastic CP: Key Points

Although spastic CP makes up nearly 80% of all cerebral palsy cases, everyone experiences it differently.

As a result, management for cerebral palsy should be personalized to each individual’s unique symptoms.

While cerebral palsy is a life-long condition, individuals with spastic CP can enhance their mobility because the brain has neuroplasticity. With continuous practice and spasticity management, movement patterns can be improved.

Hopefully, this article helped you better understand what spastic cerebral palsy is and how to manage it. Good luck!

Photos from top to bottom: iStock/sweetmonster/wavebreakmedia/olesiabilkei/KatarzynaBialasiewicz

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