This classification system is useful for determining overarching areas of deficit, but can leave much to be desired when identifying a kiddos level of ...

Understanding Cerebral Palsy Classification levels


Children with cerebral palsy may be classified as Diplegic, Hemiplegic,
Quadriplegic, Dyskinetic, Ataxic or a mixture of these depending on the
presentation of their symptoms.

This classification system is useful for determining overarching areas of
deficit, but can leave much to be desired when identifying a kiddos level of
functional capacity or severity of disability.

While these traditional markers continue to be the primary method of
classification used in the medical field, there is an additional system that can
provide a more robust picture of the kiddo as a whole.

The Gross Motor Function Classification System (GMFCS) uses 5 levels to classify
a child’s individual motor abilities through an analysis of functional mobility
or more simply, how they get from place to place.


5 Levels of Cerebral Palsy
<Level 1>

Level 1 includes children who have no restraints when walking. They can ambulate
freely without instability. Typically children in this level do not wear any
assistive devices.


<Level 2>

Level 2 includes children who can walk without assistance but may have some
difficulty at times. Typically these kiddos cannot jump or balance on one foot,
may fall frequently and/or need to hold onto railings when walking up stairs or
over curbs.


<Level 3>

Level 3 includes children who need to use an assistive device to walk upright.
These kiddos can walk in certain environments for reduced distances by self
directing the use of devices such as revere walkers or forearm crutches. For
longer distances children in level 3 will used wheeled mobility and can often
self propel their chair.


<Level 4>

Level 4 includes children who require external assistance in order to get
around. They may use a wheelchair or a walker with significant help and support
to compensate for lack of speed and/or stability. The child on the right is
using a device called a Gait trainer, which provides trunk support for those who
are unable to fully support themselves using a typical walker..


<Level 5>

Level 5 includes children who require the assistance of a guardian for all
movements. These kiddos often cannot support their head and trunk while seated
and may utilize wheelchair positioning devices such as head rests and lateral
supports.


Sometimes, the distinctions between different levels can be unclear. Kiddos can
have varying abilities, depending on the day. The best way to determine which
level is the best fit is to think of how the child gets around most of the time,
not just their best performance. Also, although GMFCS levels may seem to focus
on lower body function, understand that many of these assistive devices require
the use of arms and hands as well.

Seek the advice of your medical or therapy team if you are not sure what GMFCS
level applies to your child or if a treatment plan is recommended to maximize
their day-to-day function.

Further Reading
Fun Outdoor Activities for Your Child With Cerebral Palsy
[https://evergreenhhc.com/pediatric-health-care-denver/fun-physical-activities-for-your-child-with-cerebral-palsy/]
Indoor Sensory Activities for Your Child With Cerebral Palsy
[http://jldtherapy.com/5-sensory-activities-to-do-at-home-with-cerebral-palsy/]

Cerebral Palsy Rehab

Move early for your stroke therapy and often to increase function.  Learn about effective stroke exercises with Smart Glove and Smart Board packages.

Stroke Therapy and Exercise: Move Early and Often to Increase Function

About Effective Stroke Exercise and Stroke Therapy


Act fast for your Stroke Therapy!

Nearly 75% of stroke survivors have difficulty with hand and arm movement after
stroke and only about 20% experience some functional recovery in the first 6
months. Focus on upper extremity exercise, particularly during inpatient
rehabilitation, is surprisingly low. In our previous post on stroke therapy dose
[https://www.neofect.com/us/blog/does-therapy-dose-really-matter-for-stroke-recovery/]
, we discussed the importance of greater intensity. When it comes to upper
extremity exercise and therapy, it seems that more is better for functional
outcomes.

Another way to increase stroke therapy dose is to apply an exercise program like 
the GRASP program [http://neurorehab.med.ubc.ca/grasp] that can be easily
self-administered and is flexible enough to work with a range of impairments.
When started early on after stroke in an in-patient setting, four weeks of GRASP
training improved arm and hand function compared to an education program.
Constraint-induced movement therapy (CIMT) can increase the dose of functional
training. Modified protocols are available to increase patient tolerance. Talk
to your therapist to see if these exercise and activity approaches would be a
good fit for your needs.

It’s also important to start moving EARLY when the brain is primed to re-wire
and re-organize itself. Neuroplasticity
[https://www.neofect.com/us/blog/why-neuroplasticity-matters-to-post-stroke-rehabilitation/] 
is the brain’s ability to find alternative pathways for the area of the brain
that was damaged due to a stroke. If we were able to encourage an intensive
therapeutic program early in stroke or brain injury recovery, using a Smart
Rehabilitation Solution like the Neofect Smart Glove
[https://www.neofect.com/us/smart-glove] or Smart Board
[https://www.neofect.com/us/smart-board], it is likely that we could improve
motor function by taking advantage of the brain’s plasticity through repetition.



Post stroke depression is a common after effect of stroke for many individuals.
Depression has been found to have negative effects on functional recovery.
Physical exercise may help in providing a supportive treatment for depression.
It has been found that those that are able to manage post-stroke depression have
greater functional outcomes as well. The take away, exercise can assist in the
management of depression and prolonged depression can keep a stroke survivor
from making the fullest recovery possible.

Move as soon as possible for your stroke therapy when you plan your exercise
program after stroke! Our Smart Glove and Smart Board packages come with
clinical support to allow you to maximize your use of our devices for your
continued stroke therapy and exercise. As you look at different options for your
stroke recovery, our Smart Rehab Solutions may be a good fit for your needs,
call us to discuss your individual rehabilitation goals: (888) 623-8984
[tel:+18886238984].


*Neofect Home Inquiry:
-www.neofect.com [https://www.neofect.com/us]
-Phone: (888) 623-8984 [tel:+18886238984]



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References

 * The future of stroke rehabilitation: upper limb recovery ACNR (
   https://www.acnr.co.uk/wp-content/uploads/2015/09/Page-61.pdf)
 * Winstein, et al. (2016). Guidelines for Adult Stroke Rehabilitation and
   Recovery (https://www.ahajournals.org/doi/full/10.1161/STR.0000000000000098)