Cerebral Palsy - Leah

Objective

Improve muscle tone and core strength in cerebral palsy in preparation for surgery.

Background

Leah, age 7, has spastic diplegia, a form of cerebral palsy characterised by constant spasms and muscle tensing in the legs, which causes mobility problems and frequent falls. To get around, she relies on her walking frame at school or for longer distances, and uses crutches when she’s at home.

Ultimately, the aim is for Leah to have the Selective Dorsal Rhizotomy (SDR) op, to permanently reduce the stiffness and spasticity. However, she has a long way to go before then, as she’ll first need surgery on her hip, and an operation to lengthen the tendons in her legs.

In the meantime, Leah needs to improve muscle strength in her legs and core, to limit the muscle and bone changes that may occur, as well as demonstrate suitability for SDR. The underwater treadmill is ideal for this as the water increases the intensity of the exercise, while giving maximum support.

Programme

  • Duration: 30 minutes
  • Water Temperature: 31˚C
  • Speed: Session 1 – 0.6kph to 1.0kph / Session 18 – 1.2kph to 2.5kph
  • Distance: Session 1 – 0.261km / Session 18 – 0.861km
  • Depth: 800mm
  • Resistance Jets: Not activated
  • Direction: Forward
  • Number of Sessions: 18

Outcomes

Leah’s programme is simply walking in the underwater treadmill in a forward direction for 30 minutes, with plenty of splashing around and fun to keep her interested.

Initially, she covered a distance of 0.261km, but by the 18th session, she was up to 0.861km. Also, the amount of time and the number of steps at the higher speeds have increased significantly.

Her mum has reported a considerable improvement in her strength and noticed that she no longer needs to hold onto the treadmill handrails to steady herself while she walks. Maintaining balance is a major challenge for Leah as she is forced to walk on her toes – one of the most common symptoms of spastic diplegia. To demonstrate the effective combination of surgery and H2O Physio hydrotherapy, Leah's videos, when compared to those of our other cerebral palsy patients, Ben and Rayn, show a marked difference with the heel to toe action.

The busy 7 year-old, who enjoys school, dance and being part of a church group, is beginning to get a curve in her spine due to the postural impact of her condition as she grows. Her mum told us that she has to sit in a ‘W’ shape as she is unable to cross her legs.

Being on oral baclofen since birth, to improve the spasticity, and undergoing a lumbar puncture with the same drug, to mimic the temporary benefits of SDR, are just some of the hurdles Leah has had to face.

In fact, the family as a whole have had to endure plenty of setbacks over the years. A move from Dudley to Sandwell resulted in her weekly physiotherapy sessions being dropped to one every 3 to 6 months, and they have also pushed from pillar to post around various hospitals.

However, Leah is progressing extremely well at H2O Physio, with sessions funded by Tree of Hope, a charity that supports children’s healthcare needs, and Leah's family continue to fundraise in the hope that she'll eventually be accepted for SDR surgery.

Visit Leah's Facebook Page >