
What is quadriplegic cerebral palsy?
Quadriplegic cerebral palsy is damage to the developing brain, that affects movement in all four limbs. Movement can be affected in many different ways and is a result of the wrong messages being sent from the brain to the muscles. Sometimes this causes weakness in muscles, or low muscle tone (hypotonia), and other times it causes stiffness, spasticity, and high muscle tone (hypertonia). The brain is a huge organ, and although cerebral palsy has different categories, no two people with cerebral palsy are affected in the same way.
Physical symptoms of cerebral palsy
Physical symptoms vary and can include some of the following: reduced head control, muscle stiffness in the arms and legs, floppiness in the trunk, spine and neck, difficulty with fine motor skills, weakness in upright positions such as sitting and standing, and cognitive delays. Some children with cerebral palsy communicate in different ways, such as Eye Gaze, vocal expressions and eye pointing.
Our superheroes
One of our long standing BBP clients, 17-year-old David, has been trialling adapted bikes over the summer of 2020! David can speak but his words come out slowly due to his muscle spasms, so he also uses an Eye Gaze when he wants to speak quickly. David enjoys walks in the park with his family, and mobilises independently with his switch-controlled power chair. In his physio sessions he likes playing skittles while lying in prone on his wedge, for a stretch to his hips! David had hip surgery last year and is making a good recovery. He would like to start building up his leg strength again on the Innowalk at his college!
How can physiotherapy help?
Physiotherapy input varies depending on the superhero and their superpowers! And what motivates them and their family. Sometimes learning to sit independently is important, and sometimes it’s building super strong neck muscles to help with head control!

Gross motor skills
All children with cerebral palsy are different, even with the same diagnosis! Some of our superheroes communicate with words, some with an Eye Gaze and some with eye pointing! We don’t believe any of our superheroes can be ‘put in a box’ or have their physical gross motor skills predicted for the rest of their life, and we value the importance of correct communication and motivation! This enables us to get the most out of your superheroes and help them reach new potentials that never seemed possible!
Strengthening
All muscles are capable of getting stronger! How we get there is different, and we utilise positioning, tone inhibiting handling, core engaging activities and our secret superpowers to make this possible in every child! For children with quadriplegic cerebral palsy, we may strengthen trunk muscles, neck muscles, shoulder and arm muscles, or leg muscles, to gain functional goals that are useful and meaningful.
Maintaining range of movement
Range of movement, or flexibility is so important for many different reasons. Good knee flexibility means the ability to stand, walk with a walker and sit in a good posture on a bench, and flexibility in the ankles can enable better balance and stability for function. At Bumble Bee Physio, we have adapted the Cerebral Palsy Integrated Pathway (CPIP) range of movement guidelines, and measure this every six months in all of our superheroes. When super-bendy or hypermobile children lose some flexibility, this may not be picked up by regular physiotherapists. Our monitoring guidelines are thorough and simple to read, with colour coded values so you can clearly see areas for improvement.
Hip development
Healthy hips are vital for function and fun, and we are in tune with all the latest evidence on maintaining healthy hips. We encourage active and passive standing and have developed our very own Bumble Bee Physio standing guidelines and programmes, based on worldwide research from countries ahead of the UK in terms of hip surveillance and maintenance. We work with representatives from excellent companies to make sure your superhero has all the equipment, and strength, for maintaining optimum hip alignment.
24-hour postural management
We understand the importance of good alignment, participation and fun! Superheroes who have difficulties with everyday activities such as standing and sitting, need adaptive equipment to help them socialise and play. We are highly experienced in recommending and prescribing a multitude of equipment, from trikes to Innowalks, from standers to seating systems, from the Upsee walker, to running bikes! We will never stop recommending functional and inclusive equipment (we hope you have a big garage!). We also team up with companies to encourage rent schemes, so children can benefit from equipment when they don’t have space to store it.
Function and participation
Your superhero’s bespoke short-, medium- and long-term goals are our main priority! These are written with fun, inclusivity and function in mind. We even make the smaller, more boring steps in-between fun! This might be with musical instruments, light up sensory toys, dancing, messy play, we even did a spa treatment physio session for Zahra!
Email our friendly administrator Hannah, to see if we can help your superhero!