Understanding hypertonic cerebral palsy

Cerebral palsy is a catchall term used to describe a wide variety of symptoms originating in the brain. The brain is the information centre of the nervous system, which governs the entire body. Therefore, once it is affected it ultimately impacts a person’s daily life functions.

When a child is diagnosed, please keep in mind that it does not set anything for your child’s future. The diagnosis involves just a general idea of what symptoms may arise. However, there are many factors which have to be taken into account for each individual. For example, even the most minor cerebral palsy can become severe if treated improperly or not at all. As well, a child’s personality has a great impact on his condition. Therefore, one child’s cerebral palsy will differ from another. The prognosis for a child with cerebral palsy will also depend on how early the disorder is detected. The younger the child is, the more likely he will be able to create alternative pathways in his brain. In some cases, with appropriate treatment, the child will be able to walk away from his cerebral palsy completely.

Hypertonic Cerebral Palsy is a condition where all the muscles in the body become tense. A child with this condition will appear “stiff.” Muscle tone is something that is present in every person. However, when a child’s nervous system is affected, it sends abnormal impulses to his muscles. As a result, the muscles contract / become spastic. The condition of a child’s hands and legs (extremities) usually follow the trunk. The trunk is king—or in other words, the center of the body. Once affected, it starts a snowballing effect on the rest of a child’s physique: if a child cannot roll from side to side, the tone in the trunk will increase (i.e. become hyper tone). This leads to increased tone in the hands and legs, which ultimately hinders a child’s daily function.

To reduce or normalize tone, a child has to be taught how to move and function in a proper way. This is learning and not rehabilitating. Rehabilitation involves regaining skills. The child never had these functions in first place—therefore, he is learning. You can compare this with learning how to drive a car. Do you remember the first time you drove? How tense you were, and how much you sweated? A child with cerebral palsy is not excluded from these feelings. The skills which he is learning are acquired skills. They were not given to him during the stages of his development. When a function becomes part of his daily interaction, he will begin to use his body and extremities in the appropriate manner. When learning to crawl for example, a child will start to put weight on his legs and hands. If he is taught to roll, he will begin to develop normal tone in his trunk. As he repeats these actions more and more, this normal, functional weight bearing will allow the tone to normalize. This will enable him to learn and perform a greater range of daily functions and movements.

Whether a child is learning to eat, use the washroom, or dress himself, these functions are necessities for daily living. They are not exercises, but practice for real-life activities. He needs to know how to do these tasks, and that is what we, as therapists, aim to achieve.

By understanding your child’s condition, his learning process and the chain reactions which occur, we will enable him to learn, grow and develop independence in his everyday life.

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