World Cerebral Palsy Day: optimising opportunities and potential with access to suitable support

Posted: 04/10/2024

World Cerebral Palsy Day (#WorldCerebralPalsyDay) is on 6 October each year. It is a global initiative that started in 2012 with the stated aim of ensuring ‘a future in which children and adults with cerebral palsy have the same rights, access and opportunities as anyone else in our society’.

Cerebral palsy (CP) is a non-progressive condition due to damage to the developing brain during pregnancy, birth, or shortly after birth. It generally leads to physical disability that affects movement and posture, muscle control, coordination and tone, reflex, and balance, but many of those with CP also have other related vision, hearing and communication needs, and there may be cognitive impact as well. CP affects people in different ways, ranging from a weakness in one hand, to almost a complete lack of voluntary movement.

This disability is a lifelong condition and while the brain injury that causes it does not change over time, the impact of living with CP often means that people experience age-related changes, like increased muscle weakness and decreased balance, much earlier than people without the condition.

When considering the support someone with CP is likely to need, it is necessary to ascertain the extent of their disability. The mobility and gross motor skills of people with cerebral palsy are categorised into five different levels using the Gross Motor Function Classification System (GMFCS)*. These five categories and their associated descriptors are set out below:

GMFCS level I

• Can walk indoors and outdoors and climb stairs without using their hands for support.
• Can run and jump.
• Has decreased speed, balance, and coordination.

GMFCS level II

• Can walk indoors and outdoors and climb stairs using a railing.
• Experiences difficulty with uneven surfaces, inclines, or while in crowds.
• Can minimally run or jump.

GMFCS level III

• Walks with assistive mobility devices indoors and outdoors on level surfaces.
• May be able to climb stairs using a railing.
• May propel a manual wheelchair; may require assistance for long distances or uneven surfaces.

GMFCS level IV

• Walking ability is severely limited, even with assistive devices.
• Uses a wheelchair most of the time and may propel their own power wheelchair.
• May participate in standing transfers.

GMFCS level V

• Has physical impairments that restrict voluntary movement control and the ability to maintain head and neck position against gravity.
• Experiences impairment in all areas of motor function.
• Can’t sit or stand independently, even with adaptive equipment.
• Can’t independently walk, though may be able to use powered mobility devices.

*GMFCS descriptors sourced from © Palisano et al (1997) Dev Med Child Neurol 39:214-23 CanChild: www.canchild.ca

Suitable support may include the provision of specialist aids and equipment, such as standing frames, wheelchairs and appropriate seating, as well as therapies to maintain mobility and reduce muscle contractures, such as physiotherapy.

The Paralympics provide a platform for those with impairments such as CP, when appropriate support is available. There are 10 eligible impairment types in para athletics: eight physical impairments as well as vision impairment and intellectual impairment. The eight physical impairments are: impaired muscle power; impaired passive range of movement; limb deficiency; leg length difference; short stature; hypertonia; ataxia and athetosis.

The performance of the Great Britain team at the Paralympic Games in Paris 2024 was most impressive, with the squad coming second in the medals table, after winning 124 medals, and showing what can be achieved both on and off the field of play. 

Alison Appelboam Meadows, a partner in Penningtons Manches Cooper’s clinical negligence team, who specialises in cerebral palsy claims, comments: “We have acted for several clients who, despite their disabilities, have gone on to excel in their chosen sports, whether on the boccia court or the track. The key is that they have had access to appropriate support from physiotherapists and occupational therapists and have been provided with key aids and equipment. By optimising their support and opportunities, they really have reached their potential.”

If you or a family member have any concerns regarding care provided during or shortly after childbirth, or a diagnosis of cerebral palsy,  the Penningtons Manches Cooper team are here to provide specialist advice. Please contact us on freephone 0800 328 9545, email clinnegspecialist@penningtonslaw.com or complete our online assessment form. An initial, free, no obligation meeting will then be arranged.

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