Hemiplegic Cerebral Palsy

Characteristic Problems Of Hemiplegic Cerebral Palsy

The hemiplegic cerebral palsy is arm, legs and muscle on one side of the body are affected, use of the hand is difficult, hemiplegic cerebral palsy in child exhibits static and stereotyped movement patterns ( abnormal portural reflexs ), spasticity, asymmetrical, sensory and perceptual disorder. The abnormal postural reflexs that the hemiplegic cerebral palsy most commonly exhibits are symmetrical tonix neck reflex.

The two mayor motor problems in hemiplegic cerebral palsy are flaccidity and spasticity. Spasticity or hypertonus is the motor problem most common and most difficult to treat. If not correctly, spasticity can progress to the point where it makes indevendent living nearly impossible. Spasticity interferes with the cerebral palsy children’s ability to move by interfering with selective motor function. It produces abnormal sensory feedback and contributes to weekness of the antagonist muscle. It can cause contractures, pain and an all consuming fear in many child with hemiplegic cerebral palsy.

The typical posture of the hemiplegic cerebral palsy with spasticity is described as follow ;

• Head  ; lateral flexion toward the involved side with rotation away from involved side,
• Upper extremity  ; scapula depression and retraction, shoulder – adduction and internal roatation, elbow – flexion, forarm – pronation, wrist – flexion and ulnar deviation, finger – flexion
• Trunk ;  leteral flexion toward the involved side
• Lower extremity ; pelvis – posterior elevation and retraction, hip – internal rotation and adduction, knee – extention, ankle – plantar flexion and inversion, toes – flexion.

Brunnstrom in movement therapy in hemiplegic adult or hemiplegic cerebral palsy described an evaluation procedure that assesses muscle tone, stage recovery, movement patterns, motor speed and prehension pattern of the upper extremity.

The child with hemiplegic cerebral palsy will require specialized methods of teaching, and many will have greater difficulty in learning and performing one handed skills. It’s need to be evaluated for sensory, perceptual, and cognitive deficits.