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- jjain999@gmail.com

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 .

Thanks for kind attention