Overview

Many people with cerebral palsy need lifelong musculoskeletal management by a multidisciplinary team, including their general practitioner (GP), paediatrician, rehabilitation physician, orthopaedic surgeon, physiotherapist, orthotist, speech pathologist, occupational therapist and other relevant medical, nursing and allied health professionals. Effective collaboration between the multidisciplinary team is essential; for advice, see Facilitation of a multidisciplinary approach to care.

Many people with cerebral palsy have a combination of spasticity and dyskinesia, and physiotherapy is fundamental to optimising and maintaining function. The objectives of interventions for musculoskeletal conditions (ie therapy, orthotics, splints, surgery) are to:

  • optimise and maintain independence and participation (ie communication, mobility, education, employment, recreation)
  • optimise and maintain safe eating, drinking and nutrition
  • optimise and maintain muscle strength and flexibility
  • prevent, control or treat dynamic tightness or fixed contractures
  • reduce muscle fatigue and pain.

In children, the aim is to improve bone and joint alignment and growth to optimise function, participation and independence. Surgical interventions in childhood to address these goals are common. In adults, interventions are more limited and focus on maintaining function, facilitating caregiving for the person, and reducing pain and functional decline.

A person with cerebral palsy will usually benefit from a formal exercise plan designed by a physiotherapist that can be implemented with the assistance of those providing daily support (eg exercise physiologist, personal trainer). Physiotherapist-supervised hydrotherapy may facilitate movement and strength training.

People who use a wheelchair need expert attention to their seating and posture control to ensure their comfort, avoid pressure injuries, optimise upper limb function and minimise further deterioration of their posture; see Mobility aids and equipment.

For advice on specific neuromuscular disorders that are common in people with cerebral palsy, see: