Understanding Brain Injury and Motor Impairment
Classification of Injuries
Types of Injuries
- Macroscopic Brain Lesions: Organic changes visible through diagnostic imaging like CT scans, arteriography, and microscopy.
- Brain Injury at the Biochemical Level: Organic changes affecting nerve impulse conduction speed, leading to impaired reaction times.
- Motor Impairment Effects: Motor impairments occur when motor circuits are affected. Cognitive development may remain normal if sensorioperceptive tracts are preserved, depending on the impact of the motor problems on the individual’s life.
- Sensorioperceptive Involvement: When injury affects sensory pathways and processing areas, it impacts information handling, communication, and cognitive development.
- Joint Involvement: Generalized disturbance of the central nervous system (CNS) affects both motor and sensory-perceptual cognitive areas.
Topographic Location
The suffix “plegia” denotes total paralysis, while “paresis” indicates slight or incomplete paralysis.
- Monoplegia: Paralysis of one limb (arm or leg).
- Hemiplegia: Paralysis on one side of the body.
- Paraplegia: Paralysis of both legs.
- Quadriplegia: Paralysis of all four limbs.
Categorization of Motor Impairments
Cerebral Origin: Cerebral Palsy (CP)
CP has diverse etiologies, with factors related to prenatal, perinatal, or postnatal periods up to 3 years of age. The International Society of PC defines it as a non-immutable and permanent disorder of posture and movement due to brain injury before development and growth are complete.
Salient Features of CP
- Spasticity: Marked increase in muscle tone with exaggerated extension reflexes during voluntary movements. Excessive muscle contractions can occur at rest or be triggered by exertion or emotion.
- Athetosis: Difficulty in controlling and coordinating voluntary movements, leading to involuntary parasitic movements that interfere with intended actions. These movements are uncontrollable, asymmetrical, and involve hyperflexion and hyperextension.
- Ataxia: A cerebellar syndrome affecting balance and movement accuracy. It involves difficulty judging force, distance, and direction, resulting in slow, clumsy movements. Lack of trunk stability, spatial disorientation, and difficulty coordinating arm movements for balance during walking are also common.