DISCUSS IN DETAIL THE ISSUES ASSOCIATED WITH AGING IN CEREBRAL PALSY ? 10 MARKS
A 3 INTRODUCTION
Cerebral palsy (CP) is often seen as a disorder involving children only. But children with CP nearly always grow up to become adults with CP, and with continuing improvements in survival, it has become increasingly important to plan appropriate service provision for such adults.
FUNCTIONAL CHANGES IN ADULTS WITH CP
A ) changes in motor function
1 - loss of ambulation skills in 35 % of population
2 - a 50 % decline in walking ability
3 - early development of osteoporosis - 50 %
CAUSE / ETIOLOGY
A ) changes in muscle flexibility
B ) strength and endurance
C ) increased spasticity
D ) arthritis
E ) falls and fractures
F ) pain; and fatigue.
G ) Limited weight bearing
H ) medications (especially for epilepsy )
I ) inadequate nutrition, and other causes were considered potential risks for the early development of osteoporosis in these individuals
B ) CHANGES IN COMMUNICATION
1 children with CP can have speech, language, and hearing impairments that cannot be remediated and thus persist into adulthood.
2 In addition, one or more of these areas (e.g. hearing) may decline as part of the aging process or because of co-morbidities such as acquired neurological conditions.
3 Speech sound errors with the primary disorder of dysarthria are the most common communication disorders in cerebral palsy.
A ) Dysarthria is an umbrella term for speech disorders caused by damaged central and/or peripheral motor-sensory loops that interfere with one or more component of the speech-production system (i.e. respiration, phonation, resonance, articulation).
4 Language skills can be described on the basis of what the adult with CP understands (i.e. receptive language skills) and of what the adult says (i.e. expressive language skills).
5 Hearing assessment using pure tone audiometry or physiological tools such as otoacoustic emissions (OAEs) or auditory brainstem response (ABR) are the most commonly reported communication measures in CP studies.
6 However, several CP surveillance systems use 40 or 70 dB hearing loss cut points to describe hearing loss, instead of 20 dB, as is more commonly used in audiological research and practice, results in underreporting of milder hearing difficulties in individuals with CP.
C ) CHANGES IN SWALLOWING
1 - The act of eating can be thought of as a timeline of motor actions: getting and keeping food and drink into the mouth, oral preparation, oral transport, pharyngeal transport, and/or esophageal transport.
2 People with CP may have trouble with one or more of these motor actions, which may make getting adequate nutrition and hydration difficult.
3 Some people with CP use assistive technology, including tube feeding, to eat.
***** So , Eating and swallowing impairments may develop or worsen as the adult with CP ages.
4 Some clinical anecdotes suggest that changes in eating and swallowing can happen rapidly, which may mean that adults, caregivers, and professionals should monitor for early symptoms of eating difficulties (Workinger, personal communication) vv imp
5 adults with CP have a heightened risk for developing overuse syndromes and nerve entrapments.
MAIN BARRIERS OF ADULTS WITH CEREBRAL PALSY
1 Community non acceptance due to communication disorders
2 Activity limitations and participation restrictions
3 Assistance in eating and drinking
4 Lack of participative ability
CHALLENGES EXPERIENCED BY PERSONS WITH CEREBRAL PALSY
1 Premature aging -
A ) Between about 20 to 40 years old, most adults with cerebral palsy will experience some form of premature aging.
B ) This is due to the excess strain and stress their bodies go through just to complete everyday tasks.
C ) For people with CP, walking up a small flight of stairs may require all the energy they have.
2 Post impairment syndrome -
A ) Individuals with cerebral palsy use more energy than able-bodied people when walking or moving around. This can cause post-impairment syndrome.
B ) The best way to avoid developing this condition is by working with various therapists throughout early adulthood, such as an occupational therapist, who will work to strengthen these muscles over time.
3 Challanges in workplace