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Children with Cerebral Palsy (CP) have quite complex problems that vary in each case, especially in terms of movement and spasticity. If parents notice any abnormalities in their child, they should consult a doctor immediately to ensure more effective treatment.
<h2>Types of Spasticity Found in Children with Cerebral Palsy</h2>
<ul>
<li>Type 1 Spasticity in the lower limbs of both legs (excluding one side)</li>
<li>Type 2 Spasticity in all four limbs of the body, meaning both arms and legs, usually more spasticity in the legs than the arms</li>
<li>Type 3 Spasticity on one side of the body, either left or right</li>
</ul>
<h2>Severity Levels of Spasticity in Children with Cerebral Palsy (Gross Motor Function Classification System; GMFCS)</h2>
<ul>
<li>Level 1 Mild physical abnormalities, such as in the arms or legs. The child can still perform activities normally without using walking aids.</li>
</ul>
Treatment approach: Physical therapy and occupational therapy to promote the child’s movement as close to normal as possible.
<ul>
<li>Level 2 Slightly impaired movement, more difficulty moving, harder to go up and down stairs, may need walking aids for longer distances such as walking outside the home.</li>
</ul>
Treatment approach: Physical therapy and occupational therapy to strengthen muscles, reduce spasticity, and train movement.
<ul>
<li>Level 3 The child has spasticity and weakness, requires walking aids, and must use a wheelchair for long distances.</li>
</ul>
Treatment approach: Physical therapy and occupational therapy to reduce spasticity using specialized equipment for specific parts.
<ul>
<li>Level 4 The child cannot stand, walk, or propel a wheelchair independently.</li>
</ul>
Treatment approach: Physical therapy and occupational therapy focusing on sitting balance, standing for exercise, and promoting basic self-care.
<ul>
<li>Level 5 The child is very weak and spastic, can barely or cannot help themselves, requiring close care.</li>
</ul>
Treatment approach: Physical therapy and occupational therapy to prevent complications, proper bed positioning, turning, and muscle stretching.
<h2>Planning Individualized Physical Therapy </h2>
Because the severity of cerebral palsy varies, it requires the expertise of a multidisciplinary medical team to care for the child, along with individual assessments of the child’s abilities to set stepwise treatment goals based on symptoms. Parents are informed about the child’s condition and the likelihood of achieving treatment goals, combined with proper education from professional physical therapists so that parents can safely care for the child at home. Physical therapy includes both Intensive Care and Long Term Care depending on the child’s condition.
The child’s physical development should grow alongside good mental health. Care and attention from parents, warmth, and encouragement help motivate the child to be ready for continuous treatment, build confidence, achieve the best quality of life according to their abilities, and reduce anxiety in adapting to social life with others.
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Dr. Phitsanu Sunthornpiyaphan 
Specialist in Cardiac Rehabilitation Medicine
Rehabilitation and Physical Therapy Center, Phyathai 2 Hospital

Children with cerebral palsy (CP) have quite complex problems. Each individual has different symptoms, especially regarding movement and spasticity. Parents can observe and notice abnormalities in their child from a very young age.

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Physical therapy for children with cerebral palsy: The earlier the treatment begins... the better the results.

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