March is Cerebral Palsy Awareness Month. We want to celebrate the warriors: children with Cerebral Palsy (CP), who every single day overcome tremendous obstacles. After working with children with CP and their families for over twenty-years, I find myself reflecting this month in particular. There are so many topics that come to mind. For one, my own challenges and how the kids in my life have taught me to approach them. Additionally, the evolution of physical therapy intervention as it relates to cerebral palsy over the past 20 years, in my experience . Most importantly, the use of a multimodal approach for treatment of children with cerebral palsy. Finally, the impact electrical stimulation has had on some of my patients.
One of my first thoughts is regarding my challenge to write. Most days I am happy to be on the mat all day working with my amazing patients. What I do not relish, however, is writing. But in this special month, I am going to channel the lessons of discipline and courage that I learn every day from my patients, leave my comfort zone, and begin to share some insights gleaned from those 20 years working with these kids, by writing! First, there are some warriors I want to celebrate. All children with CP are celebrated every day in my life and at Dynamic Solutions; but I want to call out a few.
Today I want to tell you about Maddy.
I first met Maddy when she was four years old and recently diagnosed with Cerebral Palsy, hemiplegic type. Her parents were so concerned about her very tight right leg, her falling, her inability to run or jump, her lack of confidence and difficulty playing with peers. Clinically, her presentation included a right leg that was tight and contracted in her ankle and knee. She was unable to step on her foot flat and she resisted therapy. Her hips were weak. Her balance and stability was decreased. Her parents began exploring options with physical therapy at Dynamic Solutions, some Botox, and eventually some serial casting.
Maddy worked hard in PT twice a week consistently. She became stronger and more flexible and, most importantly, more confident. She tolerated and enjoyed PT. She learned for the first time what it feels like to push her body beyond her comfort zone. For Maddy, we incorporated a multimodal approach. We used:
- strengthening principles
- sensory integration principles
- gait analysis and training
- parent education and a custom home program
- long duration home and overnight stretching
- consultation with her team of doctors and therapists at spasticity clinic
- foundational principles of proper alignment and posture
- orthotic management, and finally
- electric stimulation.
The electric stimulation to her gastrocsoleus and gluteal muscles really got us to the next level of strength and proper alignment in standing and during gait. I will write more about electric stimulation in the coming weeks. Today we celebrate Maddy and her accomplishments. But we are not done! We keep going because she is young and at only seven years old, growth spurts and body changes affect her alignment and spasticity and strength and range of motion.
I am so proud of Maddy’s ability to push through and participate in community activities such as gymnastics and downhill skiing with great success and confidence. Movement is now fun and exciting. Keep up the amazing work!
Follow us on social media to see Maddy\’s success videos.