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Rollators improve walking with cerebral palsy and include a seat for resting.
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Cerebral palsy is a disorder that mainly affects a person's ability to move. The brain sends abnormal messages to the muscles, significantly impacting function. Altered muscle function causes balance problems, making it difficult for the person to stand and walk.
Cerebral palsy develops in the womb, during birth or in the first few months of life. There are 4 types of cerebral palsy: spastic, ataxic, athetoid and mixed. Spastic cerebral palsy is characterized by excessive muscle tightness in certain areas of the body. Ataxic cerebral palsy is characterized by decreased muscle coordination and balance, while athetoid cerebral palsy causes involuntary body movements. Mixed cerebral palsy is a condition that includes features of more than 1 type of cerebral palsy. Each type of cerebral palsy is associated with balance problems. Severe balance problems may prevent a person with cerebral palsy from standing or walking, requiring a wheelchair for mobility.
Spastic Cerebral Palsy
Spastic cerebral palsy is the most common form of cerebral palsy. Spasticity -- excessive muscle tightness or "tone" -- causes tension in the muscles even while a person is resting. Excess muscle tone pulls on the bones and joints, and can lead to permanent joint deformities, causing long-term balance problems. Spastic cerebral palsy often affects the calf muscles, pulling the toes down toward the ground. In a standing position, this causes the knees to bend excessively backwards and the hips to bend forward. The body center of gravity is altered in this position, affecting balance.
Ataxic and Athetoid Cerebral Palsy
Ataxic cerebral palsy is caused by damage to the cerebellum -- the area of the brain that controls body movements. Balance problems caused by ataxia are characterized by a wide base of support -- walking with the feet far apart, forward leaning and staggered steps.
Athetoid cerebral palsy is characterized by body movements that a person is unable to control. This type of cerebral palsy significantly affects balance, both in sitting and standing.
Several treatments may help improve balance for people with cerebral palsy. Physical therapy uses stretching to temporarily decrease muscle tightness and reduce the risk of deformity. Plastic braces are often worn to hold the ankle at approximately 90 degrees to improve standing and walking. Assistive devices, such as walkers, are used to support a person as they move. Strengthening exercises target weak trunk muscles to improve ability to hold the body upright. Treadmill walking is sometimes performed using a harness to support a person's body weight. This improves coordination by sending "normal" muscle messages to the brain through repeated movements.
Medications are sometimes used to relieve excessive muscle tightness. Surgery is sometimes used to selectively cut nerves that cause this muscle tightness.