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September 22, 2021

A Primer on Down Syndrome, Cerebral Palsy, and Spina Bifida and How Physical Therapy Can Help

Definitions, symptoms, challenges, and solutions offered by physical therapy 

Physical therapy can:

  • Help children with Down syndrome learn new skills, improve their motor functions, and become more independent.
  • Help children with cerebral palsy develop better coordination, strength, balance, and flexibility.
  • Help children with spina bifida improve their mobility and function.
  • Help children with spina bifida learn how to use devices like wheelchairs, braces, or crutches.

Lumiere Children’s Therapy offers a wide range of services for children who have been diagnosed with physical, developmental, and cognitive conditions, including Down syndrome, cerebral palsy, and spina bifida. Parents and caregivers naturally have questions and concerns about these conditions, including how different types of therapies can help children learn new skills, gain independence, and improve their quality of life.

We discuss each condition, including the signs to look for, specific challenges children might face, and how physical therapy can help.

Down Syndrome

Down syndrome is a genetic disorder related to abnormal cell division. This abnormality results in a full or partial copy of a particular chromosome (21). This leads to physical, mental, and developmental changes. Down syndrome is a lifelong condition with a range of severity depending on the child.

Signs and symptoms

The symptoms can range from mild to severe, depending on the child. Many children remain physically healthy, while others struggle with significant health issues that can include heart defects. Most people with Down syndrome share distinct physical similarities.

Physical signs:

  • Flattened face
  • Upward, slanting eyelids
  • Small head and ears
  • Short neck
  • Low muscle tone
  • Broad, short hands and feet
  • Short height

Children with Down syndrome may also have a range of cognitive, social-emotional, speech, and language delays. Gross motor development can be affected as well in babies and toddlers, so tasks like sitting up, crawling, and learning to walk can be difficult. Children, adolescents, and adults may also note delayed motor skills when compared to similar aged peers.

How physical therapy can help

Physical therapy for children with Down syndrome focuses on helping kids develop necessary life skills and acquire gross motor milestones. Each skill is broken down into smaller parts and then practiced in each step until the new skill is mastered. Practice is done through repetition until the movement or skill becomes more natural.

The method of teaching skills can differ depending on your child’s learning style. Some children are more motor-driven, while others like to observe and physical therapists adapt to each individual’s learning style for the best possible outcomes.

Cerebral palsy

Cerebral palsy (CP) can include different disorders that affect physical movement, muscle tone, and posture. It happens when a baby’s brain becomes damaged during the developmental stage (before birth), during birth, or in the first three-five years of life. This can happen from infection during pregnancy, stroke in the womb or after birth, untreated jaundice, genetic disorders, or medical problems in the mother during pregnancy.

“Cerebral” references the part of the brain called the cerebrum, which controls motor function. “Palsy” refers to a paralysis of voluntary movement in parts of the body.

Most children are diagnosed as infants or toddlers.

Signs and Symptoms

The signs and symptoms can vary widely but usually include one or more movement or coordination challenges, including:

  • Floppiness or rigid muscle tone
  • Involuntary movements
  • Lack of balance and muscle coordination
  • Stiff muscles and exaggerated reflexes
  • Delayed motor skills
  • Difficulty walking
  • Excessive drooling/problems swallowing
  • Delayed speech
  • Learning difficulties

Depending on the severity, some children may have neurological or brain conditions, such as difficulty hearing/seeing, GERD, and sleep disorders.

How physical therapy can help

Physical therapy for children with cerebral palsy is designed to help develop better coordination, strength, balance, and flexibility. Therapists set goals for children to reach developmental and cognitive milestones.

Goals can include:

  • Improving physical limitations
  • Expanding the range of motion
  • Strengthening the muscles
  • Finding alternative ways to perform daily tasks
  • Increasing fitness and flexibility
  • Improving posture and gait
  • Increasing independence

Spina bifida

Spina bifida is a fairly common birth defect that occurs during a baby’s development. It occurs when the group of cells that form the brain and spinal cord (neural tube) doesn’t close all the way, leading to a range of physical and mental issues.

There are three main types of spina bifida:

  1. Spina bifida occulta (SBO) – The most common and mildest form that doesn’t usually cause disability.
  2. Meningocele – A rare type that can cause bladder and bowel issues.
  3. Myelomeningocele – The most severe type that can cause weak leg muscles, seizures, or other impairments.

Signs and symptoms

The signs and symptoms of spina bifida can vary depending on the type. With SBO, the most common sign is a tuft of hair or birthmark at the sight of the defect. With the two other types, it’s possible to see a sac of fluid poking through the skin on the back.

Complications vary greatly, also depending on the types, but may include:

  • Walking/mobility issues
  • Orthopedic problems (curved spine, dislocated hip, bone/joint deformities)
  • Bowel/bladder issues
  • Fluid in the brain
  • Meningitis
  • Sleep-disordered breathing
  • Skin problems

On the other hand, people with SBO often have very mild to no symptoms. They may not even know they have it as the spinal cord and nerves are not affected.

How physical therapy can help

Physical therapy for children with spina bifida focuses on improving mobility and function. It may also include instructing children how to use assistive devices like wheelchairs, braces, or crutches.

Therapy can help children learn to:

  • Roll or crawl
  • Pull up to a standing position
  • Walk without help
  • Walk using ankle braces
  • Walk with crutches/walker
  • Use a manual wheelchair
  • Use a power wheelchair

Find help for your child

If your child has been diagnosed with a condition like Down syndrome, cerebral palsy, or spina bifida, Lumiere Children’s Therapy can help. Our Physical Therapy experts will work with your family, offering exercises to build strength, coordination, and balance. We help your child build new skills and achieve milestones.

We also provide other comprehensive therapies for children with a wide range of physical, emotional, and developmental conditions, including:

  • Speech therapy
  • Occupational therapy
  • Developmental therapy
  • Social work
  • Augmentative alternative communication
  • Early intervention
  • Teletherapy

Lumiere Children’s Therapy is a full-service, multidisciplinary pediatric therapy practice located in Chicago that serves the developmental needs of children from birth to 18 years of age. Learn more about how our team of clinicians works to improve the lives of children and their families.

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