Children’s Hospital Boston’s Cerebral Palsy Program provides interdisciplinary evaluation and treatment of children with cerebral palsy and other neuromuscular disabilities.
Cerebral palsy (CP) occurs when there is injury to the developing brain; children with it can present with abnormal muscle tone or difficulty with coordination, balance, posture and movement. The CP team offers family-centric care with an emphasis on maximizing quality of life.
CP can look very different from child to child. With diplegia, only the legs are involved, with hemiplegia only the left or right side is involved and with quadriplegia both upper and lower extremities are involved. The child may also present with spasticity, ataxia, dyskinesia or dystonia.
The CP Program treats 1,800 patients each year with a range of conditions, including CP, progressive neuromuscular conditions, congenital anomalies, muscle tendon contractures, skeletal deformity and deformities of the spine, hip, knee, ankle and foot.
Children with CP often cannot exercise or stretch their muscles, which can lead to poor muscle and bone growth. Weakened and unbalanced muscles do not adequately support the bone and joint structures causing secondary conditions like scoliosis, hip dislocation and foot and ankle deformities. Secondary conditions can be prevented or treated by managing spasticity.
Often, children with CP have medical conditions in addition to their orthopedic issues, such as developmental delays, feeding and swallowing disorders, seizure disorders, gastroesophageal reflux, constipation, poor nutrition, aspiration, drooling, asthma, airway difficulties, difficulty with urination, visual impairment, hearing loss and communication impairment.
- Physical therapy helps achieve motor function and mobility
- Occupational therapy improves function and independence
- Special braces and orthotics control joint deformities, stretch contracted muscles and support weak muscles
- Surgical lengthening helps if contractures are severe or are causing problems with movement, balance and coordination
To assess walking problems, an evaluation in the Gait Laboratory is available by referral. At this evaluation, children walk in front of a special high-speed camera that records muscle activity with each step. This information is then processed and studied by our team to determine the best treatment.
New patients are evaluated to determine the range of medical issues and developmental abilities. Depending on a child’s need, and in consultation with the family and primary physician, referrals are generated to our subspecialists. When possible, appointments with multiple specialists are coordinated on the same day.
Laurie Glader, MD, pediatrics, complex
Travis Matheney, MD, MLA, hip and lower extremity conditions
Donna Nimec, MD, physical medicine
Robert Rosenthal, MD, orthopedic care
Brian Snyder, MD, PhD, cerebral palsy, pediatric orthopedics, spinal deformity and trauma
Seymour Zimbler, MD, cerebral palsy and pediatric orthopedics
More information: childrenshospital.org/cp