Ambulant cerebral palsy

Abstract

Cerebral palsy (CP) is the result of a non-progressive lesion or injury to the developing brain and has multiple causes and manifestations. This non-progressive lesion leads to progressive limb problems due to imbalance in muscle tendon unit (MTU) structure and function across joints. This leads to dynamic problems during movement and with posture that may progress over time to become fixed. Abnormal movement and posture result from contractures, lengthening and problems with tone in MTUs. Torsional problems, contractures and joint instability lead to lever arm dysfunction that has a detrimental effect on gait.This article aims to summarize the aetiology and pathophysiology of cerebral palsy, improve understanding of gait in the context of muscle imbalance and lever arm dysfunction, and describe an approach to the assessment and management of these patients.