1 of 1

The Effects of Dance Therapy on Children and Adolescents with Cerebral Palsy

Angela Gagliardi Campos – Literature Review

California State University, Long Beach

Hypothesis: Dance therapy, along with stretch and general physical therapy can improve the gait, strength, and overall well being of children and adolescents with cerebral palsy.

Abstract

​

The purpose of this study was to understand if dance and stretch therapy in rehabilitation can have a positive effect on a child or adolescent living with Cerebral Palsy (CP). Cerebral Palsy is an impairment in the brain that affects movement, tone, and posture, that can occur when a young, developing, or pre-birth brain is damaged. The effects can be mild to severe, and often makes it difficult for a person with CP to move efficiently; this can ultimately cause psychological, social, and self identity issues. It is important to understand that even though CP has characteristics that define motor function, it does not define the person. Children and adolescents with CP have strengths, goals, desires, and individual personalities. Children and adolescents with CP need rehabilitation in order to experience many things that the typical person takes for granted, such as walking, playing, and socializing. Spasticity (excessive, involuntary tone in the muscles) can be addressed with stretch and dance therapy. These kinds of therapy can often lead to measurable outcomes in range of motion, self identification, and overall well being. Often the research dedicated to using these methods for rehabilitation lead to an acknowledgment that more research needs to be conducted. Most of the studies measured development in muscle groups, enjoyment levels, and socializations. Outcomes varied depending on GMFCS levels (Gross Motor Function Classification System), tools of measurement, and involvement. In conclusion it seems as if more research is needed to prove dance therapy as a valid, important, and critical aspect of rehabilitation for children with CP. Studies that focused solely on stretch and general treatment seemed to gather clear information on improvement. It is understood that the impairments of CP recur in the body, so continual and intensive therapy is necessary. Dance programs innately include stretch, body organization, play, and socialization, therefore can be a valid form of rehabilitation for children and adolescents with CP.

Methods

Results/Conclusion

Each research study contributed a different perspective on the variability, outcome, and approach to rehabilitation and kids with CP. Whether the study was looking at gait changes, leisure preferences, or unique ways to engage a child with CP in movement rehabilitation (AVG), there was always an understanding of how the child is affected by their impairment. A concern for physical as well as emotional well-being seems to be a goal for each study. In the study that utilized classical ballet as a focus for rehabilitation the authors addressed the importance of somatic and how a mind body approach to therapy for children with CP may be ideal for improving outcomes. (López-Ortiz et al. 2011 47) A mind body approach takes the entire person into consideration. Although there are specific needs and goals for particular muscles that need to be stretched or strengthened, the overall big picture and concern for the individual becomes the main focus in rehabilitation. Almost every study measured enjoyment and or understanding of self. Most studies commented on social implications related to the impairment of CP as well. Not being able to walk efficiently can damage self-esteem, set children apart in social situations, and set a child up for further motor complication throughout life. The research for mobility improvement in children and adolescents with CP in rehabilitation programs focusing on dance, stretch, strength, and control seem promising, but it is clear that more research needs to be done. The research needs to be focused on gait improvement and dance, or stretch therapy and gait efficiency, and one important measurement needs to be overall well-being. If these kind of studies were specifically conducted, I could confidently say that dance and stretch therapy can improve the gait of children and adolescents with CP. Currently I am left with a positive suggestion in favor of my hypothesis, but not a definitive agreement. Watching my own son in dance classes, I can see an improvement in mobility, self-confidence, and social awareness; I will remain hopeful that more research will be dedicated to this work.

Quotes Taken from the Research

• “Within its intrinsic organization, classical ballet positions and steps act to counter the main movement deficits present in CP from flexibility, to posture control, to selective motor control.” (Lopez-Ortiz et al. 2001 46)
• “Children with CP demonstrate a high level of interest in a variety of leisure activities, especially those that are social and recreations.” (Majnemer et al. 2009 72)
• “...our lives are governed, largely, by our ability to walk from one place to another.” (Adams et al. 2000 114)
• “...repetitions of guided movement helped the cerebral palsied child to feel secure, enabled measurement of improvements each day, and encouraged the child to attempt new tasks.” (Lasseter et al. 1989 311)
• “...movement is the basis for many human experiences, such as community activities, play and cognitive development.” (Lopez-Ortiz et al. 2001 46)

Resources

About the BrainHQ Exercises. (2015). Retrieved July 29, 2016, from http://www.brainhq.com/why-brainhq/about-the-brainhq-exercises, Adolescent Growth Spurt. (n.d.). Retrieved July 31, 2016, from https://carta.anthropogeny.org/moca/topics/adolescent-growth-spurt, Adams, M. A., Chandler, L. S., & Schuhmann, K. (2000). Gait Changes in Children with Cerebral Palsy Following a Neurodevelopmental Treatment Course. Pediatric Physical Therapy, 12(3). doi:10.1097/00001577-200012030-00003, Bleck, E. (1990) Management of the Lower Extremities in Children Who Have Cerebral Palsy. The Journal of Bone and Joint Surgery, (72)1, 140-144., CerebralPalsy.org | Help, Resources for Children with CP. (n.d.). Retrieved July 29, 2016, from http://www.cerebralpalsy.org/, Darrah, J., Wessel, J., Nearingburg, P., & O'connor, M. (1999). Evaluation of a Community Fitness Program for Adolescents with Cerebral Palsy. Pediatric Physical Therapy, 11(1). doi:10.1097/00001577-199901110-00004,

Howcroft, J., Klejman, S., Fehlings, D., Wright, V., Zabjek, K., Andrysek, J., & Biddiss, E. (2012). Active Video Game Play in Children With Cerebral Palsy: Potential for Physical Activity Promotion and Rehabilitation Therapies. Archives of Physical Medicine and Rehabilitation, 93(8), 1448-1456. doi:10.1016/j.apmr.2012.02.033, Lasseter, J., Privette, G., Brown, C., Duer, J. (1989) Dance as a Treatment Approach with a Multidisabled Child: Implications for School Counseling. The School Counselor, 36, 310-315., López-Ortiz, C., Gladden, K., Deon, L., Schmidt, J., Girolami, G., & Gaebler-Spira, D. (2011)., Dance program for physical rehabilitation and participation in children with cerebral palsy. Arts

& Health, 4(1), 39-54. doi:10.1080/17533015.2011.564193, Majnemer, A., Shikako-Thomas, K., Chokron, N., Law, M., Shevell, M., Chilingaryan, G.,

Rosenbaum, P. (2009). Leisure activity preferences for 6- to 12-year-old children with cerebral

palsy. Developmental Medicine & Child Neurology, 52(2), 167-173. doi:10.1111/j.1469-8749.2009.03393.x, O'dwyer, N., Neilson, P., & Nash, J. (2008). Reduction of Spasticity in Cerebral Palsy Using Feedback of the Tonic Stretch Reflex; A Controlled Study Developmental Medicine & Child Neurology, 36(9), 770-786.

doi:10.1111/j.1469-8749.1994.tb08188.x, Pin, T., Dyke, P., & Chan, M. (2007). The effectiveness of passive stretching in children with cerebral palsy. Developmental Medicine & Child Neurology, 48(10), 855-862. doi:10.1111/j.1469-8749.2006.tb01236.x