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Children with diparetic CP learn to walk with assistive devices.
Amos Morgan/Photodisc/Getty Images
According to the Centers for Disease Control and Prevention, cerebral palsy is the most common childhood disability that affects body movement. CP is a neurological condition that develops before birth, during birth or during the first five years of life. Diparetic CP is a type of spastic CP, characterized by excess tightness in specific muscles in both legs.
Cerebral palsy is a group of disorders that affect motor function in children. Although the symptoms do not get worse, the ability to move is affected throughout a person's lifespan. Diparetic CP specifically affects both legs, with little or no impairment in the arms. Muscles are excessively tight due to increased muscle tone, causing decreased range of motion in the joints of the legs. This significantly impacts the person's function, and some people are not able to walk.
Although the cause of cerebral palsy is not always known, several contributing factors have been identified. Genetic abnormalities, brain damage and infections in the womb can cause CP prenatally. Toxemia during labor and delivery can poison an infant, leading to the development of CP. Children born prematurely are at increased risk for CP. According to James Madison University, approximately 50% of children with CP were born before 36 weeks gestation. CP can also develop during the first 5 years of life as a result of traumatic brain injury or brain infections. According to a study published in 2010 in Pediatric Research, specific types of microorganisms found in the placenta were associated with the development of diparetic CP.
Diparetic CP is not a progressive disease, however symptoms continue to impact a person throughout the lifespan as the body grows and new motor skills are learned. Diparetic CP is not a painful condition, and sensation remains intact. Increased muscle tightness in the inner thigh muscles and calves cause the legs to pull toward each other and the heels to lift off the ground. This results in a "scissoring" gait pattern where the legs may actually cross in front of each other as a person walks. Orthotics are often worn to hold the ankle joint at a 90 degree angle to improve walking abilities, keeping the toes from catching on the floor. Assistive devices such as a wheeled walker are used for ambulation with decreased balance.
Although there is no cure for diparetic CP, interventions are used to manage symptoms to improve quality of life. Oral medications are sometimes prescribed to reduce muscle tightness, however they are associated with significant side effects, preventing long term use. Botox injections are sometimes used to reduce tightness in a specific muscle, such as the calf or the inner thighs.
Physical therapists use strengthening and gait training techniques to improve mobility for people with diparetic CP. Occupational therapists teach people with CP how to perform daily activities with the use of adaptive equipment for self-care tasks. Occupational therapists also assist with job modification to promote success in the workplace.