Iona’s Summary Notes (August 2019)

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Rates of Cerebral Palsy have reduced by 30%. Simultaneously, the severity of the CP experience has reduced (smaller brain injury) – less children are being diagnosed as Level IV and V with secondary issues such as cognitive impairments.
100 new interventions for CP researched in the last 6 years. 300 are under consideration or being trialled in the next 8 years.
Interventions focus on acquisition of new skills (improve function), compensation, injury prevention (joint surveillance).
There are currently 6 active stem cell trials being conducted which CPA is monitoring.
CPA is reassuring the “traffic light system” looking at the efficacy and research evidence behind different CP treatments and interventions. “Green” has a comprehensive large body of evidence. “Orange” has some evidence and is a good idea in theory but lacks the robustness of clinical trials. “Red” is problematic and requires large interventions from families for very little gains.
The various causal pathways of cerebral palsy require and receive different interventions. Researchers around the world are studying the effects of different management strategies throughout pregnancy, perinatal and antenatal. These include magnesium sulphate, caffeine, cooling caps, and different incubation techniques.

The key definition of a treatment from Iona’s perspective is the following: what it’s involved, where it is based, how many hours it’s involved for, what level and type of CP it can help, and where it can be based.
Treatments for CP can be both active and passive, meaning treatments can be done to the person who actively engages their own muscle groups. For CP, active is generally better for promoting long term gains.
Interventions need to be defined by active modification of the CP experience or successful and meaningful adaptation of the environment (equipment or environmental changes).
Intensive rehabilitation is not a treatment in and of itself. The concept is that a variety of treatment is performed for shorter periods of time at an intense rate i.e. 6 hours a day for 3 weeks. There is no one structure for intensive rehabilitation.

- One of the most important features of treatment is to get the child or adult to “buy-in” to the concept. Therefore, clinicians are starting to include the individuals with CP in the goal-making process.
- The goal is broken down into systematic steps that can be achieved over a length of time with consistent efforts.
- This type of therapy can be checked around all levels and types of CP.
- It is important to translate therapy into functional everyday tasks that the individual can use in a meaningful way.