Cerebral palsy

Last updated 15-03-2021

In this target group entry, you can gain an overview of a number of assistive products that can be useful for you, if you or a relative has cerebral palsy. The aids can, for example, contribute to easier communication, support you in moving about, and in participating actively in everyday and leisure life.

Cerebral palsy (CP) is caused by damage to the brain that occurs in the womb, during birth or when the child is newborn. The damage to the brain does not worsen throughout life, but the consequences becomes more apparent as the child grows up. Depending on which brain areas are affected, there may be challenges in relation to mobility, using the hands and arms or speaking. In some cases, the damage can also affect sight and hearing or cause cognitive difficulties such as problems with learning, concentration or language. Late consequences in adults can occur in the form of early wear and tear and increased fatigue, as a result of an inappropriate undesirable pattern.

The motoric disability can be described according to the extent to which the body is affected:

A single arm or a single leg (monoplegia)
One side of the body (hemiplegia)
Both legs (diplegia)
Both arms and both legs (tetraplegia)

CP can be divided into three types: Atacic CP (unsteady and imprecise movements), dyskinetic CP (muscle laxity), and spastic CP (increased muscle tone with involuntary movements). The motor impairments are often accompanied by other impacts, e.g. of the senses, perception, cognition and communication.

CP thus covers a wide range of different motor, communicative and cognitive difficulties, which can express themselves in very different ways. CP can therefore involve a complex combination of challenges, and there may therefore be a big difference as to which assistive products are relevant for you.

Mobility

This section on mobility is divided into three subsections. The first section is aimed at persons who need assistive products for walking. The second section is aimed at persons who use wheelchairs – either manual or powered. The last section is aimed at people who want to use a bicycle, powered scooter or similar.

Walking aids

Depending on how you walk, you will need different types of walking aids. If your walking ability is only slightly reduced, you will often be able to get by with a walking stick or a crutch. If your walking ability is severely reduced, you may want to use a walker or a walking table. Many, especially children, benefit a lot from a walking chair.

Walking sticks

There are different types of walking sticks that you can use if you have an unsteady walking. This could be, for example, walking sticks with special handles that provide a good grip. In addition, you can get a light or a heavy walking stick, depending on what works best for you. It is important to be aware that folding and adjustable walking sticks are often less solid than one-piece walking sticks. If you need to support heavily on the walking stick and possibly twist it when you walk, it is important to get a walking stick that can withstand this load. Using a walking stick can be stressful for the shoulders, and it can be an advantage for some to choose a walking stick with shock absorption or shock-absorbing tips (ferrules).

Walking sticks

Rollators

If you need more support than a cane can provide, a rollator may be relevant for you. The most common rollators are those that you push in front of you. In AssistData, you can filter your search by whether you will be using the rollator outdoor, indoor or both. On most rollators, you have the option of mounting a small tray or a basket at the front. Rollators for outdoor use typically have a seat for resting.

There are also posterior rollators that you pull behind you. These can have the advantage that they stimulate an upright posture and that they provide a larger space in front of you.

Rollators

Walking chairs and walking tables

If you need more support than a walking stick or a rollator can give you, you can use a walking chair or a walking table. A walking chair typically has a seat or a harness that can support your weight when you walk in it. In addition, they are available with different degrees of support for the back or pelvis to stabilize your body and increase your control over your legs. Walking tables correspond to rollators with the arm support at chest height. This allows for a more secure support.

Cycles, powered scooters and running cycles

If you would like to get around a little faster than you can with a rollator, you have the option of using a bicycle, a powered scooter or possibly a running cycle.

Cycles

If you are able to walk and need to get around over longer distances, a tricycle (possibly with an electric motor) might be the solution for you. The three wheels allow you to keep your balance, especially when getting on and off the bike, and they make the bike easier to handle if you can only use one hand. There are tricycles with a low entry height, where you do not have to lift your foot high to get on the bike, and tricycles with the seat placed low, e.g. a chair seat, so the bike has a low center of gravity. In addition, there is a lot of equipment for the bike, e.g. bicycle saddles with extra support to maintain balance, and straps to keep your feet firmly on the pedals.

You can read more in the guide Tricycles

Powered scooters

If you cant ride a bike, a powered scooter might be a solution. They are available with either three or four wheels. Many consider the four-wheeled scooter to be safer than the three-wheeled, but this is not true in all cases. A four-wheeled scooter is more directionally stable on long and straight stretches. It is also more stable if you need a lot of support when getting in and out of the scooter. The three-wheeled scooter, on the other hand, is more manageable and maneuverable in narrow areas, such as in a supermarket. If you need to sit with your legs slightly stretched out in front of you, there will typically be more room for them on a three-wheeler, because you can sit with one foot on either side of the front wheel.
It is therefore important that you try the powered scooter before purchasing one.

Electrically powered wheelchairs with manual direct steering

You can read more in the guide Powered scooters

Running cycles

Another way to get around is on a running cycle, which is a bike without pedals, and where you push with your feet on the ground. They are available for both children and adults and in a two-wheeled and three-wheeled version. A running cycle can be an aid that can contribute to being able to move at a faster pace and over longer distances than with, for example, a rollator. In the three-wheeled version, running cycles are also used for sports (race running).

Running cycles

Wheelchairs

Wheelchairs are roughly divided into manual and powered. A manual wheelchair can either be pushed by an assistant, or you can drive it yourself by pushing the wheels. A powered wheelchair is typically controlled via a joystick by yourself or an assistant.

Manual wheelchairs

A manual wheelchair is propelled on the large wheels or pushed by an assistant. It is physically demanding to drive a manual wheelchair yourself. It can be hard on the arms, shoulders, and hands, just as it can be difficult to keep control of your legs due to involuntary movements while driving. A propulsion unit can be mounted on the wheelchair for relief. The propulsion unit can be either user- or assistant-controlled.

A manual wheelchair is quite smaller and weighs much less than a powered one, and accessibility to shops, other peoples private homes etc. can be easier with a manual wheelchair. You can also take a manual wheelchair with you in most cars.

Powered wheelchairs

A powered wheelchair with joystick control can be maneuvered with minimal force, and you can go long distances with it. Various individual adaptations can be made with respect to, e.g. propulsion and operation of functions. For example, you can use a 0-1 switch, chin control, motion-stabilizing joystick, or assistant control. A powered wheelchair is significantly larger and heavier than a manual one, and you can only take it with you in a car if the car is specially equipped.

Adjustment of the wheelchair

It is recommended that a professional adjusts your wheelchair, so that you get the best basis for using your body, so you don’t develop malalignments caused by the sitting position. A wheelchair must be adjusted continuously, as your level of function can change over time, and it is important that the chair constantly supports you in your various activities and resting positions.

For some people with CP, there will be increased wear and tear on the wheelchair because of the spasticity. This means that the accessory parts on your wheelchair, such as leg supports and neck support, must be extra strong or replaced regularly. There may also be a need for seat belts or harnesses that can help you maintain your sitting position in the wheelchair. There may also be a need for a special seat cushion or back padding in the chair.

Accessories for the wheelchair

There are different kinds of lap trays that can be attached to the wheelchair, both for manual and powered wheelchairs. A wheelchair lap tray gives you the opportunity to carry out various activities, for example, you can have your computer or communicator on the lap tray, possibly retained with a mounting arm. If you need to be able to stabilize your body while carrying out the activities, a hand grip can be mounted on the lap tray for you to hold on to.

Orthotics

An orthosis is a body-worn assistive product, which stabilizes, corrects, or relieves a part of your body for a shorter or longer period.

There are various types of orthoses for the body (corsets). It can be, for example, elastic corsets for the lower back, which can relieve fatigue or weakened muscles, and which can give a more erect posture and a better sitting position. Another type of corset is used to counteract the development of scoliosis, and is made of foam plastic or plastic or a combination of fabric and braces, e.g. carbon fiber.

A corset can also enhance your ability to breathe, eat, and drink, keep your head in balance and control your arms and legs via a better and centered sitting position.

A wrist orthosis can make it easier for you to use your hand in everyday life by stabilizing it, protecting you from overloads and preventing misalignments.

Orthopedic insoles for shoes can correct misalignments in your feet and make it easier for you to keep your balance, relieve pain and prevent the misalignments from getting worse.

If your ankle joints are very unstable, they can be stabilized with foot splints, which are fixed orthoses that guide and support the ankle joints. Foot splints, also called AFOs, are available with or without joints and in many different types of material, e.g. plastic, carbon fiber, or leather.

It is important to keep the skin under a bandage clean and dry to avoid damaging the skin.

You must consult a doctor specializing in orthopedics or an orthotist to have your need for an orthosis assessed.

Orthotics

Clothing and footwear

There are quite a few different types of custom-made clothing and footwear that can give you extra support or comfort, or that is designed to be practical. There are also a number of assistive products for undressing and dressing.

Clothing

Some clothes are designed for easier put on and take off, for example with longitudinal zips in the sleeves and legs or with good width in the armholes. In addition, there are various options for replacing the closing mechanisms with alternatives, e.g. Velcro, magnets and press studs.

For wheelchair users, there are clothes that have a special fit for use in a sitting position, for example jeans and skirts with extra height at the back. There is also outerwear, including coveralls and rain clothes, which are specially designed for use in a wheelchair.

If you sit a lot, but also if you get tired after walking, using anti-oedema stockings can strengthen the blood circulation in your legs. These stockings are available with different levels of support and in different lengths. However, they can be quite difficult to put on and may require a helping hand, e.g. in the form of rubber gloves or a stocking applicator.

If you have problems with drooling, it may be an idea to use a small scarf to protect your other clothes. These are available as bandanas in different colors and designs and with absorbent or liquid-proof inserts.

Read more in the guide Clothing and footwear

Footwear

In many cases, an individually adapted insole can make walking a better experience for you. If you use foot or leg splints, it may be necessary to have custom-made shoes to make room for the splint. There will often be increased wear and tear on the footwear.

In relation to footwear and insoles, it is important that you get professional guidance from an orthotist to find the best solution.

With reduced walking ability, it is important that your footwear fit you well. That can be a challenge if you cant tie your shoelaces. You might choose to replace the regular shoelaces with elastic shoelaces or string-fasteners, or you can choose shoes without laces.

Assistive products for undressing and dressing

Even with specially designed clothing and alternative fasteners, getting dressed can still be a challenge. It could be helpful to use a rack to hold the jacket or shirt while tucking your arms into the sleeves, or to use a dressing hook or stick for the trousers. In addition, a long shoehorn, possibly with a bootjack, could be a good help, especially if you wear close-fitting shoes without shoelaces.

Assistive products for putting on or removing socks and pantyhose

Communication

Difficulties with communication and speech can manifest itself in different ways, depending on how your CP affects you. For example, you might have difficulty speaking fluently or pronouncing words leading to others having difficulty understanding you. To help you communicate, there are a variety of low- and high-tech aids.

Communication boards and communication books

You can use, for example, letter, word and picture boards or communication books with graphic symbols for communication. Both letter, word and picture boards and communication books can consist of collections of letters and/or symbols. There are countless options for combination, and it is important to find the tools that work best for you. It is also important to continuously develop and adapt the tools.

Letter and symbol sets and boards

Dialogue units

Dialogue units often have the shape of a tablet and are available with various features and accessory options, e.g. physical grid for positive finger location, fields with specially adapted pressure sensitivity, or with eye control. The software for the communicators can be based on symbol or letter communication and can be adapted to your needs. If you use a powered wheelchair, the dialogue unit can often be integrated with it, so that you can operate the communicator via the wheelchairs joystick. If you use a wheelchair, you can mount your communication aid, either on a wheelchair lap top or fastened in a holder. If your equipment is fixed to and integrated with the wheelchair, you will need additional communication aids for the times when you are not in your wheelchair.

Call and alarm systems

If you have impaired voice, but need to be able to call for help or assistance, it may be relevant to use a personal emergency alarm system. There are various systems and models, which can be mounted, for example, on your bed or wheelchair, systems with either one-way or two-way communication

Personal emergency alarm systems

Cautionary notes in relation to aids for communication

Regardless of which communication aids are relevant for you, it is important to have individual adaptation and training in using the aids, both for you and for those around you. It is recommended that you and your relatives receive guidance from a professional with knowledge and skills in alternative and augmentative communication. In addition, it is important to continuously develop your assistive product, for example by replacing symbols or adding new words as you develop and gain new interests, experiences and skills.

Memory and attention

If your CP causes challenges regarding concentration, memory, or attention, it can be difficult to maintain an overview and get structure in everyday life. There are tools for reminding you of appointments or tasks and tools for making schedules and visual overviews of sequences. Some of these tools are electronic devices or apps others are low-tech solutions.

Cooking and meals

A well-equipped kitchen is of great importance to your ability to cook and work in the kitchen. There are, for example, cupboards on height-adjustable consoles and overhead cupboards, which can be lowered to a low height. You can remove base cabinets to make room for sitting, and you can place the oven at table height. In addition to this practical adjustment of the kitchen, there are many assistive products that can make kitchen work easier. In this paragraph, the focus will be on assistive products for cooking and meals.

Cooking

There are a number of assistive products that can make it easier to prepare meals. For example, there are aids for opening packaging such as cans, jars and bottles, aids for cleaning, peeling and slicing vegetables and aids for holding on to e.g. bread or vegetables when you have to cut them. You can also use a non-slip pad to put under cutting boards, bowls and the like when you have to work with it. Some tools, e.g. knives, are available with angled or thickened handles.

If you need to sit down while cooking, you can get work chairs with different characteristics, depending on your needs, for example with or without a central brake and with electric or hydraulic height adjustment. There are also different types of standing chairs that support you in a near-standing position.

It can be helpful to use a tea trolley for transporting crockery etc., for example when table setting.

Read more in the guide Assistive products for cooking

Meals

If you have problems using regular cutlery, you can get specially made cutlery that can be easier to handle. It can be, e.g., cutlery with multiple functions (knork (fork and knife in one)), so you can eat with one hand, or cutlery where the handles are shaped so that you have an easier grip. There are also grip adapters for ordinary cutlery, or grip adapters that can be attached to your hand if you cannot hold on to the cutlery yourself. Par som spiser, kvinden bruger vinklet redskab

If the food is difficult to catch on the plate, you can use plates with either high rims or attachable food guards, or plates with designated areas that separate the food and make it easier to handle.

It can be helpful to use mugs or glasses with one or two handles. Handles are also available as loose attachments that can be used on different mugs or glasses. If you have difficulty bringing a glass to your mouth, you can use a straw. If your suction power is impaired, you can get a straw with a valve, so that the liquid that you have taken up in the tube does not flow back into the glass.

See the guide Special cutlery and the guide Plates and mugs with special design

Protection of clothing during meals

With CP there can be many challenges with personal care and hygiene. In the following, you will find examples of assistive products related to taking a shower and going to the toilet, as well as aids for other types of personal care and hygiene.

Bibs

Personal care and hygiene

In the bath

If you have reduced balance or tire out when you stand, it is important to have support when taking a shower. Grab bars can be mounted in one or more strategic places on the wall to help you keep your balance. A non-slip bath mat can be an extra help. There are also a number of assistive products that can help you, e.g. dispensing soap, washing your feet, hair or back, controlling the showerhead, and other things related to bathing.

If you need to sit when you bathe, you can use a shower chair, which is available with or without back support and arm support. You can also use a mounted shower seat, mounted on the wall at a suitable height and foldable.

If you need a great deal of help when taking a shower, it may be a good idea to use a shower chair, possibly with electric height adjustment to make it easier for your assistant. Shower chairs are available both with and without wheels.

Toileting

If you use a regular toilet, arm or back supports can support you while sitting on the toilet. Arm and back supports can either be permanently mounted on the toilet, mounted on the wall behind the toilet, or a free-standing frame with two armrests. The armrests can also be fold-up, which can be an advantage if the toilet must be used by others who do not need the support, or if you need the help of others when being on the toilet.

A toilet roll can be mounted on the armrests, so that the toilet paper is easy to reach when you are sitting on the toilet.

If you internally rotate and adduct your hips and therefore have difficulty keeping your balance when sitting, there are various devices to keep your knees apart during toileting. It could be, for example, a knee separator or a wedge-shaped splash guard.

If you need more support than you can get on a regular toilet, using a commode chair could be an option. The commode chairs have a collection receptacle, can be used over or beside a regular toilet, have many adjustments options, and are available both with and without wheels.

Commode chairs

If you only need help to sit down and get up, you can use a raised toilet seat, possibly in combination with a support handle on the wall.

If you need help to clean yourself after toileting, a toilet seat with built-in raising mechanism can be a good solution, as it gives your assistant a better working posture. Another option is toilets or toilet seats with a douche and air dryer.

If you are on the move or in a place where the toilet is not accessible for you, there are various types of assistive products such as urine bottles, reusable rubber bags and pee funnels. These are available in different sizes and different designs, for both women and men, so you have the opportunity to manage visiting the toilet, even in non-domestic surroundings. If you are in a wheelchair, it may be a good idea to use either a waterproof cover or disposable pad on your seat cushion, as it may well leak, either when the bottle/funnel is misplaced or when it is removed.

Additional personal care and hygiene

For other kinds of personal care and hygiene, there are a number of small assistive products, e.g. combs or washcloths with handles of different types and lengths, grip adapters for e.g. toothbrushes, nail and foot files as well as various types of holders, e.g. for toothpaste and hair dryers. It can also be helpful to have a touch-free soap dispenser with a sensor by the sink.

Sexual life

The consequences of CP can make sexual activities difficult, but there are a number of assistive products that can make it easier for you to engage in sexual activities, either on your own or together with others. You can e.g. get vibrators and dummies with different functions that have a design that makes them easier to hold and operate, or vibrators and dummies that are operated hands free.

Positioning cushions can also be relevant, as they can support you in placing yourself and maintaining a certain position. The positioning cushions can support different body parts, e.g. legs, arms or back.

Sleep

Some people with CP may have difficulty getting a full nights sleep. There are various reasons for this, but in some cases, the experience is that a weighted cover provides the rest needed to have a good sleep. The covers are available in many weight classes, and it will be a good idea to try different ones before choosing. Positioning cushions can also help to lower your tone and thus give you a more restful sleep.

Leisure life

There are many assistive products for leisure, whether you are into quiet or more physical activities.

Sports and movement

Regular physical activity can enhance your motor skills and to some extent counteract the development of contractures and muscle atrophy.
For many people, an active sports life also means good experiences, increased quality of life and be an important part of ones identity. Likewise, it can be rewarding to be part of a community around sports. Therefore, being into sports not only strengthens your body, it can also enhance your well-being. Sports can also assist you in your ability to learn new things and develop throughout life.

A large number of assistive products have been developed targeting different sports from water sports to team ball games, which can support you in being able to participate in various sports activities. There are, among other things, 3-wheeled running cycles, specially designed wheelchairs for sports and remedies for swimming and for ball games.

Assistive products for sports

Reading experiences

For many people, reading a good book is a great joy. If you are challenged in reading, either because you are not a strong reader, or if you find it difficult to hold onto and flip through a book, you can get aids that support you.

For supporting the book while you read, there are various reading stands that can either stand on the floor, stand on a table or be fastened to the wheelchair. There are also reading cushions, so you can have the book on your lap while you read.

If you need to have the book read aloud, you can get screen readers for a computer or tablet so that you can have it read directly from your screen, or you can use a reading app for your smart phone.

Read more in the guide Reading and writing technology

Toys for children

There is a wide range of specially developed toys and games that can support your child in terms of developing motor skills, to support the childs social development, and for entertainment. For example, there are board games that are designed so that the pieces are easier to handle and sit more stably on the playing board, or playing card holders that can hold the cards. 2 børn spiller kort - drengen bruger kortholder If your child has problems sitting on the floor while playing, you can get special seats (floor seats) that support the child in being able to sit in a playing position on the floor.
For the playground, you can get special swings that have extra support for the body, and swings where the child can lie down while swinging.