Exercise and Cerebral palsy: bathing, hygiene, dental care, dressing, feeding, hearing, nutrition, play, seizures, sleep, suctioning techniques, suppositories & enemas, toilet training & bowel issues, and vision care.

“Ask whether your physiotherapist is trained in Bobath. If not, ask her to find out more about Bobath. You can ask your consultant to refer you to the Bobath centre for assessment. Some basic Bobath exercises can be carried out without interfering with your own life too dramatically. For example, while your child is very young you can give her a good stretch at the same time as sitting down watching television. You are likely to have your child on your lap to read stories to her. At the same time you can be holding her in such a way that her posture is being corrected.

In every activity it will be helpful to your child if her posture is taken into account and rectified whether you are walking in the park, playing in the garden, playing in the house or just sitting down in front of the television together. It need not be a chore as, with practice, it becomes second nature to keep your child’s positioning and movements stable. As she grows older your early training will hopefully reap rewards and she will become able to self-correct automatically. If is also essential that you teach anyone who is likely to handle your child for any length of time the correct way to hold her. Otherwise you are likely to become frustrated and feel that only you can be trusted with your child. This will only add to your stress.

The first priority for a child who has CP is to avoid contractures (permanent tightening or slacking of the muscles) which could ultimately cause deformity (bone structure growing incorrectly). The likelihood of contractures increases with the severity of the mobility restriction. The second priority is to enable your child to move as nearly as possible in normal motor patterns. This will give her the greatest opportunity to feel comfortable and confident.

There are a number of publications which can be obtained through Scope which offer advice to parents on physiotherapy in the home.” (The Cerebral Palsy Handbook: p 101)

“As the parent of a child with cerebral palsy, you will want to make sure that your child gets all the exercise he needs. Consequently, if you child is passive and content to lie back and watch the world around him, you may need to impose movement upon him.

For young children with cerebral palsy, one of the best ways to encourage movement is through the roughhouse play that other children instinctively make a part of their regular exercise. The touch and movement input that is so much a part of this type of play is essential to the development of normal tactile (touch) and vestibular (response to movement) systems. Furthermore, your child will enjoy roughhousing, so long as you keep in mind the principles of good handling and pay attention to your child’s body. For example, if throwing your child up in the air makes him stiff as a board, think of another, slower activity, involving some trunk rotation and leg dissociation (separation) to reduce his tone. A good alternative might be the human merry-go-round, in which you hold your child face-to-face with his legs straddling your waist and twirl around. Try to remember that low-tone children generally respond well to fast movements, while high-tone children respond better to a slower pace. Also remember that your child won’t break, so don’t be afraid to handle him.

Ideally, you will be able to make your child’s exercise a part of your daily routine by incorporating it into such activities as diapering, dressing, and feeding. Your child’s occupational and physical therapists can give you specific tips on how to do this, but here are two general guidelines: 1) Place objects far enough away from your child that he needs to reach for them or crawl to them. For example, if you are working a puzzle with your child, don’t simply hand him the pieces. Let him pick them up (or try to pick them up) from the table or tray. 2) Encourage your child to do all the physical activities he is capable of, even if it sometimes seems easier for you to do them. For example, if y our child has the movement skills to put his blocks away in his toy chest but takes a very long time to do it, try not to get impatient and do it for him….

As with many aspects of raising a child with cerebral palsy, much trial and error is involved in finding enjoyable exercises that are right for your child. Like any child, your child will have likes and dislikes when it comes to certain types of exercises. It is important to respect these feelings as much as possible so that your child comes to see exercise as a natural, enjoyable part of life, not a chore. Remember, fresh air and exercise are important for everyone, and if your child values them when he is young, he will likely value them for a lifetime.” (Children with Cerebral Palsy: p. 123-126)

“When the child with cerebral palsy moves she may do so in a very strange or abnormal way. To some extent this should be allowed, as long as the child is able to do things as best she can. But also show the child other ways to move in order to correct some of the abnormal positions that she repeats again and again.”
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	Perhaps the importance of the relationship between play and exercise is even more evident with a child that has cerebral palsy. The passages below explore opportunities to bridge from play to excercise along with other alternatives to guide your child toward greater health.