Facts about the forms of CP
http://formsofcerebralpalsy.com/index.html
Forms of Cerebral Palsy
Cerebral Palsy is a motor disorder appearing in children before the age of three years, due to damage of the brain before it has fully developed. The damage to the brain affects strictly the motor system, producing poor coordination, poor balance, or abnormal movement patterns. Children with Cerebral Palsy may also have other kinds of neurological disorders, such as epilepsy, mental retardation, learning disabilities, or attention deficit-hyperactivity disorder.
Cerebral palsy is non-progressive, or static, meaning that it will not get better or worse over time. Most cases of cerebral palsy are congenital, or from birth; brain damage that occurs after the age 3 is usually diagnosed as stroke or traumatic brain injury.
CP can usually be diagnosed before the age of 18 months. Physicians analyze delays in developmental motor milestones, such as reaching for toys, sitting and walking.
Although CP is strictly a motor disorder, other medical problems are often associated with it. These include:
Mental retardation
Learning Disabilities
Attention deficit-hyperactivity disorder
Epilepsy
Visual impairment
Swallowing difficulties
Speech impairment
Hearing loss
Scoliosis
Hip dislocation
Contractures of joints
Discrepancy in leg length
Communication disorder
Drooling
Poor nutrition
Depression
Fragile bones and frequent fractures
Cavities
Constipation
The Cerebral Palsies are classified by the type of motor impairment they produce. Spastic CP, characterized by stiff muscles, effects 80% of people with CP. Athetoid CP effects 5% to 10%, and is characterized by involuntary movement. Ataxic CP is the least common type of Cerebral Palsy, effecting 5% to 10% of people with CP. The remaining people with CP are mixed, having a combination of the types.
The Cerebral Palsies are further classified by the limbs that they involve. Diplegia is a form of CP primarily affecting the legs. Hemiplegia is a form where one side of the body (an arm and a leg) are affected. Monoplegia, Triplegia, and Quadriplegia refer to one, three and four involved limbs, respectively.
Cortical Vision Impairment or CVI
http://www.cerebralpalsy.org/news/cerebral-palsy-and-children-with-cvi-cortical-visual-impairment/
Cerebral Palsy and Children with CVI (Cortical Visual Impairment)
A large percentage of children with cerebral palsy also have CVI (Cortical Visual Impairment). In fact, 80% of children with cerebral palsy also have CVI.
The definition: Cortical Visual Impairment (CVI) refers to visual impairment due to damage to the visual cortex, the posterior visual pathways or both.
One of the major causes of CVI is asphyxia, meaning that the oxygen supply to the brain was at some point disrupted. Because the visual cortex part of the brain is furthest from the main blood supply (which is how oxygen reaches the brain), the visual cortex is most vulnerable in case of interruption of oxygen. When oxygen is not allowed to get to the brain other areas are also affected which is why CVI rarely occurs on its own without other problems.
Other causes of CVI are developmental brain defects, birth injuries, head injuries and infections of the central nervous system such as encephalitis or meningitis.
Conductive Education
http://www.conductive-ed.org.uk/
The Principal Hypothesis of Conductive Education (Dr. Mari Hari 1991)
The primary aims of Conductive Education are:
* To set up an active life-style.
* To develop cognitive functions.
* To provide a complex but unified educational programme.
* To teach the process of intending.
* To help disabled children to learn to walk, attend school and go to work. (Of course, not all achieve this!)
* To provide a programme that in some cases can be built into the framework of special and ordinary schools.
What is Conductive Education
- Conductive education is a system of learning developed by the Hungarian physician Professor Andras Pëto in Budapest, Hungary. (Peto Institute)
-Conductive education was initially developed for the needs of children with cerebral palsy.
-Conductive education in its fullest form is a unified system of rehabilitation for people with neurological disorders such as cerebral palsy, Parkinson’s disease multiple sclerosis and those who have suffered strokes or head injuries.
-Conductive education is a system in its own right. It is not a composite or amalgamation. It is a system of learning that has been developed with groups of individuals with motor disorders.
-Conductive education is a learning process, not a treatment or therapy.
-Conductive education is a partnership between the educator (the Conductor) and learners to create circumstances for learning.
-Conductive education is an all day all life on going learning process.
-Conductive education approaches problems of movement as problems of learning.
-Conductive education can be directed towards all age groups.
-Conductive education for Children should start as early as possible. Many centres have parent and baby groups. (Ability Camp, Inc.)
-Conductive education involves all that can be expected from a child’s relevant age group.
-Conductive education teaches children and adults to achieve what they want and the motivation to find their own way of doing so.
-Conductive education enables the child to work in an integrated way with others with similar but often different problems.
-Conductive education embraces learning and development of movement, speech and mental ability simultaneously, not separately or consecutively.
-Conductive education is based on the theory that the motor disabled child develops and learns in the same way as their peers.
-Conductive education is not a miracle cure. It needs a concentrated effort over a period of time to enable the participants to achieve recognised goals directed by task analysis.
-Conductive education is a positive concept that looks for ways in which the individual can develop purposeful movement. It does not have a negative approach where complicated aids and equipment are used to facilitate motor control and stability.
-Conductive education uses only simple well-designed, good quality furniture and equipment.
-Conductive education has now become established in countries all round the world.
-Conductive education has FIVE main elements to facilitate the process.
Elements of Conductive Education
Five important elements are required in order to facilitate the process of conductive education:
* The conductor
* The programme
* The task series
* Intention / Rhythmical Intention
* The group
1: The Conductor
This is the professional who delivers the programme.
Have an intensive four year University based ‘hands on’ professional training
They are responsible for the initial assessment, organisation and delivering the programme
They create situations that encourage learning and problem solving
They observe each persons’ performance and modify the programme and timetable according to their needs
They concentrate on the positive to ensure that the individual meets with success and feels the effort is purposeful and worthwhile
They give clear guidance, support and a sense of direction
2: The Programme
This is often described as complex but can be thought of as a planned learning programme.
Is a planned day by day programme of learning and practising
Each days programme starts with waking and finishes with sleeping
For many this includes getting out of bed, going to the toilet, washing and having breakfast
It includes all the activities included in a daily routine
For school children it embraces academic lessons, playing with peers, eating, toileting etc.
For adults it may include the full routine of living, working, hobbies and interests etc.
3: The Task Series
The task series is the basis of the work session, which prepares children for function.
Tasks are taught, learnt, practised, generalised and used
Tasks are broken up into elements with appropriate goals
Each member of ‘the group’ works towards the successful completion of the task
Tasks are a structured part of the daily programme
Tasks are teaching tools, not a set of exercises
Tasks are developed to meet the needs of the individual
Tasks are most effective when carried out in a group
Tasks are presented in such a way that allows the individual to succeed at the same time learning a new skill or reinforcing a newly acquired one
Success lies with the individual
4: Intention / Rhythmical Intention
Is the method by which a child uses speech or inner speech to express an intention and is followed by movement, which is carried out rhythmically.
The use of language to plan, imagine, intend and implement a movement
The use of speech or inner speech to express an intention
It facilitates motor activity
It regulates the motor act
It focuses attention on the movement
And at a later stage...
It controls speed and rhythm of movement
It controls language of movement
LANGUAGE MOVEMENT AND FUNCTION
Develop together - are taught together - are learnt together -
5: The Group
The basic unit in which the participants may be matched for ability and age.
With children...
They learn not only from their conductor but from their peers
They are encouraged to become ambitious to succeed
The group socialises the child to avoid adult orientation
The group encourages each to wait for attention or conversely to ask for help
The group members are aware and observe other children solving similar problems
The group members know the progression when the immediate problem is solved
The children are given the chance to be responsible for themselves
Praising one child encourages another.
Cerebral Palsy and Hyperbaric Oxygen Therapy
http://www.hbotoday.com/treatment/cp.shtml
Cerebral Palsy and HBO Therapy
More than 500,000 Americans have cerebral palsy (CP). There are more than 4,500 new cases of CP each year. The term cerebral palsy is not a diagnosis; it is a loose descriptive term that is used to describe a group of chronic disorders—specifically, motor disorders—which impair the control of movement. These disorders usually appear in the first few years of life.
Cerebral refers to the brain's two hemispheres, or halves that contain the higher nerve centers. Palsy refers to any condition marked by tremor or any disorder that impairs control of body movement. CP is not describing disorders in the muscles or in the nerves. The impairment stems from damage to the motor areas of the brain, which in turn cause the brain to poorly control movement of the body's muscles.
Medical Disorders
There are other medical disorders associated with cerebral palsy. These include:
Seizures or epilepsy. Up to half of all children with CP experience one form of seizure or another.
Mental impairment. Although about one-third of children with CP are not intellectually impaired, one-third are mildly impaired, and the remaining third are moderately to severely impaired.
Vision and hearing problems. A large number of children with CP have a condition called "strabismus," characterized by the eyes failing to properly align because of differences in the left and right eye muscles.
Growth problems. A syndrome called failure to thrive is common in children with moderate to severe cerebral palsy. Failure to thrive is a term that is used to describe growth and development that does not meet realistic expectations in infants and children.
Sensation and perception problems. The ability to feel certain sensations, such as touch and pain, can be impaired in some children with CP. These children may also have stereognosia, a condition characterized by difficulty identifying objects using the sense of touch.
Hyperbaric Oxygen (HBO) Therapy
HBO therapy is a medical treatment that uses the administration of 100 percent oxygen at controlled pressure (greater than sea level) for a prescribed amount of time—usually 60 to 90 minutes. HBO therapy is commonly used to treat conditions such as burns and difficult healing wounds. HBO therapy facilitates healing in these conditions by increasing the amount of oxygen in the blood by up to 2000 percent, depending on the treatment depth. This in turn dramatically increases the amount of oxygen at the cellular level.
In the case of cerebral palsy in children, HBO therapy is administered at 1.5 ATA or equivalent to a depth of 16.5 feet below sea level. Some research has been completed using treatment depths up to 1.75 ATA, or 25 feet below sea level, with positive results. Each treatment lasts one hour and one or two treatments are prescribed each day, five or six days per week. The total number of treatments given in each case varies. It is common to administer 40 treatments in the first phase of treatment. The question of further HBO therapy is then resolved by the medical team involved in each case and is dependent upon a number of factors. However, many believe that if improvement is observed in the first phase of treatment, then a break of one to four weeks should be taken, followed by another 40 HBO treatments.
At the Chico Hyperbaric Center we use a multiplace chamber, which allows a parent to be in the chamber with their child during treatment. Also, no patient at the Chico Hyperbaric Center undergoes treatment without a health care professional in attendance during treatment.
Promising Therapy
Why does HBO therapy show promise in helping cerebral palsy patients? First, let's confirm some previously mentioned facts. Cerebral palsy is the result of damage to motor areas in the brain. This in turn disrupts the brain's ability to properly control the movement of the body's muscles. What causes this damage? A National Institute of Neurological Disorders and Stroke (NINDS) study found that in most cases of CP, no direct cause for the damage could be found. In other words, cerebral palsy is a result of the brain not properly communicating with the muscles because the brain has been damaged for one reason or another.
Documentation now exists that clearly shows that HBO therapy can dramatically improve some CP symptoms. For example, a study in Brazil1 revealed a 50 percent reduction in spasticity of 94 percent (218 patients) of the patients involved in the study. Improvements have also been seen with vision, hearing, and speech. However, one should understand that improvement, if any, will vary from patient to patient.
Dormant Areas
Back to our question, "Why does HBO therapy show promise in helping cerebral palsy patients?" In order to answer this question we need to look at one of the terms that we use to describe the type of brain injury involved in cerebral palsy. The term is traumatic brain injury.
Traumatic brain injury (TBI) is a condition in which certain nerve cells in the brain may be permanently destroyed. Conditions such as stroke and cerebral palsy are forms of TBI. It is important to note that although some of the brain may be permanently damaged when TBI occurs, a much larger area surrounding the permanently damaged area may also be affected. This larger area may be in a dormant state because the amount of oxygen it receives has been reduced due to a decrease in blood flow. Swelling and a change in cell physiology can cause reduced blood flow.
Reduced blood flow—and the resulting decrease in oxygen levels at the cellular level—as well as the swelling of brain tissue are of particular importance when attempting to understand traumatic brain injury and cerebral palsy in children. This is because some researchers believe that the lack of oxygen and swelling of brain tissue plays a part in the inability of the myelin sheaths to develop.
Myelination
Myelin sheaths are coverings that protect nerve fibers in the brain. These nerve fibers connect the brain to the spinal cord and they play an important role in impulse transmission. The process of myelination—that is, the action of the delicate myelin sheath cells as they envelop the brain's nerve fibers—begins a month prior to birth and continues until about two years of age. If myelination does not properly occur, the nerve fibers are left exposed and they slowly deteriorate. This disrupts communication between the controlling nerve cells in the brain and the muscles. The result may be spasticity.
Given the presence of just a small amount of oxygen, the cells in the dormant area may remain in this suspended animation state for many years. The dormant area is often referred to as "not dead but sleeping." This is where HBO therapy shows such promise. It is believed that the high oxygen levels that are attained in the body's cells during HBO therapy cause a physiological change to the cells of this dormant area—effectively waking them up—thus, increasing the capacity for recovery. It is also believed that HBO therapy reduces swelling in the brain by constricting blood vessels, and provides an ideal internal environment for the growth of new brain tissue.
It should be remembered that HBO therapy is not a cure, but a method of ensuring that the most complete recovery possible takes place. The degree of improvement will vary from patient to patient because the amount and type of damage to the brain varies with each patient.
The SPECT Scan
Modern technology has been a positive factor in the treatment of cerebral palsy and other forms of traumatic brain injury. Specifically, SPECT imaging, or what is commonly termed the SPECT scan, is helping to identify those parts of the brain that are in a dormant state due to a lack of oxygen. As Dr. Philip James of the Wolfson Hyperbaric Medicine Unit at the University of Dundee in Scotland has stated, "Loss of function in the brain can be either due to tissue swelling, which is reversible, or tissue destruction, which is not."2 When we combine what Dr. James said with what the SPECT scan can do, it is clear that the SPECT scan can help us identify those parts of the brain that stand a chance of being revived.
SPECT stands for Single Photon Emission Computed Tomography. The SPECT scan can give a clear picture of which parts of the brain are awake and working, which parts are dormant and sleeping, and which parts are lifeless and permanently damaged. This is of particular significance when considering HBO therapy because, to be blunt, the SPECT scan has the ability to indicate if HBO therapy is working or not by monitoring the change in brain tissue blood flow.
Let's Sum Up
Some brain cells become dormant due to a lack of oxygen, which can be caused by reduced blood flow. Swelling can cause reduced blood flow. HBO therapy has been shown to reduce the swelling of brain tissue by constricting blood vessels. Also, HBO therapy dramatically increases the amount of oxygen at the cellular level, which, it is believed, may revive dormant, oxygen starved areas of the brain. The ability to perform a SPECT scan before and after a course of HBO therapy can help identify those parts of the brain affected by the therapy. The SPECT scan will identify those areas of the brain that have reacted in a positive manner to an increase in oxygen, indicating the potential for recovery.
Timing Is Important
Obviously, the earlier that HBO therapy can be administered, the better the opportunity for recovery. However, HBO therapy has been shown to resolve tissue swelling even after the lapse of years. It is hoped that HBO therapy will also help revive the secondary, dormant areas of the brain that are not permanently damaged. This appears to be true for stroke patients and there are encouraging results indicating that this may also be true for cerebral palsy patients as well.
Risks?
HBO therapy is a medical procedure, and like any other medical procedure there can be risks. However, when HBO therapy is administered by trained health care individuals these risks are minimal. (As with any medical procedure, the evaluation and understanding of the current health status of the patient is of prime importance.)
Minor ear discomfort is the most common complaint related to HBO therapy. This may present a greater concern with young children who cannot verbalize this discomfort. It is helpful to remember that the initial stage of each HBO treatment session is similar to sitting in an aircraft while it descends. Like the airline passenger, the patient's ears have to adjust to a change in air pressure. The hyperbaric health care professional works with the patient or parent and teaches them various techniques on how to equalize pressure in the ears, such as swallowing.
If one cannot equalize the pressure in the ears, damage can occur to the eardrum. However, this is very rare. Some individuals who experience discomfort with their ears may require a procedure called a Myringotomy, or what is commonly called placing tubes in the ears. An ear, nose and throat specialist usually performs this outpatient procedure right in the doctor's office.
Other complications can occur if a patient has lung abnormalities such as emphysema. However, with proper evaluation prior to HBO treatment any concerns can be eliminated. There is no evidence that other potential problems associated with much deeper depths are a concern at the relatively low pressures attained during HBO therapy for cerebral palsy patients (1.5 ATA or equivalent to a depth of 16.5 feet below sea level).
Research
The benefits of treating cerebral palsy with HBO therapy appear to be very positive. Several research studies have been completed, including studies at the University of Texas Medical Center (UTMC) and McGill University in Montreal, Canada. Some controversy exists with respect to the McGill study as results indicated the placebo group, treated with ambient air at 1.3 ATA, showed improvement similar to the group treated with HBO. Most experts agree that the methodology for evaluation in the McGill study was not optimal. Other research continues and more recently Dr. Maurine Packard of NY Presbyterian Hospital studied the effects of HBO in children ages 1-5 with moderate to severe CP. These studies and additional research will add to our knowledge and understanding of CP and HBO therapy. For the complete text of these studies, and others, please visit the Research Studies section of this site or click on the following link: http://hbotoday.com/treatment/clinical/researchstudies.
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Oxford Hyperbaric Therapy Center
http://healingwithhbot.com/
Oxford Hyerbaric Medical Center was founded by the husband and wife team of Tami and Bruce Powell after witnessing first-hand the power of healing that HBOT offers.
The Powell's were introduced to Hyperbaric Oxygen Therapy (HBOT) when researching for treatment options for their young daughter who developed viral encephalitis after a bout with chicken pox. Encephalitis had left their daughter with brain damage. Doctors deemed her prognosis poor with little hope for a life without profound physical, emotional and mental impairments. Undaunted, they pursued alternative treatments and discovered HBOT. You can watch their daughter's amazing journey from disability to health by clicking here.
After hyperbarics gave the Powell's their daughter back, they felt they were called to help others find the same ray of hope they found in medical hyperbaric therapy.
Providing high quality hyperbaric therapy demanded that they obtain the finest hyperbaric training available. The pursuit of excellence led Bruce and Tami to seek their specialized HBOT training from a world leader in hyperbaric therapy, Dr. Paul Sheffield at San Antonio Nix Hospital.
While working with Dr. Sheffield, the Powell's received rigorous training required to become a Hyperbaric Medical Technician as well as additional training in the area of Wound Care Management with special focus on Hyperbaric Medicine for Accelerated Wound Healing.
Upon completion of their training the Powell's immediately began the process of opening their own hyperbaric clinic, the Oxford Hyperbaric Medical Center.
Treatment Indications for HBOT (FDA Approved)
* Air or gas embolism
* Carbon monoxide poisoning and carbon monoxide poisoning complicated by cyanide poisoning Clostridial myositis and myonecrosis (gas gangrene)
* Crush injury, compartment syndrome, and other acute traumatic ischemias
* Decompression sickness
* Enhanced healing of selected problem wounds
* Exceptional blood loss anemia
* Necrotizing soft tissue infections Osteomyelitis (refractory)
* Delayed radiation injury (soft tissue and bony necrosis)
* Skin grafts and flaps (compromised)
* Thermal burns Intracranial abscess
Treatment Indications for HBOT ('Off-label')
* Autism / Autistic Spectrum Disorders
* AIDS / HIV
* Allergies
* Asthma
* ALS (Amyotrophic Lateral Sclerosis)
* Alzheimer's
* Arthritis (Rheumatoid, Osteoarthritis, Osteoarthrosis)
* Atherosclerosis
* ADD (Attention Deficit Disorder)
* Bell's Palsy
* Brain Injury
* Burns
* Cerebral Palsy
* Cancer
* CFS / CFIDS (Chronic Fatigue Immune Dysfunction)
* Coma
* Crohn's Disease
* Dementia
* Depression
* Diabetes
* Epilepsy / Seizure Disorders
* Fibromyalgia
* Hearing Loss
* Heart Disease
* Hepatitis
* Infection
* Injury
* Healing
* Interstitial Cystitis
* Lupus
* Lyme Disease
* Macular Degeneration
* Memory Loss
* Migraine
* Multiple Chemical Sensitivity
* Multiple Sclerosis
* Near Drowning
* Neuropathy
* Parkinson's Disease
* Post-Polio Syndrome
* Post-Surgical Wound Healing
* RSD (Reflex Symapthetic Dystrophy)
* Rheumatic Diseases
* Spinal Cord Injury
* Sports Injury
* Stroke
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CVI (Cortical Vision Impairment) and other vision issues have had success with HBOT (Hyperbaric Oxygen Treatments).
