We are often asked how Key to CP intensives differ from other CP intensives out there. Key to CP intensives always individualized – just like no two people with CP are exactly the same, no two intensives can be the same. We use a highly unique and systematic approach to both assessment and treatment. One component is followed by the next, but we cannot go on to the next component before we successfully finish the previous component. Here is why:
By alignment, we mean alignment of the entire body: trunk, head, arms and legs. There is a reason why alignment is first. If an area of the body is not in alignment, joints and muscles cannot work the way they should and over time wear and tear causes pain and loss of function.
The most important reason for making sure that all areas of the body is in good alignment is that it will bring muscles into their most effective length. A muscle that is over lengthened/elongated is weak; a muscle that is short is also very weak; a muscle that is maintained in mid range – in between short and long – is strong. By just bringing a muscle into in mid range it is stronger and easier to use. All our muscles work best if they are in their optimal range – no a point but a range. All of our joints work best if they are supported and only allowed to move the way they are supposed to.
Now think about muscle tone: spastic muscles are short and weak, muscle with low tone are long and weak, muscles that oppose the short spastic muscles are elongated and thereby weak, muscles that oppose low tone elongated muscles are likely short and weak. The common denominator is: WEAK
Honestly, it blows my mind that alignment is not addressed routinely in people of all ages with CP – it is an easy and logical way to ensure good function and prevent future pain.
We always start at the trunk. For children and adults with low muscle tone in their trunk and high muscle tone in their arms and legs, supporting the weak trunk often results in an immediate reduction in muscle tone in their arms and legs, which allows them to learn to use their arms and legs better. We see an immediate improvement in head and trunk control when the trunk is supported, which allows the child to be social and participate in play!
Think of ankles and feet for a moment. If the ankle collapses in and the person is on their toes (a common condition in CP) that happens because of a combination of spastic weak muscles and elongated weak muscles then the joints of the ankle and feet are stressed in a way that they are not designed for and over time damage will occur to both joints and muscles. Not only can the person with this type of ankle and foot position not learn to stand and walk well, but they will likely develop wear and tear and have pain later in life. If you speak to adults with CP they will tell you that pain are in pain and the pain causes loss of function.
The good news is that this cascade of events does not have to happen! If we support all joints including the trunk in optimal alignment to allow muscles and joints to work properly then good movement control is the immediate result. The long term result is prevention of pain and loss of function.
In Key to CP intensives we have a variety of tools in our therapy tool box to address alignment. Once we secure good alignment we see an IMMEDIATE change in function and we can go on to step 2.