She is Ela. 7 Years old. She can’t move her arms, legs. She can’t eat without getting help. She has difficulty moving her head. - WHY ?

CEREBRAL PALSY Seher Yıldırım GPC METU NCC

CEREBRAL PALSY = BRAIN PARALYSIS Definition Prevalence Etiology Classifications Clinical Presentation Treatments Substantially Disabling

COMPLICATIONS OF NEURODEVELOPMENTAL DISORDERS Cognitive Dysfunction Motor Dysfunction Behavior Dysfunction Seizures

CEREBRAL PALSY: DEFINITION Cerebral Palsy is a static encephalopathy (Brain Injury) Cerebral : Brain and Palsy: disorder of movement or posture It is non progressive There are various etiologies that causes the CP Often associated with epilepsy, speech problems, vision compromise, & cognitive dysfunction Can occur before, at or soon after birth.

CEREBRAL PALSY: PREVALENCE %10 of the world's population Cerebral Palsy (stroke) patient. The number of people with this disease in Turkey about 8 million. 7-10,000 new babies each year 150 years ago it was described by Dr. Little During past 3 decades considerable advances made in obstetric & neonatal care, but unfortunately there has been virtually no change in incident of CP

CEREBRAL PALSY: CLASSIFICATION There are various classifications of CP -Physiologic -Topographic -Etiologic

CEREBRAL PALSY: PHYSIOLOGIC 3 Main Types of Cerebral Palsy Spastic *Stiff and difficult movement *Most commont type of CP Atheoid * Involuntary and uncontrolled movement *Second most common Ataxic *Disturbed sense of balance and depth perception *Effected part of brain: Cerebellum

CEREBRAL PALSY: TOPOGRAPHıC Arm and leg on one side: Hemiplegic Both Leg Only: Paraplegic or Diplegic Both arm and both leg: Quadriplegic

ETIOLOGIC AND CAUSES Prenatal (70%) Infection, anoxia, toxic, vascular, Rh disease, genetic, congenital malformation of brain Natal (5-10%) Anoxia, traumatic delivery, metabolic Post natal Trauma, infection, toxic Often occurs due to brain damage from lack of oxygen before or during birth

CEREBRAL PALSY: SıGNS Depending on which areas in the brain have been damaged, someone with Cerebral Palsy may experience *Muscle tightness or spasm *Involuntary movement *Abnormal sensation and perception *Seizures (sudden and abnormal activity in the brain: Epilepsy)

TREATMENT: BENEFıT AND RISK OF EXERCıSE Benefit : Slow streching, warm external temparature and good positioning can help decrease the dynamic condition found the spasticity form of CP Risk: quick movements, cold external temparature and emotional stress can increase a spastic dynamic condition Increased effort and emotional stress can increase the involuntary and uncontrolled movements. Use adaptive equipment.

SOME EQUIPMENTS

SOME EQUıPMENTS

SPECIAL EDUCATION Depending on the type of cerebral palsy and the degree of its severity, the current trend is to “mainstream ” the child, or place the disabled child into regular classes with non-disabled children. Social-emotional development. Make certain that properly trained staff are available to meet the needs of your child and to manage interactions with other children. The degree of severtiy they can be seperated from others who aren’t with CP For children with CP, the first special school in Turkey is SEMA. It was opened in Teachers, doctors, physiotherapists, social workers, psychologists, nurse partners should work together for effective treatment and education.

REFERENCES ACSM (2010). Guidelines for exercise testing and prescription. Baltimore, MD: Lippincott, Williams & Wilkins.