Brains and bodies learn experientially – that means that if we do a movement with bad form, bad form is what we learn. Athletes know that it is all too easy to learn a function incorrectly and once learned, it is much harder to correct it than it is to learn with good form in the first place. This basic rule that Function Follows Form is also true for the older child with the established movement patterns (aka Habits) of cerebral palsy.
The first step to changing a maladaptive habit is to correct the Form by whatever means is necessary to create as normal as possible body alignment. Peak performance athletes, blessed with an above normal neuromotor system understand the importance of good form first. They use a wide range of compression garments, bracing, splinting and Kinesiotaping to learn new movement patterns with their bodies supported in alignment.
For children with cerebral palsy, at all levels of severity, step one of changing a maladaptive habit is getting the body into the best Form before trying to teach improved Function. If you try to teach function with abnormal body alignment you will teach maladaptive function. This blog post demonstrates how effective this approach can be in an older child with athetoid quadriplegia. Quick Fixes – Take Your Therapist’s Hands Home with You.
The good news is that Habits Can Be Changed, but it takes work. This short animation provides one of the best explanations of making and changing habits. It is crucial that both parents and therapists understand these concepts. Rewire Your Brain with a New Habit
Dr. Pape, I just finished reading your book. Thank you so much for taking the time to get this valuable information in the hands of parents. One of the points you drove home was treating CP patients like athletes. Myself, my husband and my extended family are all athletes so it was great to hear we were on the right track! Our daughter is almost 4, and even though we had very early pt and ot she has some pretty serious habits to correct going forward. I have a question that I have not found that you have addressed. We banked blood cord stem cells on both of our other daughters and our youngest daughter with CP has an opportunity to receive their stem cells. What are your thoughts on umbilical cord stem cell therapy as it pertains to CP.
Thanks for your kind comment.Stem cells are an exciting new area of research. I refer people to the Duke University program
for specific advice. This is about the use of sibling cord blood. https://parentsguidecordblood.org/en/news/sibling-cord-blood-therapy-cerebral-palsy
Thank you for your response. Duke University is who we are working with. We are hopeful the sibling blood cord study will begin soon!
I am in the process of reading your book. My son was born at 28 weeks and has IVH grade 4 (left) and grade 3 (right). He developed hydrocephalus and has a VP shunt. We are still in the NICU, day 81, with his due date being yesterday. He is working on eating. What advice would you give as we start out on this path of life with an early brain injury. I want to give him his best chance at normal function. Thanks.
Dear Shelley, In Chapter 4 of my book I talk about the outcomes that have been measured for this degree of bleeding. The major risk is hydrocephalus as you have discovered. The unilateral Grade 4 bleed has a variable incidence of hemiplegia. This is a type of cerebral palsy that affects one side of the body. These blogs talk about some of the things to consider.
http://www.karenpapemd.com/cerebral-palsy-hemiplegia-gmfcs-i-to-iii-part-one/
http://www.karenpapemd.com/cerebral-palsy-hemiplegia-gmfcs-i-to-iii-part-two/
Hope this helps.