💪 Therapies & Treatment

Physiotherapy

Physiotherapy is the cornerstone of CP management and typically begins in early childhood. Physiotherapists work on:

• Strength and flexibility — building muscle strength while managing spasticity
• Gross motor skills — sitting, standing, walking, and transitioning between positions
• Balance and coordination — improving stability and reducing fall risk
• Fitness — building cardiovascular health and endurance
• Pain management — stretching, positioning, and exercise to manage pain
• Post-surgical rehabilitation — recovering movement after operations

Modern physiotherapy for CP is goal-oriented and activity-based, focusing on real-life activities that matter to the person. Evidence-based approaches include constraint-induced movement therapy, task-specific training, and strength training.

Occupational Therapy

Occupational therapists (OTs) focus on enabling people to participate in daily activities:

• Fine motor skills — writing, typing, eating with utensils
• Self-care — dressing, bathing, grooming
• Equipment and modifications — recommending and fitting adaptive equipment
• Home and workplace setup — modifying environments for accessibility
• Splinting and orthotics — hand and wrist splints to improve function
• Sensory processing — addressing sensory sensitivities or seeking

Speech Pathology

Speech pathologists work with people with CP on:

• Speech clarity — exercises and strategies to improve articulation
• Communication systems — introducing AAC (augmentative and alternative communication) such as communication boards, apps, or eye-gaze devices
• Swallowing — managing dysphagia and reducing aspiration risk
• Feeding — improving oral motor skills for eating
• Language development — supporting understanding and use of language

Medications

Several medications are commonly used in CP management:

• Botulinum toxin (Botox) — injected into specific muscles to reduce spasticity. Effects last 3–6 months and injections are repeated as needed
• Baclofen — oral or intrathecal (pump) to reduce generalised spasticity
• Diazepam and other benzodiazepines — for short-term spasticity relief
• Anti-epileptic medications — for seizure management
• Pain medications — from paracetamol to specialist pain management
• Medications for drooling — anticholinergic medications or Botox to salivary glands

Surgery

Surgery may be considered when other treatments are not sufficient:

• Orthopaedic surgery — to lengthen tight muscles and tendons, correct bone alignment, or stabilise joints. Common procedures include hip reconstruction, hamstring lengthening, and spinal fusion for scoliosis
• Selective Dorsal Rhizotomy (SDR) — a neurosurgical procedure that permanently reduces spasticity in the legs by cutting selected nerve roots. Best suited for specific cases of spastic diplegia
• Intrathecal baclofen pump — surgically implanted pump that delivers baclofen directly to the spinal fluid for severe spasticity
• Deep brain stimulation — for selected cases of dyskinetic CP

Emerging Treatments

Research continues to explore new treatments:

• Stem cell therapy — clinical trials are investigating whether stem cells can repair brain injury. Results are promising but still experimental
• Robotic-assisted therapy — exoskeletons and robotic devices for gait training and upper limb rehabilitation
• Virtual reality — using VR for engaging, motivating therapy sessions
• Transcranial magnetic stimulation (TMS) — non-invasive brain stimulation being explored for motor recovery
• Neuroprotection — research into cooling therapy and other strategies to prevent brain injury at birth

Choosing Therapies

With so many options, choosing the right therapies can feel overwhelming. Key principles:

• Focus on therapies with good evidence behind them
• Set meaningful, achievable goals
• The person with CP should be central to all decisions
• Therapy intensity matters — more is not always more, but consistent is better than sporadic
• Life balance matters — therapy is important, but so is play, socialisation, and rest

Be cautious of treatments that promise cures or miraculous results. If it sounds too good to be true, it usually is. Ask your medical team about the evidence.