Cerebral palsy

 

Cerebral palsy or CP is a group of permanent disorders associated with developmental brain injuries that occur during fetal development, birth, or shortly after birth. It is characterized by a disruption of motor skills, with symptoms such as spasticity, paralysis, or seizures.

Cerebral palsy is a form of static encephalopathy. One form of it, spastic diplegia, is sometimes known as Little's disease in the United Kingdom. Properly speaking, the fact that CP does not get better or worse implies that it is a 'condition' (chronic nonprogressive neurological disorder) rather than a 'disease.' The incidence is about 1.5 to 4 per 1000 live births. There is no cure, but therapy has been shown to be helpful in the maintenance of motor functions. While severity varies widely, cerebral palsy ranks among the most costly congenital conditions to manage.

 

Cerebral palsy develops while the brain is under development. 80% of all cases occur before the baby reaches 1 month old, however this disorder can occur within about the first 5 years of life. It is a nonprogressive disorder; once damage to the brain occurs, no additional damage occurs as a result of this condition. Cerebral palsy neither improves nor worsens, though symptoms may seem to increase with time, likely due to the aging process.

Cause

Since cerebral palsy refers to a group of disorders, there is no exact known cause. Some major causes are asphyxia, hypoxia of the brain, birth trauma or premature birth, get The "Secrets" of Weight Loss

The 2 Most Important Facts about Successful Weight Loss

Before beginning any diet, it’s important that you understand these two important facts:

Weight loss depends on energy balance.

To lose weight, your energy intake must be less than your energy expenditure. This will always be true. There are no foods, pills, or potions that will magically melt the pounds off. The only approach that works is eating less and/or exercising more.

Permanent weight loss requires permanent change.

Don’t assume that you can spend six weeks on a diet and then return to your old eating habits. Short term diets only produce short term results. The only successful way to keep the weight off is to make small but permanent changes in your lifestyle. Coincidentally, this is also the best way to improve your health.

The Most Important Principles for Enabling Weight Loss

Although many different weight loss techniques exist, nearly all are variations of just six basic principles. Study these principles, and make them part of your action plan:

Maintain or improve your health.

If you don’t take care of your body, it won’t take care of you. So, as a first step, make sure that your diet supplies adequate amounts of vitamins and minerals, that you’re drinking plenty of water and getting enough sleep and fresh air, and aren’t under too much unhealthy stress. Everything that you do to improve your overall health will help make weight loss more likely to occur.

Reduce your total Caloric intake.

To lose weight, you have to change your energy balance. (See Fact #1 above.) There are just two ways to do this – either consume less energy (Calories) or expend more energy (via exercise). The easiest way to reduce your consumption is simply to cut back on the size of your meals and/or the amount of high-Calorie foods that you consume. This doesn’t mean that you have to give up any particular food. In fact, completely avoiding a food can lead to strong cravings that derail your diet. A smarter approach is to just eat less of those high-Calorie foods.

To get a good perspective of how many Calories that you consume, it’s important that you keep a food diary. You don’t have to keep your diary going forever, but do track your daily intake for at least one week. The Running Total function of ND’s Pantry make this Calorie counting exercise especially easy to do, and also provides you with totals of all other nutrients as well.

Also beware of foods containing "hidden" Calories. For example:

Watch what you drink. What you drink during the day can have a major impact on the number of Calories that you consume. There is very little difference between the satiating effects of different drinks, so this is one of the easiest places to improve your diet. Water is almost always your best choice, but coffee, tea, and diet drinks can also help cut Calories.

Be smart about condiments and toppings. Butter, mayonnaise, and a lot of the "special sauces" used by restaurants are very concentrated sources of Calories. If you want to add flavor to your food, try using lemon juice, soy sauce, salsa or different spices instead.

Maintain or increase your metabolism.

One of the most common mistakes that dieters make is to get excited or impatient with their diet, and reduce their Caloric intake too far. If you do that, your body will respond by lowering your metabolism and slowing your weight loss. To prevent this downward adjustment of your metabolism, make smaller changes to your eating habits. Your patience will pay off in terms of more consistent weight loss, more energy, and fewer cravings.

For the best results, add exercise to your plan. Regular exercise not only expends energy as you’re doing it, but can also lead to increases in your basal metabolic rate, so you’ll burn more Calories even at rest. High-intensity exercises burn the most Calories, but don’t select exercises solely on their fat-burning potential. Instead, pick exercises (i.e. sports activities) that you enjoy, and want to incorporate into your daily routine.

Avoid hunger.

Hunger is one of your body’s strongest stimuli, and can be an evil challenger to your will power. Hunger is also relatively slow to subside, and can cause you to eat more than you intended. To break this unproductive hunger-overeating habit, always try to eat before you get hungry. This may seem counter intuitive to someone who’s trying to limit their Calories, but it’s a very effective concept. Two different techniques can help make this easier to accomplish:

Eat smaller, more frequent meals. Instead of three meals per day, try eating five or six smaller meals. By eating more frequently, there will be less time between your meals, and less chance of you experiencing such intense hunger. As an extra benefit, there is some evidence that suggests that eating more frequently can also help raise your metabolism.

Include more slow-to-digest foods in your meals. When it’s not possible to eat more frequently, make sure that your meals contain a mix of nutrients. In particular, fats and protein are much slower to digest than carbohydrates. While most carbohydrates leave your stomach within about two hours, protein takes approximately four hours to digest, and fat takes as long as six hours.

Note: The slower digestion of fats is one of the primary reasons that people on low-carb diets (like Atkins™ and South Beach™) experience less hunger than those on low-fat diets. It’s not necessary to completely eliminate carbohydrates from your meals, though. Most people on balanced-nutrient plans (like the Zone Diet) also experience better hunger control.

Correct bad eating habits.

We eat not only for nourishment, but also as part of our social interactions. However, many people develop unhealthy habits that encourage overeating. Here are a few examples of bad eating habits that you should try to avoid:

Mixing food and entertainment. It’s easy to mindlessly eat a tub of popcorn, a whole bag of chips, or a carton of ice cream while you’re watching TV. Make eating a separate activity, and you’ll consume less.

Eating to relieve stress. There’s nothing wrong with taking pleasure from eating, but try not to use food as your primary stress reliever. Find other ways to dissipate stress (such as exercising, listening to music, or meditating) before eating.

Eating on the run. With the abundant availability of convenience foods, it’s easy to grab something from a vending machine and eat your meals in your car. But try not to make this a regular daily habit. Plan your schedule to include enough time to prepare and eat your meals in a quiet place, without the rush.

No one eats perfectly. However, if you continuously have trouble controlling what you eat, realize that correction of your eating problems may be beyond your own abilities. Please consult a psychologist or weight loss professional for additional help.

Make a record of everything you eat

When making changes to your diet, it's very easy to lapse back into your old eating habits. Keeping a food diary is a great way to help prevent that from happening. Buy an inexpensive spiral notebook, and simply write down everything that you eat during the day. If possible, keep your food diary with you, and make your entries soon after you've eaten. For maximum benefit, keep making entries for at least three weeks. Keeping a food diary forces you to give conscious thought to everything that you eat. It may be a tedious task at first, but it will help you more quickly develop better eating habits. Your food diary will also be a tremendous asset if you later consult a dietician or health care provider for assistance with your diet.

When keeping a food diary, it's also a good idea to take the time to add up the total Calories and nutrients that you consume each day. For your diet to be successful, your total Calories will need to decrease from their original level, but your nutrient intake must at least meet your minimum needs. One of the easiest ways to determine this is with the Running Total feature of ND's Pantry. The Best Way to Satisfy Your Hunger without Overeating

If you practice the above six dieting concepts, it’s possible to reliably and painlessly lose weight. However, there will still be times when you get very hungry and are tempted to overeat. To best control your hunger and provide some resistance to overeating, we recommend that you incorporate more foods into your diet that fill you up with fewer total Calories.

To help you identify the foods that can fill you up with fewer Calories, ND created the Fullness Factor™. This unique index predicts how well each food can satisfy hunger. For more about this index, please see our Fullness Factor page.

 

The Best Exercises for Weight Loss

It is possible to lose weight without exercising, but exercise can greatly accelerate your weight loss progress. In fact, exercise can help you lose weight in three separate ways:

1.  Your body will burn extra Calories while you are exercising;

2.  If the exercise is high enough in intensity (i.e. significantly increases your heart rate and respiration), your body will continue to burn Calories at an elevated rate for an extended period after your exercise session has ended; and

3. If the exercise places a high enough load on your muscles, they will increase in size, and burn more Calories even when your body is at rest.

This last item (i.e. muscular adaptation to exercise) is an important factor for weight loss, because it enables your body to burn more Calories at all times. Muscle tissue is more "metabolically active" than body fat. With more muscle and less fat, your metabolic rate is naturally higher.

Muscular adaptation occurs most readily when the load placed on a muscle exceeds about 60% of its maximum contractile strength. This makes weight training one of your best exercise choices, and the most direct path to a sleeker, shapelier body.

 

How to Get Started With Weight Training

If you're serious about getting results, forget about the fancy machines in the gym and the made-for-TV products. Take the time to learn a few basic free weight movements, including the squat, bench press, dead lift, bent row, and shoulder press. These exercises activate your body's largest muscles, and will have the most dramatic effect on transforming your body. A good personal trainer at any commercial health club will be happy to help you get started.

If you can't afford the time to go to a health club, you can easily set up a weight training area in your own home. It really doesn't require much space or equipment. A good set of dumbbells and a sturdy exercise bench is all that you need. We personally recommend PowerBlock's dumbbells and bench. PowerBlock also produces wall posters that clearly illustrate all of the most effective dumbbell exercises.

 

What About Aerobic Exercise?

Aerobic exercise (e.g. aerobic dance, running, biking, etc.) improves cardiovascular health and can help you burn a considerable number of Calories. However, aerobic exercise does not usually place enough load on your body to create much muscular adaptation. Because of this, aerobic exercise is not nearly as efficient as weight training from the perspective of maintaining long-term weight loss.

All exercises make weight loss easier, though, so don't choose an exercise solely for its efficiency. The best exercise for you is simply the exercise that you enjoy and are willing to do consistently. Even walking is a wonderful exercise. Walking just 15 extra minutes a day will equate to about a pound of additional weight loss each month for the average person.

If your exercise program becomes boring, look for ways to make it more interesting and productive. For example, a weighted exercise vest could add a new twist to your morning walk. Keep challenging yourself, and exercise will become a very fulfilling part of your lifestyle.

The Best Way to Monitor Your Weight Loss Progress

 

Although measuring your weight seems to be the most logical way to track your progress, weight alone is an unreliable measurement. Your weight may fluctuate several pounds over the course of a day, depending on how well hydrated your body is and on what’s currently passing through your digestive system. Weight loss is a gradual process. So if you do weigh yourself, we recommend doing so not more than once or twice a week.

Some diet plans make target weight recommendations based on your height, age, and sex. A target weight may be a good motivator for some people, but don’t get too hung up on that particular goal. Most weight recommendations are based on your Body Mass Index (BMI), which is a ratio of your weight to height. BMI recommendations may be appropriate for the average person, but they don’t take into consideration a person’s bone structure and muscle mass, and are especially unsuitable for athletic people.

Unless you’re trying to qualify for a lower weight class at a sporting event, weight isn’t what you care about, anyway. We talk about weight loss, but what you’re really interested in is fat loss. You’ll know when you lose that extra fat, simply because you’ll look and feel better. If you want feedback on your fat loss, we recommend having your percentage body fat measured. Most health clubs will do a body fat test for you. There are also body fat calipers made for home use, such as the Accu-Measure Personal Body Fat Tester, which costs less than $20 and is surprisingly accurate

netic susceptibility, certain infections in the mother during and before birth, central nervous system infections, trauma, and consecutive hematomas. In most people with CP, the cause is unknown. After birth, the condition may be caused by toxins, physical brain injury, incidents involving hypoxia to the brain (such as drowning), and encephalitis or meningitis. Despite all of these causes, the cause of many individual cases of cerebral palsy is unknown.

 

Recent research has demonstrated that asphyxia is not the most important cause as it was once considered to be, though it still plays a role, probably accounting for about 10% of all cases. The research has shown that infections in the mother, even infections that are not easily detected, may triple the risk of the child developing the disorder.

Premature babies have a higher risk because their organs are not yet fully developed. This increases the risk of asphyxia and other injury to the brain, which in turn increases the incidence of cerebral palsy.

Incidence and prevalence

The incidence is about 1.5 to 4 per 1000 live births. This amounts to approximately 5,000-10,000 babies born with cerebral palsy each year in the United States. Each year, around 1,500 preschoolers are diagnosed with the disorder. In around 70% of all cases, cerebral palsy is found with some other disorder, the most common being mental retardation.

Overall, advances in care of pregnant mothers and their babies has not resulted in a noticeable decrease in cerebral palsy. Only the introduction of quality medical care to locations with less than adequate medical care has shown any decreases. The incidence increases with premature or very low-weight babies regardless of the quality of care. Twins are also four times more likely to develop cerebral palsy than single births, and triplets are more likely still to develop it.

Despite medical advances, the incidence and severity of cerebral palsy has actually increased over time. This may be attributed to medical advances in areas related to premature babies or the increased usage of artificial fertilization techniques.

Types

Based on the group of muscles involved (typically only used to further describe spastic CP):

1. Tetraplegia or Quadriplegia : Involvement of the four limbs, the trunk and the head. The great majority of these individuals will not be able to stand up or walk.

2. Diplegia: The four limbs are affected, but lower limbs are more involved than upper limbs. Some of the people with diplegia will be able to walk alone, with orthosis, or by the use such as crutches or walkers.

3. Hemiplegia: Only the right side or the left side of the body is involved. People with hemiplegia are the most likely to walk, even though people with the above two types can often walk without assistance, if severity allows.

NOTE: These are not the only 3 types of spastic CP. Occasionally, terms such as monoplegia, paraplegia, triplegia and pentaplegia may be used.

1. Ataxia: Persons with ataxia have damage to their cerebellum which results in problems with balance, especially while walking. It is the most rare type, occurring in at most 10% of all cases.

2. Athetoid or dyskinetic: Persons with this type generally have involuntary body movements. The damage occurs to the extrapyramidal motor system and/or pyramidal tract and to the basal ganglia. It occurs in ~20% of all cases.

3. Spastic: Persons with this type have damage to the corticospinal tract, motor cortex, or pyramidal tract. It occurs in ~70% of all cases.

These three types may be found together. In 30% of all cases of cerebral palsy, the spastic form is found with the one of the other types. There are a number of other minor types of cerebral palsy, but these are the most common.