Context & purpose

In the past 25 years there has been many successes in Cerebral Palsy research and practice: the definition, the assessment and the rehabilitation of cerebral palsy. These developments aim to enhance participation for children with cerebral palsy.  Unfortunately, in parts our continent, many interventions are still impairment based and little attention is placed on enhancing children’s engagement in life in meaningful ways. Our purpose is to encourage Physiotherapists to focus on the most effective strategies that will address the specific functional goals of the children and their families.

Relevance

Questions should be raised about the evidence for the indiscriminate and routine use of these physical modalities: massage, passive movements, static positions, infrared lamps, hot packs etc. Continuing to use outdated treatment recipes does not necessarily enhance the quality of life but reinforces the misconception that addressing the motor or structural impairments will lead to improved function and therefore improved participation.

It is important to be reminded that

The aim of our intervention is to assist the individual interact with his environment, be part of his world and not make him “normal” or fix all his motor impairments.

• We need to understand the ideas promoted by the ICF
• We need relate the use of Physiotherapy modalities to meaningful contexts
• Understanding some basic principles of motor control, motor learning and neuroplasticity in practice are important
• One child with cerebral palsy is that child with cerebral palsy: celebrate variation

Description

The presentation will cover:

• The ICF
• The flipped ICF
• Physiotherapy and theories of motor control
• The framework for the assessment, goal setting, rehabilitation
• Short videos to illustrate the topic

Evaluation

The essence of the concept “participation” is attendance and involvement. How the Physiotherapists’ intervention enhances the life of the child with the use of available outcome measures and evidence-based techniques will be evaluated against the child and family goals.

Conclusion

All rehabilitation interventions for people with cerebral palsy must start with the person or their family desire. Physiotherapists therefore need to work with the person with cerebral palsy and their family for participation, through activities and be mindful of his body structures and body functions.

Physiotherapists need not only keep their eyes on the body structures when applying these prescribed physical or manual modalities but look at what the person needs to be part of his world.

Keywords

Cerebral Palsy, ICF, Physiotherapists

Funding source & acknowledgements

This presentation is not funded by any institution.

Acknowledgements: Donne Descroizilles, Physiotherapist, Cape Town