Motor Control and Muscle Tone Problems in Cerebral Palsy

Abstract

Children with cerebral palsy (CP) have a large variety of motor impairments, all of which are secondary to the encephalopathy. These impairments, which directly emanate from the encephalopathy and the disability that results, are well recognized as specific problems; however, the pathophysiology connecting the encephalopathy to the impairment and the disability is not well defined. Motor control affects all of the systems which require muscles for control including oral motor function, eye movement, and other various body segments which are controlled by muscles. The treatment goal for children with CP is to allow them to function in their environment, and ideally in the larger society, to the best of their abilities. The definition of motor control means the central nervous system is conceiving and then developing the program to be performed by the musculoskeletal system. The execution of this movement should be smooth, efficient, and with the required accuracy. This means that the muscles are required to have the proper tension or tone in preparation of response. Pathologic abnormalities of motor control develop into movement disorders. Movement disorders include dystonia, athetosis, chorea, hemiballismus, and tremors. Abnormalities of muscle tone range from hypotonia to hypertonia also known as spasticity. The goal of this chapter is to develop a theoretical understanding of central nervous system motor control and the importance of muscle tone. The definition of the pathologic states and treatment options will be briefly considered.