What is Infantile Cerebral Palsy?

Infantile cerebral palsy (ICP) is a general term for various movement disorders that result from damage to the brain in early childhood. It is one of the most common physical disabilities in childhood. The brain damage can occur before, during or after birth and is not curable. The causes are varied and can affect different areas of the brain. Risk factors include brain malformations, strokes, infections during pregnancy, prematurity, head injuries, placental insufficiency, or drugs and medications consumed by the mother. Often, however, the exact cause cannot be determined. The diagnosis is usually not made immediately after birth, but within the first two years of the child's life.

Medical illustration of types of cerebral palsy and areas of the brain.

What are the symptoms of Infantile Cerebral Palsy (ICP)?

Depending on the affected region in the brain, a broad spectrum of symptoms can be observed. Typical are movement and posture disorders with a spastic increase in muscle tone, which can affect the entire body or parts of it. In addition to spasticity, ataxia, i.e. impaired coordination of movement sequences with balance disorders, and athetosis, i.e. the occurrence of screw-like, uncontrolled movements, may be present.

Cramped muscles result in joint and spinal misalignments as well as bone deformities. Typically, spinal curvatures, hip and leg deformities, and pointed feet occur. Depending on the severity of ICP, affected individuals may have only mild limitations in walking or may be dependent on orthotics or a wheelchair. Often, ICP is accompanied by speech and vision disorders, epilepsy, and reduced intelligence.

How is ICP treated?

ICP is not curable. However, through close cooperation between various disciplines, it is possible to alleviate symptoms, train movement patterns, correct malpositions and thus improve quality of life. This includes antispasmodic medication, surgical measures, extensive physical and occupational therapy, and speech therapy. Aids such as orthoses can help prevent joint malpositions, improve the mechanics of the gait pattern and thus achieve the greatest possible mobility and independence.

Sorg wheelchair for cerebral palsy

What is the purpose of an orthosis for Infantile Cerebral Palsy (ICP)?

Affected persons exhibit a pathological gait pattern, as the individual muscles do not work harmoniously. In addition, paralysis can occur. These further restrict the movement possibilities. Therefore, depending on the degree of disability, it may make sense to work with an orthosis to improve the gait pattern. The reason for this is that an orthosis provides support when standing and is additionally helpful when walking.

Of course, an orthosis is not an option for all sufferers, but it is often a sensible solution if walking and standing are still basically possible. Then an improvement is conceivable, which is achieved by the right fitting.

An orthosis offers the following advantages:

In general, orthoses provide:

  • Stop when standing
  • Walking support
  • A correction of the position and posture
  • Support for correct foot elevation
  • An improvement in muscle function and movement patterns
  • A regulation the muscle tension

Whether an orthosis is applicable depends on the individual's condition. To prevent joint malpositions, it makes sense to use orthoses at an early stage. During growth, constant individual counseling and regular adjustment of the orthosis is necessary.

Conclusion: More mobility and independence in everyday life thanks to an orthosis

Infantile cerebral palsy restricts the movement of those affected to various degrees. In addition to interdisciplinary treatment, orthoses offer the possibility of preventing and correcting malpositions and supporting the musculoskeletal system. As a result, patients regain some of their independence and are more mobile in everyday life.

[1]        Gulati, S., Sondhi, V., 2018. Cerebral Palsy: An Overview. Indian J Pediatr 85, 1006–1016. https://doi.org/10.1007/s12098-017-2475-1

[2]        Kerkum, Y.L., Buizer, A.I., van den Noort, J.C., Becher, J.G., Harlaar, J., Brehm, M.-A., 2015. The Effects of Varying Ankle Foot Orthosis Stiffness on Gait in Children with Spastic Cerebral Palsy Who Walk with Excessive Knee Flexion. PLoS One 10, e0142878. https://doi.org/10.1371/journal.pone.0142878

[3]        Lintanf, M., Bourseul, J.-S., Houx, L., Lempereur, M., Brochard, S., Pons, C., 2018. Effect of ankle-foot orthoses on gait, balance and gross motor function in children with cerebral palsy: a systematic review and meta-analysis. Clin Rehabil 32, 1175–1188. https://doi.org/10.1177/0269215518771824

[4]        Meyns, P., Kerkum, Y.L., Brehm, M.A., Becher, J.G., Buizer, A.I., Harlaar, J., 2020. Ankle foot orthoses in cerebral palsy: Effects of ankle stiffness on trunk kinematics, gait stability and energy cost of walking. Eur J Paediatr Neurol 26, 68–74. https://doi.org/10.1016/j.ejpn.2020.02.009

[5]        Michael-Asalu, A., Taylor, G., Campbell, H., Lelea, L.-L., Kirby, R.S., 2019. Cerebral Palsy: Diagnosis, Epidemiology, Genetics, and Clinical Update. Advances in Pediatrics, Advances in Pediatrics 66, 189–208. https://doi.org/10.1016/j.yapd.2019.04.002

[6]        Novak, I., Morgan, C., Adde, L., Blackman, J., Boyd, R.N., Brunstrom-Hernandez, J., Cioni, G., Damiano, D., Darrah, J., Eliasson, A.-C., de Vries, L.S., Einspieler, C., Fahey, M., Fehlings, D., Ferriero, D.M., Fetters, L., Fiori, S., Forssberg, H., Gordon, A.M., Greaves, S., Guzzetta, A., Hadders-Algra, M., Harbourne, R., Kakooza-Mwesige, A., Karlsson, P., Krumlinde-Sundholm, L., Latal, B., Loughran-Fowlds, A., Maitre, N., McIntyre, S., Noritz, G., Pennington, L., Romeo, D.M., Shepherd, R., Spittle, A.J., Thornton, M., Valentine, J., Walker, K., White, R., Badawi, N., 2017. Early, Accurate Diagnosis and Early Intervention in Cerebral Palsy: Advances in Diagnosis and Treatment. JAMA Pediatr 171, 897. https://doi.org/10.1001/jamapediatrics.2017.1689

[7]        O’Shea, T.M., 2008. Diagnosis, treatment, and prevention of cerebral palsy. Clin Obstet Gynecol 51, 816–828. https://doi.org/10.1097/GRF.0b013e3181870ba7

[8]        Vitrikas, K., Dalton, H., Breish, D., 2020. Cerebral Palsy: An Overview. Am Fam Physician 101, 213–220.

[9]        Wright, E., DiBello, S.A., 2020. Principles of Ankle-Foot Orthosis Prescription in Ambulatory Bilateral Cerebral Palsy. Phys Med Rehabil Clin N Am 31, 69–89. https://doi.org/10.1016/j.pmr.2019.09.007

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