Cerebral palsy
Cerebral palsy is the name for a group of lifelong conditions that affect movement and co-ordination. It's caused by a problem with the brain that develops before, during or soon after birth. Symptoms of cerebral palsy may not be obvious at birth, but usually become more noticeable in the child’s early life and may include delayed milestones, arms and legs feeling stiff or floppy, clumsy or uncontrolled movements and weakness. For more information visit: https://www.nhs.uk/conditions/cerebral-palsy/
The Physiotherapy service will support children and young people with cerebral palsy and their families in a variety of ways. The therapy intervention we offer is evidence-based and may include:
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Individual or small group sessions for direct therapy. Treatment sessions will be delivered in blocks and be goal-focused.
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Work alongside Hertfordshire Equipment Service (HES) to provide recommendations and provision of equipment.
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CPIP (cerebral palsy hip surveillance) reviews 2-16 years.
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Recommendations for adaptations to the equipment.
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Access to ongoing support via telephone/email.
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Provision and sharing of information, reports and advice.
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Referral to and/or liaison with other professionals and services
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24-hour postural care management.
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Training and support to parents/carers and educational colleagues to enable them to deliver the therapy programme incorporated throughout the day (at home and school)
Children undergoing Selective Dorsal Rhizotomy under the NHS will receive therapy in-line with the NICE guidance for 2 years post-operatively. Children will be discharged on completion of the recommended intervention, following assessment and when no further functional goals are identified. However, all CYP will be invited to an annual CPIP assessment and children/families are able to self-refer via our long-term condition clinic as the need arises. For more information on postural, positioning and use of equipment, including our webinar on understanding postural management, please click here.
Cerebral Palsy Integrated Pathway (CPIP)
CPIP is a follow-up programme for children with cerebral palsy or suspected cerebral palsy, allowing early detection of changes in muscles and joints with the option of earlier treatment for your child. The purpose of CPIP is to ensure that children with a risk of developing contractures or hip dislocation are detected early enabling timely intervention. We will invite all children aged 2-6 years for a 6-month assessment, then annually until they are 16 years old. For further information, please see the attached information leaflet.
As part of the CPIP programme, we share the clinical information with other health professionals involved with your child’s care, including using a national database which other professionals including paediatricians or orthopaedic consultants can access. For further information about data sharing for this purpose, please see the consent form. Your child’s physiotherapist will be happy to discuss this further with you if required.
Physiotherapy advice and exercises
Following your CPIP assessment or review appointment with a physiotherapist, they may recommend certain stretches or exercises in order to improve your strength, walking or gross motor skills. A copy of the exercises can be found here (GMFCS level 1— 3) or here (GMFCS 4 — 5) but please speak to your physiotherapist for any specific instructions.
Your physiotherapy advice may also include using orthotics or splints. If you have questions about your splints you can speak to your physiotherapist, or alternatively contact the orthotics team directly on 01923 470680 (for children in St Albans and Hemel Hempstead) 01442 287883 (for children in Watford) or 01438 286084 (for children in East and North Hertfordshire).
Keeping active is all important for everyone, particularly those with long-term health conditions including cerebral palsy. In addition to any specific exercises recommended by your physiotherapist, participating in activities and sports is a great way to help manage your health. For information on disability sports, inclusive local activities and activity guidelines, please see our Activity Guidelines & Participation in Sports page
