Medical Matters for Drivers, Caregivers & Family Members

Mobility Challenges

Below are links to more information based on your mobility challenge.

Cerebral Palsy

MobilityWorks and You

At MobilityWorks, we understand that Cerebral Palsy does not typically "progress" in the sense that symptoms get worse. From the perspective of accessible transportation, the progression we focus on is the physical growth of your child and the changes in their size, weight and the mobility equipment (i.e. wheelchairs) that they use. In addition, we understand that the number of members in your family may increase through the years and as a result, you will need mobility solutions that can accommodate all.

So, as you can see--- "growth" is the major consideration. Based on this, we like to have you give consideration to the following:

  • Be sure to select an accessible vehicle large enough to accommodate your entire family now
  • Plan for the future. If you think that your family may grow in number while you have this vehicle, be sure to plan accordingly
  • Ensure that the lift or ramp in the vehicle is in a position that works best for both the individual with Cerebral Palsy as well as all other family members
  • Remember that wheelchair-users and non-wheelchair uses will have to enter and exit the vehicle and ride together comfortably. For this reason, organizing the wheelchair vehicle to accommodate your needs and preferences will help in providing the best solution for your unique situation
  • Also remember that lifts and ramps can be put in the rear or side of the vehicle and that several different styles of each are available. Be sure to weigh the advantages (or potential disadvantages) of each for your family
  • Be sure to equip your accessible vehicle with the features that will have the most impact on your long-term satisfaction. For example; if you will use the wheelchair securement system in your vehicle day-in and day-out, be sure that you review the different securement systems that are available and select the best option for you.  You have a choice between manual and power ramps. Manual ramps are less expensive and easier to maintain but require some effort on your part when you open/close the door and ramp. Power options are the easiest to use but come at an additional cost and have the potential for malfunction.
  • Finance the vehicle according to your plans. The length of time that you expect to own the vehicle should be a  major consideration/factor when making your choice.

Our team of Certified Mobility Consultants pride ourselves on developing last relationships with our customers. We want to ensure that you have the most appropriate mobility equipment for your needs---today and in the future.

Cerebral Palsy Overview

Cerebral palsy is a neurological disorder caused by a non-progressive brain injury or a malformation that occurs when a child's brain is under development—before birth, during birth or just after birth.

Cerebral palsy affects body movement, muscle control, muscle coordination, muscle tone, reflex, posture and balance. It can also impact fine motor skills, gross motor skills and/or oral motor functioning.

Signs and symptoms of cerebral palsy may not always be immediately apparent at birth. A child with cerebral palsy will experience delays in development and growth milestones. The early signs of cerebral palsy include a lack of muscle coordination when performing voluntary movements; stiff or tight muscles and exaggerated reflexes; walking with one foot or leg dragging and/or muscle tone that is either too stiff or too floppy.

Cerebral palsy is classified into several different types:

  • Spastic: The most common type of cerebral palsy in which reflexes are exaggerated and muscle movement is stiff
  • Dyskinetic: Dyskinetic cerebral palsy is sub-divided into two categories; athetoid cerebral palsy which is marked by involuntary, slow, writhing movements and dystonic cerebral palsy in which trunk movements are more affected than limb muscles, resulting in a twisted posture
  • Ataxic:  A type of cerebral palsy in which voluntary muscle movements are not well coordinated
  • Hypotonic: A type of cerebral palsy in which muscle tone is decreased or floppy
  • Mixed: A form of cerebral palsy which is comprised of combinations of the symptoms listed above

Symptoms

A parent is likely to notice when a child doesn't roll over when he or she should, or when an infant is not taking their first steps. When this occurs, it could mean the child is slow to develop, or it could be a sign of developmental delay. Developmental delay is an early indicator that a child may have cerebral palsy.

Doctors look for visible signs of brain injury when they evaluate children for cerebral palsy. Doctors will also look for evidence of excessively stiff or loose limbs. Radiological signs of cerebral palsy are visible in the brain through neuroimaging techniques like MRIs, CT scans, and cranial ultrasound.

If developmental delay is suspected then a developmental evaluation will be performed by a specialist. Tests performed at this stage are to diagnose as well as to rule out certain conditions. Developmental screening is also used to detect whether possible impairment of the child's development exists. Doctors ask parents questions and interact with the child to gauge capabilities, reflexes and responses.

About two to three out of every 1,000 children have cerebral palsy. Although there is no cure for the disorder, the condition is non-progressive. The disorder can be managed and individuals with cerebral palsy can live long, healthy quality lives.

Risk Factors/Prevention

In many cases, cerebral palsy cannot be prevented. However there are also some preventable situations that – if left unattended – increase the chances that a child could be born with cerebral palsy. On the part of expectant mothers and physicians, there are some measures that when implemented can help reduce the likelihood that a child will have cerebral palsy.
The risk factors that parents should be mindful of include

If a child is conceived through assisted reproductive technology, or IRT

  • A mother has chronic infections
  • A mother has an improperly treated sexually transmitted disease
  • A mother is Rh-negative
  • A mother has not received regular pre-natal care
  • An accident has taken place that has resulted in a physical injury

After a child is born, the risk factors include:

  • A child is injured, abused, or shaken
  • An infection is acquired that causes decreased blood flow to the brain
  • The child suffers a stroke
Treatments and Rehabilitation Information

In general, the earlier treatment begins the better chance the child has of overcoming developmental disabilities and of learning new ways to accomplish tasks that challenge them. Treatment may include physical and/or occupational therapy, speech therapy, administration of drugs to control seizures, relax muscle spasms and alleviate pain, use of braces and other orthotic devices, wheelchairs and communication aids such as computers with voice synthesizers.

In addition, other forms of therapy; including acupuncture, aqua therapy, chiropractic care, music therapy and even hippotherapy (which utilizes horses to assist children in learning how to make adjustments to their gait, tempo, rhythm and repetition) can also be used to aid in the management of cerebral palsy.  

Surgery may be used to release joint contractures and/or insert feeding tubes. Other surgeries can help relieve pain and spasticity.

Research

Recent research into the study of cerebral palsy has increasingly shown evidence that suggests that genetic mutations play a role in at least some cases of cerebral palsy.

According to findings published online in the journal Molecular Psychiatry, approximately 14 percent of cerebral palsy cases may be caused by genetic mutations.

In the study researchers analyzed the DNA of 183 people with cerebral palsy to look for genetic anomalies (mutations). Similar testing was also done on the participant's parents. The researchers found that about 1 in 7 of those had a "potentially disease-causing gene variant".

The findings may now help lead to earlier diagnosis of some cerebral palsies, assist in the management and treatment of the disorder and aid preventative genetic techniques (gene therapies) for the future.

Resources

Mobility Challenges

Below are links to more information based on your mobility challenge.

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