Aging in children with cerebral palsy
DR JITENDRA KUMAR JAINConsultant Pediatric Orthopedic Surgeon
Secretary, Samvedna TrustPresident Trishla Foundation
Allahabadwww.samvednatrust.com
www.trishlaortho.comFb:samvednatrust.cerebralpalsy
Youtube:jjain999Email- [email protected]
Introduction
They grow up, they grow old; They continue to have cerebral palsy &
face its changing challenges every day of their lives.
Many of them are going to have problem
Some of them live long with quality of life
It is you & me who can give good quality of life
How ?
Cont. • Adults with CP may have a shorter lifespan due to existing co-morbidities not because of cerebral palsy.
• Recent statistics show that nearly 50 percent of people aged 65 or older have some type of physical,
psychiatric, or cognitive disability.
• For adults with cerebral palsy, as for the rest of the "normal" aging public, it's only
going to get worse
Problem faced by adult & older population with CP
• Musculoskeletal
• Cardiovascular
• Gastrointestinal
• Reproductive health
• Psychological Status
• Social issues
Effect on Musculoskeletal system
• Increase in muscular spasticity.
• Decrease in flexibility, limited muscle strength, endurance & restricted movement
• 3-5 time more Energy expenditure
• Difficult to perform tasks & take longer time
• Frequent fatigue
• Muscle Sore
Cont. • Anti epileptic drugs, sun exposure, poor intake
lead to Vit D deficiency (osteomalacia)
• Less Wt. bearing & poor muscle lead to osteoporosis
• Abnormal muscle tone lead to deformity & torsion of bone & dislocation of joint, Increase
chances of spondylosis.
• Early degenerative arthritis
• Overuse syndromes (repetitive motion injuries)
End result• Loss of stamina, loss of physical functioning
• Obesity
• More need of support during standing & walking
• Fracture with trivial trauma
• Nerve entrapments.
• Myelopathy
Management • Continuation of therapy programme in
adulthood• Yoga & swimming
• Standing and walking with any support is much better than wheal chair
• More use of assistive devices• Sufficient intake of Vit D and calcium
• Treatment of osteoporosis • Medical treatment for pain & Spasticity• Barrier free environment at home and
public places
Effect on general health
• Diabetes• Obesity or malnutrition
• Hypertension & coronary artery disease• Problem in bladder control like Urinary
retention, incontinence.• Recurrent chest infection & restrictive lung
disease • Pressure sores
Cont.
• Due to extra strain & stresses
Cardiovascular & Pulmonary system have to work hard & they age prematurely around 40 year of age.
• Prevention is better than cure • Regular screening of cardiovascular problem • Early intervention in any cardiovascular &
pulmonary problem • Good nursing care in severely disable patient
Effect on GI system
• Earlier onset of disturbance in gastrointestinal functions
• Combination of mouth breathing, poor hygiene, tooth grinding, mal-occlusion &
abnormalities in tooth enamel & peridontal diseases
• Problem in chewing, swallowing
Cont. • Gastro-esophageal reflux
• Frequent vomiting & aspiration • Constipation
• hemorrhoids
• Feeding & nutritional issues
• Poor general nutrition, retarded physical growth .
Effect on psychological state
• The rate of depression is three to four times higher
• Early memory loss• Sleep deprivation
• Fluctuating emotional status • Loss of self-esteem
• Self neglect• They need social support system
Reproductive health
• Body image • Problem in menstrual cycle,
• Menopausal symptom• STD, birth control
• Pregnancy• Proper counseling & direct care of
guardian
Social issues
• Lower level of education • Higher level of poverty
• Higher level of unemployment• Less disposable income
• Self care• Lesser social activities and communication
problem due to ambulatory & speech problem
• Social abuse, drug & alcohal abuse
Cont.
• Education for all• Job
• Social and independence skills• Social support
• Implementation of life planning
• Group discussion
Group discussion
Detail counseling & meeting with other cerebral palsy
affected adults who has more confidence & balanced mind
Academic, extracurricular & sport activity
•Extracurricular activity like sport, drawing,
music and literary work to maintain stamina &
moral
Message
• It is not only important to live long but it is the quality of life which matters.
• So by good knowledge and well planned
strategy we can prevent impending problems and miseries of life.
• It is the parents / guardian /affected person himself who can change the whole life and
can make their life beautiful .