Upper Limb Problems in Cerebral Palsy

The most common problems and challenges associated with spasticity in the upper limbs include

• Difficulties with activities of daily living: Children with upper limb spasticity may struggle with activities of daily living such as dressing, grooming, and self-care. They commonly need assistance or adaptive equipment to perform these tasks.

• Loss or failure to maximise function: Spasticity can lead to a limited range of motion in the affected limbs. This can make it difficult for children to perform everyday tasks such as reaching, grasping objects, or feeding themselves.

• Pain and Discomfort: Spasticity can cause pain and discomfort in the affected muscles and joints. This can be particularly distressing for children and may affect their overall well-being.

• Communication and Social Interaction: Difficulty using the upper limbs can impact a child's ability to interact with their peers, engage in play, and participate in activities that are essential for social and emotional development.

• Cosmesis & psychological impact: The appearance and functional limitations associated with upper limb CP can also have psychosocial effects on individuals, affecting their self-esteem and social interactions.

• Educational Challenges: Writing, drawing, and other fine motor tasks can be particularly challenging for children with upper limb spasticity, potentially affecting their educational progress.

Millions of adults and children are affected by upper limb cerebral palsy worldwide. Children with upper limb spasticity typically learn very early on how to adapt and live with any restrictions. They find amazing ways to get around their deficit. However, in particular if only one arm is affected there is a natural tendency for these children to ignore the impaired arm, despite the potential for functional improvement. 

For many years the focus of cerebral palsy care has been on the lower limb, but historically assessment and treatment of the upper limb has not been very well established. New developments in clinical research, methods of assessment and treatment now allow us to treat the shoulder, elbow, wrist and hand of spastic patients with safe and predictable results.

We believe the upper limb in cerebral palsy must be assessed and managed early in order to develop its potential and fully use its capacity, even if the goals are limited.