The Adult with Cerebral Palsy
Section snippets
Spasticity
Botulinum toxin A (BTX-A) continues to have a positive role in adults for relaxing hypertonic muscles for functional gain in the absence of fixed contractures. The toxin can be particularly helpful for individuals with dystonia in relieving painful spasms, improving vertical posture, and controlling unwanted upper extremity motions or tremors that interfere with functional tasks. BTX-A inhibits the release of acetylcholine from the nerve terminal, causing partial paralysis of the muscle lasting
Spine
Scoliosis can be present in up to 60% of adults with CP and is particularly likely in those with nonambulatory status having spastic quadriparesis.25 Progression with aging can occur to approximately 1° per year and should be monitored carefully over time. Decompensation can be accompanied by loss of function, improved somewhat with custom molded seating or postural thoracolumbar orthosis, depending on the individual. Pain, when it occurs, is often associated with thoracolumbar soft tissue
Hip
Hip displacement occurs in approximately 1% of patients with spastic hemiplegia, up to 15% of those with diplegia, and more than 50% of those with quadriplegia.23, 55, 56 It has been shown that children who function at GMFCS level I have almost no chance of hip subluxation57, 58 and those who function at GMFCS levels IV and V have up to a 70% to 90% chance of hip dysplasia. As the GMFCS level increases, the degree of hip abnormality increases and the ability to walk decreases.23 Pain with
Summary
The conditions that have been discussed in this article are not uncommon to the adult with CP and should be anticipated by the specialty medical provider. Other yet-to-be-identified secondary and associated conditions are most certainly present in the adult and require further clinical definition and research. Interventions to the child with CP need to be weighed carefully over the lifetime, with functional outcome variables presenting themselves into the adulthood years. The need to look
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Cited by (29)
Factors associated with walking activity in adults with cerebral palsy
2021, Gait and PostureCitation Excerpt :Cerebral palsy (CP) is a disorder affecting posture and movement resulting from a non-progressive disturbance to the neonatal or fetal brain [1,2].
Cerebral Palsy
2020, Encyclopedia of Infant and Early Childhood DevelopmentMuscle fibre morphology and microarchitecture in cerebral palsy patients obtained by 3D synchrotron X-ray computed tomography
2019, Computers in Biology and MedicineCitation Excerpt :As a secondary response to the brain injury, individuals with cerebral palsy experience various muscular symptoms including muscle weakness [3], impaired muscle growth [4], spasticity [5] and increased passive stiffness [6]. Increased muscle stiffness, also called muscle contractures is, however, the most limiting factor that influences individuals with CP since it hinders normal movement [7]. The mechanisms that lead to the development of contractures are still poorly understood.
Cerebral Palsy
2018, Braddom's Rehabilitation Care: A Clinical HandbookKinematic determinants of anterior knee pain in cerebral palsy: A case-control study
2012, Archives of Physical Medicine and RehabilitationTools for Nutrition Assessment of Adults with Cerebral Palsy: Development of a Gold Standard
2023, Current Nutrition Reports