Physical and occupational therapy remains a pillar in the treatment of cerebral palsy. The daily range of motion and stretching exercises and strengthening exercises are essential in the ongoing treatment of these patients. The therapist helps in the selection and adaptation of equipment to enable the patient to be as independent as possible.

Orthoses (splints) hold the joints in proper position for function. For example, a WO (wrist orthosis) keeps the wrist in the dorsiflexed position, and allows the patient to use his hand more effectively to grasp. An AFO (ankle-foot orthosis) holds the ankle and foot in the neutral position to allow the patient to walk more normally.

Various surgical procedures have been used over the years to correct deformities in cerebral palsy. The following are some of the more common ones.

• Hip adduction with scissoring gait is a common deformity. Adductor release, by dividing the adductor muscles at the groin, corrects the scissoring gait. In more severe cases, the hip subluxates or dislocates. Surgery to correct this consists of Pelvic or iliac osteotomy and femoral varus-derotation osteotomy.
  
  

• Knee flexion contractures are common, and hamstring releases or lengthenings are often used to correct these problems.
  
  

• Equinus deformities (Plantarflexion deformity where the foot points downwards) is common, and heel-cord lengthening is effective. More recently, surgeons are tending towards selective lengthening of the gastrocnemius where possible, to prevent weakness of pushoff during gait.
  
  

• An Equinovarus deformity (where the foot points downwards and inwards) can be corrected surgically by a split posterior tibial tendon transfer, or a split anterior tibial tendon transfer with posterior tibial tendon lengthening. An Equinvalgus deformity (where the foot points downwards and outwards) is best corrected by a heel-cord lengthening and calcaneal lengthening. In the older patient with a severe painful fixed deformity, a triple arthrodesis may be the only option.