CEREBRAL PALSY
Integrated Pathway
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VISION
To improve the lives of Children/Young People with Cerebral Palsy by offering a high quality, standardised programme of regular physical and radiological examination, enabling early detection and treatment of secondary musculoskeletal conditions and facilitating multidisciplinary management.
How does the Cerebral Palsy Integrated Pathway Work?
CLINICAL ASSESSMENT
When you/your child are diagnosed with cerebral palsy you will be referred in to the Cerebral Palsy Integrated Pathway.
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From age 2, you/your child will be seen by specially trained paediatric physiotherapists who will ask questions about your condition and care. They will then perform a physical assessment which currently focusses on the spine, hips and legs.
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X-RAYS
Children with cerebral palsy have a risk of their hip joints gradually moving out of place. This is hard to pick up so, in addition to the examination, a hip x-ray may be needed. This depends on how old you/your child is and how severely you/your child is affected by cerebral palsy.
COMMUNICATION
Following you/your child's CPIP assessment, the information will be entered on to a specially designed computer system. Only specialists involved in you/your child's care will be able to access your personal information. It will also be instantly available so for example, if you/your child needs to see their orthopaedic surgeon (s)he will be able to access their CPIP assessment and enter information about future plans of care (e.g. surgery).
RESEARCH
You/your child's anonymised information may be used for ethically approved research. One of our goals is to follow in the footsteps of our Swedish colleagues (who's CPUP system is the basis for our CPIP one) and their more than 80 peer reviewed scientific publications! The Cerebral Palsy Integrated Pathway not only attempts to make your/your child's life better, but also the lives of children in the future.
What happens during a physiotherapy assessment?
The video below was created by What? Why? Children in Hospital. They are a Scottish charitable organisation who have made over 60 extremely helpful and high quality videos and information leaflets encompassing many aspects of the hospital experience for children and their carers. Please have a look at their website here.
Other useful resources and links
Physical activity and sport is so important and everyone should have the opportunity to participate.
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CP Sport is the national disability sports organisation supporting people with cerebral palsy to be able to access and enjoy being physically active throughout their lives​.
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Please visit their website here for more information about their activities, sports, events and opportunities to get involved.
Postural Management
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Children and young people who have limitations to their movements benefit from interventions to ensure their joints are as mobile as possible. By doing this, muscle shortening is minimised, deformity reduced and function maximised.
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This document is a 'two-pager' developed by specialist physiotherapists in Scotland and is a good summary of postural management principles.
This document, also developed in Scotland by NHS Grampian supported by The Archie Foundation, is an excellent source of patient/carer information, including parent stories, illustrating the importance of postural management.
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The phsyiotherapy team at Torbay and South Devon NHS Foundation Trust have made some excellent videos explaining postural management and its various elements - seating, standing, splints, footwear and sleeping.
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Bone Health
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Children with Cerebral Palsy, especially those unable to walk by themselves, are at risk of low bone density and consequently have a higher risk of fractures.
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This evidenced based document was collated by senior physiotherapists and highlights how CPIP should be used to identify children who are at risk of fractures.
Referenced in the above document is this single page pdf developed by specialists in Belfast. It shows exactly how bone health should be assessed in children with Cerebral Palsy, how to minimise the risk of fractures and how to investigate and treat children appropriately.
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