POP sees children with all types of disabilities, some resulting from trauma injuries, as well as muscular dystrophy, spina bifida, Down’s syndrome, microcephaly, hydrocephaly, congenital birth deformities and many other problems, but most of the children we see have cerebral palsy (CP). 

POP works alongside Malamulele Onward carer 2 carer facilitators in Maseru, Leribe and Butha Buthe districts, supporting their outreach programs and CP carer 2 carer workshops. POP provides specialist physiotherapy assessments and knowledge and assessments for assistive technology. This includes bespoke APT (Appropriate Paper-based Technology) furniture, wheelchairs and mobility devices for children who are identified as benefitting from such equipment.

CP is the most common cause of motor disability in children. It is a neurological disorder affecting a person's motor function and mobility due to problems with muscles, posture, and balance. Cerebral means having to do with the brain. Palsy means weakness or problems with using the muscles. It is caused by a problem with the brain that develops either before, during or soon after birth.  

There are different types of CP according to which area of the brain has been affected. CP also has common associated conditions of epilepsy, autism and learning difficulties. This means CP children often have complex needs which can lead to misconceptions and poor treatment. It is therefore very important they are individually assessed by a physiotherapist to ensure they receive bespoke care, exercises and equipment.  

https://www.cerebralpalsyguidance.com 

According to the Centers for Disease Control and Prevention (CDC), incidences of CP occur between 2 to 4 live births per 1000 live births with the highest levels found in Low to Middle Income Countries (LMIC), like Lesotho. Its findings also showed that in LMIC nearly 74 % of children were classified in Gross Motor Function Classification System levels III to V, at the more severe level. Yet nearly 48 % of children never received rehabilitation services and over 75% of school-age children had no access to education. 

https://www.cdc.gov/ncbddd/cp/facts.html 

GMFCS 

Physiotherapists usually classify levels of CP in children using the Gross Motor Function Classification System (GMFCS) This gives the level of the mobility of the child and the assistive support they need. The GMFCS goes from 1 to 5, with 1 and 2 being the lowest level of impairment. It takes account of an individual’s age when assigning a level and looks at 5 different age groups. 

Under 2yrs, 2<4yrs, 4<6yrs, 6<12yrs, and 12<18yrs 

Children with CP in Lesotho tend to be at the most severe end of the spectrum of impairment with levels four to five on the Gross Motor Function Classification System (GMFCS). This means they have a high need for rehabilitation services and assistive equipment, however most of these children's needs are not met. This means they do not reach their potential and are at high risk of secondary problems, including hip dislocation, contractures, scoliosis, and pressure sores.  

Standing