It is of great advantage if the stiffness of the orthosis can be adjusted separately from one another via resistances of the two functional elements in the two directions of movement, dorsiflexion and plantar flexion. Prognosis
CP is not a progressive disorder (meaning the brain damage does not worsen), but the symptoms can become more severe over time. A person with the disorder may improve somewhat during childhood if he or she receives extensive care, but once bones and musculature become more established, orthopedic surgery may be required. People with CP can have varying degrees of cognitive impairment or none whatsoever. The full intellectual potential of a child born with CP is often not known until the child starts school. People with CP are more likely to have learning disorders but have normal intelligence. Intellectual level among people with CP varies from genius to intellectually disabled, as it does in the general population, and experts have stated that it is important not to underestimate the capabilities of a person with CP and to give them every opportunity to learn.The ability to live independently with CP varies widely, depending partly on the severity of each persons impairment and partly on the capability of each person to self-manage the logistics of life. Some individuals with CP require personal assistant services for all activities of daily living. Others only need assistance with certain activities, and still others do not require any physical assistance.
Others
Infections in the mother, even those not easily detected, can triple the risk of the child developing cerebral palsy. Infections of the fetal membranes known as chorioamnionitis increases the risk.Intrauterine and neonatal insults (many of which are infectious) increase the risk.Rh blood type incompatibility can cause the mothers immune system to attack the babys red blood cells.It has been hypothesised that some cases of cerebral palsy are caused by the death in very early pregnancy of an identical twin. Diagnosis
The diagnosis of cerebral palsy has historically rested on the persons history and physical examination and is generally assessed at a young age. A general movements assessment, which involves measuring movements that occur spontaneously among those less than four months of age, appears most accurate. Children who are more severely affected are more likely to be noticed and diagnosed earlier. Abnormal muscle tone, delayed motor development and persistence of primitive reflexes are the main early symptoms of CP. Symptoms and diagnosis typically occur by the age of two, although depending on factors like malformations and congenital issues, persons with milder forms of cerebral palsy may be over the age of five, if not in adulthood, when finally diagnosed. Cognitive assessments and medical observations are also useful to help confirm a diagnosis. Additionally, evaluations of the childs mobility, speech and language, hearing, vision, gait, feeding and digestion are also useful to determine the extent of the disorder. Early diagnosis and intervention are seen as being a key part of managing cerebral palsy.