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Joint Contractures and Treatment Options

Muscle impairment is a common aspect of cerebral palsy. Some children with cerebral palsy suffer from joint contractures, which are characterized by shortened muscles and, therefore, reduced movement. As with many conditions associated with cerebral palsy, there are a variety of treatment options available if your child is experiencing joint contractures.

Defined

To understand joint contractures, you must first understand how muscles work. For an average person, muscles will work together to perform various movements. However, for children with cerebral palsy, muscles will work independently or even counter-productively, which results in limited range of motion. As this condition persists over time, joints will shrink and may end up in a static position. It is this that can account for issues with posture that many children with cerebral palsy face in their lives.

Joint contractures are more common in cases of spastic cerebral palsy than other types of cerebral palsy. The disorder is not limited to one part of the body; muscles found in the arms, legs, torso, face and other areas can all be affected by joint contractures.

Signs and Symptoms

As a child with spastic cerebral palsy grows, contractures can become more prominent and can cause issues with their physical development. Many of the symptoms of joint contractures are easy to identify at a young age, such as:

· Limited range of motion

· Unusual movement

· Delayed physical growth

· Limited ability to stretch

· General discomfort while moving

If you notice any of these signs, speak to your child’s doctor. They can refer you to a joint mobilization specialist (or they may have skill in this area themselves). These medical professionals can run a variety of tests to determine the exact range of your child’s movements and identify specific areas that may be causing discomfort. In some cases, the doctor may take x-rays to get a better sense of the severity of your child’s condition.

Prevention

There are several exercises occupational therapists and physical therapists use to help prevent joint contractures from forming. Structured stretching exercises, for example, can offer many long-term benefits for those with joint contractures. Many occupational and physical therapists will incorporate exercises into their therapy practice which aim to increase strength, improve mobility and add to flexibility. Other practitioners will make use of posture-correcting techniques after exercise or stretch sessions and can recommend equipment to continue this process after a therapy has finished.

It’s important to note that, once joint contractures have occurred, they cannot be treated through exercise. In fact, exercise or extended physical activity can actually cause more damage to the joints. Preventive measures should take place as early in the child’s development as possible. If early intervention hasn’t occurred and joint contractures have formed, the next step is to explore treatment options.

Treatment Options

Physical therapy is perhaps the most common form of treatment for joint contractures. As is common with this treatment, physical therapy aims to improve muscle tone and strength, which can offer pain relief to those suffering from joint contractures. In addition to physical therapy, there are many other methods employed to help treat joint contractures.

In some cases, casts can be worn to help keep a part of the body in place and prevent further damage to the muscle. Casts can also be used to slightly stretch the affected area and allow it to have some additional functionality. Casts will have to be checked at regular intervals and may be adjusted or replaced as the therapy continues.

A more recent treatment option for joint contractures is the use of certain medications. For example, one treatment uses Botox to reduce muscle spasticity in specific areas over a period of several months. Another form of this treatment uses a surgical pump to dispense a muscle relaxant into affected areas of the body. So far, these treatments have shown to be temporary, only lasting a few months. Research is ongoing to determine if medications can offer more permanent results.

Of course, treatment options heavily depend on the severity of the condition. In more severe cases, surgery may be required. In other cases, light physical therapy may be all that is necessary. Consistent communication with your child’s doctors and members of your treatment team will help you best determine the treatment that will help your child with cerebral palsy the most.


Source by Paul Ramon


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