Water therapy used to treat cerebral palsy

A groundbreaking treatment at UNC-Chapel Hill offers adults with cerebral palsy more strength, mobility and hope, researchers say.

As cases of cerebral palsy increase nationally -- as many as 350 children are born with it each year in North Carolina -- improvements in treatment for adults will be crucial to keeping as many as possible active, independent and employed. In the trials, adults with cerebral palsy exercise in water, providing more intense workouts and less physical wear.

George Kourtsounis, 31, a Raleigh credit counselor who is participating in the trial, said he puts maximum effort into his 45-minute exercise sessions in a swimming pool three times a week so he can stay strong and mobile. He's resisting the usual course for cerebral palsy, in which adults can go downhill quickly after they turn 21 and no longer qualify for programs funded by federal and state tax dollars.

"I understand the wolves are coming -- I am going to do whatever I can to keep them at bay," Kourtsounis said. "If I've got 45 minutes to exercise, I'm like, 'Let's go hard, let's push it to new levels.' "

Cerebral palsy is an umbrella term for disorders that affect motion, balance and posture. Caused by an injury to the brain at or near childbirth, it's often, but not always, accompanied by one or more other disabilities, including epilepsy, mental retardation, hearing loss or visual impairment.

"There is a perception that if you have CP, your mental state is compromised," said Kourtsounis, a UNC-Greensboro graduate. "If I am sitting on a bar stool, you would never know."

Diane Damiano, president of the American Academy of Cerebral Palsy and Developmental Research, a Wisconsin-based research society, says the work at UNC-CH has many implications for therapeutic care. Results of the trial may also help an increasingly sedentary general population of aging adults.

"We are realizing that, even in arthritis and in any health condition, we thought exercise was contraindicated," Damiano said. "We found out it was the best thing you could do."

Water is more forgiving

The five-year, $685,000 trial, designed by UNC-CH professor and therapist Deborah Thorpe and funded by the National Institutes of Health, follows adults with cerebral palsy through a 12-week course of intensively monitored exercise in water.

On a recent spring evening, Thorpe greeted three trial participants at a heated pool at the UNC Wellness Center at Meadowmont. Kourtsounis, John Mason and Mihir Shah, along with a student trainer for each, hit the pool equipped with heart monitors.

"We've never thought we could work these people with CP at these levels," Thorpe said. "They're at the same rate as their typical peers as they work to develop strength."

Mason, a grocery store employee who has mental retardation, strode quickly through the pool with close attention from Norma Daugherty, a UNC-CH undergraduate studying exercise science. Shah, who works in UNC-CH's pharmacy school, stepped on and off a 6-inch block submerged at the bottom of the pool.

"He couldn't do that out of the water," Thorpe said. "I have people that don't ever stand or walk standing and walking in the water."

Like many adults with cerebral palsy, these men are trying to make up for past shortfalls in their conditioning.

"They kind of fall between the cracks," Thorpe said.

Teenagers with cerebral palsy soon carry a double burden, losing school- and state-supported help just as they start to lose function because of the disease. Groups such as Easter Seals UCP have many programs aimed at children, but their services for adults focus almost solely on helping them find and keep jobs.