Cerebral Palsy

Scholarly Paper Assignment

Pediatric Health Challenges:
Cerebral Palsy
Mark Kevin D. Sadiamona
N01036081

NURS209
Paul Jeffrey
November 19, 2015

Cerebral Palsy

Cerebral Palsy is a well-recognized neurodevelopmental condition beginning in early

childhood and persisting through the lifespan (Dev Med Child Neuro, 2006). Brain disorders like
Cerebral Palsy are a big issue and will continue to get bigger. It is one of the most common
congenital disorder of childhood and almost 700,000 children across United States and Canada
suffer from this condition (kidshealth.org). Most of the individuals with Cerebral Palsy often
require lifelong treatment and care. It is a disorder that affects muscle tone, movement, and
motor skills (Potter & Perry, 2014). This brain disorder also can lead to other health issues
including vision, hearing and speech problems (WebMD.com).
Patients with Cerebral Palsy are often diagnosed with impaired mobility related to muscle
weakness. As a nurse, the main priority for patients with this condition is to promote and
maintain their activities of daily living. Activities of daily living are basic human skills that are
essential for people to take care themselves on everyday life. It is important for kids to learn
them as early as possible to promote independence. A lot of people take them for granted and do
not understand the importance of their ability to do them. Due to brain damage of patients with
Cerebral Palsy, it is difficult especially to kids to learn and perform these activities. Basic skills
such as walking, exercising, feeding, bathing, grooming, and speaking are challenging for these
patients. Helping them to execute these skills on everyday life will promote their wellness.
Walking and exercising promotes good circulation to the body. Even moderate level of
exercise such as flexing and extending legs and arms can increase blood flow and reduce risk for
circulatory conditions such as atherosclerosis (Potter & Perry, 2014). Also, good blood
circulation prevents skin breakdown to the patient. If the patient does not move frequently, the
veins and arteries that supply and transport blood to skin will be blocked that causes skin tissues
to die. Skin breakdown can lead to infections that can be worsen if not treated properly. Another

Cerebral Palsy

benefit of exercising is that it helps patients to strengthen their muscles. Strengthening muscles
will allow patients to walk, grasp, and feed independently. By feeding independently, their
nutrition will be easier to maintain. Proper diet such as high protein, less cholesterol, and high
fibre are necessary to promote muscle build up, good blood circulation, and good digestion.
Speaking skill is also important to improve for kids with Cerebral Palsy. Good communication
skills will help the child to socialize and is easier for the care provider to provide the needs of the
child. In order to implement this intervention and improve these skills, a nurse must need to
collaborate for other care providers. Physiotherapists and Occupational therapists, Dietitians, and
Speech Pathologist are the most suitable care providers to promote the patient activities of daily
living.
Physiotherapists and Occupational therapists are essential for the muscle strengthening,
exercising, and maintaining good circulation for patients with Cerebral Palsy. Physiotherapists
are responsible for manual and electrical treatment such as maintaining balance, muscle
relaxation and muscle strengthening (Barber, 2008). A piece of equipment that is used by
physiotherapists to muscle relaxation is Interferential Current Equipment (IFC). This machine
produces electrical currents that passes through the affected area of the patient. By using this
machine, an increase in localized blood flow and stimulation of local nerve cell is implemented
to the patient. The electrical current that is produced by the equipment travels through four
electrodes that produces tingling sensation throughout the area that is being treated
(Physicaltherapyweb.com). This tingling sensation helps to relax the muscles. The main reason
why muscle relaxation is needed for this patient is because it reduces spasms. Cerebral palsy
patients have contracted muscles that contribute to uncontrolled spasms conducted by the brain
(Barber, 2008). Another strategy for muscle strengthening is implementing exercise. Exercises

Cerebral Palsy

such as walking, sitting, standing, and aerobic swimming will help the patient to strengthen
quads and hamstring muscles. These muscles are essential for maintaining good posture and
ambulating. Exercising also promotes good blood circulation to the patients body. Meanwhile,
Occupational therapists job is to improve the fine motor skills of the patient. Activities such as
clay grasping, writing, pointing, opening and closing of hands will help the patient to
successfully do feeding and bathing independently.
The next collaborative care providers that will help patients with Cerebral Palsy are
dietitians. For children with this disease, feeding dysfunction is a common problem associated
with poor health and nutritional status (Elsevier, 2002). Children with this disease may require
chopped or mashed foods. Dietitians can advise the patients family members on what to eat in
order to achieve a specific nutrition goal for the patient. It is vital to seek referral to a dietitian
when a modified consistency diet has been recommended, as modifying the consistency of foods
can dilute the nutrient value of a meal, leading to weight loss or malnutrition. Dietitians can help
to maximise the nutrient value of each meal (Indi.ie, 2015). Since the patient have difficulty in
swallowing related to muscle contraction, the dietician could prescribe soft diet foods. For
protein source, mashed beans and eggs, salmon, and other protein supplements are good for
building up the muscle. Building up the muscles will help the patient to maintain a good posture
and it also helps the muscles to strengthen by incorporating with exercise. Lengthy feeding times
can also help the patient to absorb enough nutrients. Offering smaller meals throughout the day
can help the patient with cerebral palsy digest it easily.
Lastly, Speech Pathologists can help a child with cerebral palsy to effectively
communicate their thoughts and ideas to people around them. It will help a lot especially to
health care providers if the patient can communicate effectively. It is easier to give the patients

Cerebral Palsy

needs if he or she can communicate properly. Speech Pathologists increase a childs oral motor
skills and communication by using exercises to train the brain to pronounce, understand, and
interpret words, numbers, and sounds (CerebralPalsy.org). They also improve the functioning of
the jaw and throat muscles that can interfere with speech. Communication can improve the
patients activity of daily living because it develops relationship with family, socializing and
making friends, and learning.
There are community resources and services across Toronto that can implement and
improve activity of daily living for the patient with Cerebral Palsy. First, is Triangle
Physiotherapy located at East Mall and Dundas intersection. This facility provide a maximum
care and have state of the art equipment essential for muscle strengthening and relaxation.
Another is Ellen Yack and Associates Pediatric Occupational Therapy Services. This facility is
especially made for pediatric patients that are having difficulties with fine motor skills. It is
essential for Cerebral Palsy patients to improve their ability to grasp, write, and feed themselves.
Also, Healthy Lifestyle Nutrition Consulting Etobicoke can help to maintain a nutrition goal. A
registered dietician with over 25 years of experience manages and owns the facility. It helps the
patient to meet the nutrition that is needed for his or her body.
In conclusion, Cerebral Palsy is a chronic disorder that affects muscle tone, movement,
and motor skills of a patient. This disorder affects the activity of daily living of the patient
because of impaired mobility related to muscle weakness. Several care providers such as
Physiotherapists and Occupational therapists, Dietitians, and Speech Pathologists can improve
the patients activity of daily living. Community resources across Toronto such as Triangle
Physiotherapy, Ellen Yack and Associates Pediatric Occupational Therapy Services, and Healthy
Lifestyle Nutrition Consulting Etobicoke are available to help and improve the patients concern.

Cerebral Palsy

References
Potter, P. & Perry, A.G. (2014). Canadian Fundamentals of Nursing.
Neurological Disorder, 31(7), 610-611.
Potter, P. & Perry, A.G. (2014). Canadian Fundamentals of Nursing.
Exercise and Physical Activity, 45(9), 1209-1210.
Elsevier. (2002). Journal of American Dietetic Association.
Feeding Dysfunction is Associated with Poor Growth and Health Status in Children with
Cerebral Palsy. Retrieved November 19, 2015.
From http://www.sciencedirect.com/science/article/pii/S0002822302900842
INDI. (2013). Irish Nutrition Dietetic Institute. Cerebral Palsy: Meeting Nutritional Needs.
Retrieved November 19, 2015. From https://www.indi.ie/diseases,-allergies-and-medicalconditions/disability/389-cerebral-palsy-meeting-nutritional-needs.html
Physical Therapy Web. (2014). Interferential Current Equipment. Retrieved November 19, 2015.
From http://physicaltherapyweb.com/interferential-current-ifc-equipment/
Barber, E. (2008). Pediatrics and Child Health. A guide to physiotherapy in cerebral pals
Retrieved November 19, 2015.

From

http://www.sciencedirect.com.eztest.ocls.ca/science/article/pii/S1751722208001352
Cerebral Palsy. (2014). Pathophysiology of Cerebral Palsy. Retrieved November 19, 2015.
From http://www.webmd.com/brain/understanding-cerebral-palsy-basicinformation

Cerebral Palsy

References
Speech and Language Therapy. (2015, September). My Child at Cerebral Palsy.org.
RetrievedNovember 19, 2015.
From http://cerebralpalsy.org/about-cerebral-palsy/treatment/therapy/speech-languagetherapy/