Afflicted children need long hours of therapy

Grandmothers can be helpful in providing children with cerebral palsy an improved quality of life, according to a study on such afflicted children in Calcutta. A team of researchers from the Indian Institute of Cerebral Palsy, Calcutta, and the Wales College of Medicine, the UK, suggests that children with cerebral palsy need to have this therapy for long hours daily. Though physiotherapists do provide trained treatment, it’s only for a certain time. It’s therefore left to the parents and family members, like grandmothers, to continue with the treatment and rehabilitation.

In most cases, however, both parents remain busy with their jobs and hardly find the time to help their children affected by cerebral palsy. Grandmothers, who are present in the house throughout the day, can help in this regard, the researchers write in the medical journal Physiotherapy. Grandmothers can also escort children to and from schools, and thus build a bond with them. This bond helps the afflicted children to lead a good life, they add.

Cerebral palsy occurs when part of the brain is damaged or has not developed properly, according to a statement by the Indian Institute of Cerebral Palsy. This may happen before birth, at the time of birth or in early childhood. “In some people, cerebral palsy is barely noticeable. Others will be more severely affected,” the statement adds.

Dr Sumana Datta Kanjilal, former associate professor of paediatric medicine at Calcutta National Medical College Hospital, explains that cerebral palsy affects motor skills, which delays activities like smiling, sitting, crawling and walking. Afflicted children also have speech and hearing problems. She adds, “Most of the time, cerebral palsy manifests itself before the child is one year old. In severe cases, the disease can be diagnosed even before the child is three months old. Some children may become impassive or even mentally retarded. Some, however, go on to become highly intelligent.”

Functional problems

For the research, Dr Tessa Hamblin from the Indian Institute of Cerebral Palsy, Dr Iris Musa from the Wales College of Medicine and their colleagues studied the families of 20 affected children living in Calcutta’s slums. “The most common problem felt by the families was that the child was unable to walk. In addition, they often mentioned a functional problem with feeding and activities related to the toilet,” the researchers write in the journal.

Researchers, however, warn that cerebral palsy has no cure, and proper motivation and therapy are the only ways to manage the disease. Says Dr Agnimita Giri Sarkar, a paediatrician at Life Line Hospital, “Every child with cerebral palsy needs physiotherapy. This helps the affected side of the body to function optimally and also boosts the functions of the non-affected side.” The children may also need speech therapy and should be taught about doing regular activities like going to the toilet, brushing, dressing, self feeding and so on. “Proper education is also required to help them lead a good social life. Playing at home can be an important way to treat these children because this can improve both their physical and mental abilities,” Dr Sarkar adds.

Dr Debasis Basu, associate professor of Neurology at NRS Medical College and Hospital, agrees that family members can help. “Treatment of cerebral palsy is basically symptomatic. Rehabilitation therapy is the mainstay of treatment and it’s done in the form of physiotherapy, speech therapy and other vocational therapies. Home-based care is an important means of rehabilitation,” Dr Basu says.

Training needed

In addition, the authors of the study say that the treatment needs to take place over long periods and should be the dominant activity each day in order for the intervention programmes to be effective. Dr Hamblin says, “Grandmothers can be involved in the routine activities of the child, such as feeding, movement, education and so on. They can be involved in playing with the child and can help him or her receive proper therapy.” She adds, “This project has shown that it’s possible to use the resilience and resourcefulness of the family to help the child to become part of his or her community, attend school and so become equipped for the future.”

However, grandmothers and other family members should properly learn the necessary techniques from trained therapists before they use them in cerebral palsy-affected children.

“Any therapy, provided by persons who’re not properly trained can be dangerous. So before implementing family-based rehabilitation in cerebral palsy children, proper training to family members should be provided,” Dr Kanjilal cautions.