Physical therapy for Hemiplegia patients

Hemiplegia is paralysis of one side of the body, either left or right. It’s a common side effect of stroke or cerebrovascular accident. Hemiplegia usually impacts children, however it’s a lifelong condition and so it also affects adults. Physiotherapy provides service and information for adults with hemiplegia and also gives a general idea of hemiplegia and its effects.

Hemiplegia is caused by injury to parts of the brain that control movements of the limbs, trunk, face, etc. This condition can occur before, during or soon after birth (within 2 years), such a condition is called ‘congenital hemiplegia’. It can also happen later in life as a result of an injury or illness, in which case it is termed as ‘acquired hemiplegia’. Generally, an injury to the left side of the brain will cause right hemiplegia and injury to right side will cause left hemiplegia.

About 80% of cases are congenital, whereas 20% cases have ‘acquired hemiplegia’. Hemiplegia can also be said as a form of cerebral palsy, a descriptive name for a wider group of conditions in which movement and posture are affected owing to injury to the brain. These conditions are lifelong and non-progressive, i.e. they do not get worse, but they may look different over time, partly because the child is growing and developing.

The causes of hemiplegia are mostly unknown yet, and usually parents only become aware of their child’s hemiplegia during infancy or early childhood as the child shows difficulties with movement on one side, which later become obvious. There is higher risk of hemiplegia in premature babies and mothers experiencing multiple pregnancies. However, it is unclear whether a difficult birth may by an occasional factor.

In most cases, the injury occurs at some point during pregnancy, and researchers have yet been unable to isolate any contributory factors. Some studies speculate that there could be an increased risk in communities where marriage between close relatives is common.

Acquired hemiplegia results from brain injury. The most common cause is a stroke (when a bleed or blood clot damages part of the brain), but it can also result from a head injury or infection.

Hemiplegia affects each child differently, so it’s difficult to generalize. A varying degree of weakness, stiffness (spasticity) and lack of control in the affected side of the body are the most obvious results. One child may have little use of hand, or may limp or have poor balance; and in another child it will be so slight that it only shows when the child attempts some specific physical activity.

Your child’s management will probably be based on a multidisciplinary approach, which includes physiotherapy, occupational therapy and possibly speech therapy. A physiotherapist and often an occupational therapist will closely with each other and with the child’s parents, to agree a programme of management with specific goals that are tailored to the child’s development and needs.

The aim will be to improve the child’s participation in everyday activities, like playing, feeding, dressing, school life, etc. The therapists will work to develop the child’s skills, assessing posture and providing muscle stretching, and possibly strengthening activities. Doing so will help prevent secondary consequences of the condition such as pain or the development of contractures (abnormal shortening of the muscles).

Treatment goals also include improving function so that the child can grasp an object with the affected hand, or walk better. A child with hemiplegia will be treated as normally as possible. It is essential to involve the affected side in play and everyday activities, to make your child as ‘two-sided’ as he or she can be. Our professional physiotherapists are well equipped with knowledge, skills and determination to help children re-live their lives as perfectly as they can!