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Hemiplegia: What treatments are out there?

CIMT Constraint Induced Movement Therapy (“CIMT” or “CI Therapy”) is a specialist form of rehabilitation of the arm and hand for children or adults with hemiplegia.

Constraint induced movement therapy involves rehabilitation of the weaker arm while restraining the stronger arm in a light-weight cast or mitt. CIMT can make significant improvements that are meaningful and lasting.

Constraint induced movement therapy has a large body of scientific research behind it, and the treatment has been shown to positively affect not only the hand and arm, but the brain itself.

A constraint induced movement therapy programme is short but intensive. Treatment is provided daily over a period of 2 to 4 weeks and led by a specialist physiotherapist or occupational therapist.

For more information or to check out our patient stories please visit CIMT. 

HippotherapyHippotherapy is a form of physiotherapy using the movement of a horse to replicate the sensory and motor output of the human pelvis in walking.

The therapist will usually work one-to-one with the disabled person or child, using the horse to help them learn to coordinate and control their responses. The therapist will place the disabled person in different positions on the horse to help develop balance and posture.

Hippotherapy is different from therapeutic riding.

Therapeutic riding is normally run by stables associated with the Riding for the Disabled Association. Conducted in small groups with a riding instructor and physiotherapist, the lesson will again use the horse’s natural movements to stimulate desired responses in the rider’s muscles and posture.

For more information or to find your local centre please visit RDA. 

Botox

Botox is most commonly known for its use in the cosmetics industry but it’s also used with people who have experienced a neurological injury affecting muscle tone such as cerebral palsy and dystonia. Botox is also used to treat spasticity where people have very tight muscles or in cases of fluctuating muscle tone.

Botulinum Toxin A (BTA) is a muscle relaxant derived from the bacterium Clostridium Botulinum. Although these bacteria can be poisonous, when used in small, controlled doses, it can provide safe, effective relief from a number of conditions. BTA has been successfully used to treat muscular conditions in children and adults for over 20 years. Clinical studies and trials have indicated positive and helpful results.

BTA is effective on muscle tone in various parts of the body such as the arms and hands if the grip is an issue or around the orbital (eye) area for dystonia affecting eye movement. However, it’s primarily used on the lower limbs to aid standing and walking.

Breathe MAGICBreathe Magic is a clinically effective, fun and engaging approach to therapy for young people with hemiplegia aged 7 to 19 years. Specialist occupational therapists work alongside magicians to teach magic tricks, designed to develop hand and arm function, cognitive abilities, self-confidence and independence. It consists of a10 day intervention over 2 consecutive weeks followed by monthly therapy sessions for six months (78hrs in total)

For more information visit Breathe Magic. 

Intrathecal Baclofen

Baclofen is a drug produced as a muscle relaxant. It can relieve the stiffness caused by spasticity (tight and stiff muscle tone).

Baclofen is delivered directly into the spinal fluid, by a pump implanted under the skin of the abdomen and connected to a thin flexible catheter. The catheter is tunnelled beneath the skin into the intrathecal space in the spinal cord, where it delivers a precisely controlled dose of the medication.

The function of the pump can be altered to suit the individual so if you or your child need a higher dose of medication at different times of day, the pump will be programmed to this effect. The pump is about the size of an ice hockey puck but can be easily housed in the abdominal cavity.

With cerebral palsy, some of the specific benefits are:

  • Facilitating improvements in self-care and social function
  • Improved motor control and function
  • If offered at the appropriate time, ITB may reduce the need or extent of orthopaedic and surgical intervention
  • Reduction in muscle tone with ITB may slow or prevent hip problems or dislocation
  • Long-term control of spasticity

Stem cell therapy

The science of stem cell therapy is an extremely fast-moving area of research and treatment across the world. It’s claimed that stem cells can address a wide range of illness and disability. However, although stem cells offer promise in a number of areas, we strongly advise waiting until benefits (short- and long-term) are proved via randomised clinical trials and long-term patient care.

Research into stem cell therapies for cerebral palsy is still at a very early stage and no treatments are currently available. Various new strategies are being explored using stem cells, but it is unlikely that any of them will offer a full cure. Instead, they aim to limit the damage to cells in the brain and reduce the symptoms. Cerebral palsy is so difficult to treat because it can involve damage to many different types of cells in the brain. Severely damaged cells can be lost completely. Scientists expect that future treatments will aim to protect and repair damaged brain cells before they are entirely lost. This means it is likely that any new treatment will have to be applied within a small window of time, between the initial injury that has caused damage and the onset of permanent cell loss.

Elliot

Article written by Elliot

As a trained CIMT therapist, I love seeing the amazing changes that people make throughout the programme. I enjoy the intensity of the programme and the bond you make with the patients and their families, but making the programme fun to me is very important to me as seeing the patients have fun whilst they improve is very rewarding.

If you like the article or would like to speak to us get in touch for more information.

Ste Parry

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