Multisystem compensations and consequences in spastic quadriplegic cerebral palsy children

Abstract

Spastic quadriplegic cerebral palsy (CP) is a permanent neuromuscular disorder causing limitation on all four limbs following a lesion on the developing brain. Most children with spastic quadriplegic CP are identified to be Gross Motor Function Classification System (GMFCS) level V, thus they have more comorbidities compared to other types at lower levels. Spastic quadriplegic CP is characterized by weak and inactive postural muscles of the neck and trunk, hence, they will undergo a total body extension as a compensatory mechanism leading to an atypical movement pattern, that give rise to multisystem consequences that reduce their quality of life. The relationship between atypical movement patterns, compensatory strategies, and multisystem consequences have not yet been explored. In fact, these multisystem consequences aggravate their condition and make movement much more atypical, forming a vicious cycle. This review aimed to provide a summary and highlight the mechanism of atypical movement pattern, multisystem compensations, and consequences in spastic quadriplegic CP children. It is true that central nervous system (CNS) lesion in CP is non-progressive, however the multisystem consequences may impair overall function over time. An understanding of how compensatory strategy and multisystem consequences in spastic quadriplegic CP offers the opportunity to intervene as early as possible to improve their quality of life.

A Case Study on the Fundamentals of Sensory Problems in Cerebral Palsy

“…The central nervous system lesion in CP is non-progressive, although the multisystem effects may eventually reduce overall function. https://www.indjst.org/ It is crucial to plan goals for therapy and create an interdisciplinary approach to handle numerous secondary conditions, taking into account multisystem compensations and repercussions that happen in children with CP (2) . Feeding difficulties are caused by both sensory processing issues and visual impairment, which additionally affects the nutritional status of CP children (3) .…”

Effect of virtual reality combined with repetitive transcranial magnetic stimulation on musculoskeletal pain and motor development in children with spastic cerebral palsy: a protocol for a randomized controlled clinical trial

“…Secondary pain caused by muscle spasms, postural asymmetries, and osteoarthrosis complications is highly prevalent in spastic CP. Muscle spasms lead to vessel compression and ischaemia, which activate local pain receptors [ 9 ]. Soft tissue may be under long-term compression due to postural asymmetries, and the resulting chronic pain occurs mostly in the back [ 10 ].…”