6 Cerebral Palsy Exercises to Improve Functional Mobility

Cerebral palsy (CP) is a group of neurological disorders that affects your ability to move and communicate. It's usually a result of damage to the brain before, during, or shortly after birth. People living with CP experience the condition in different ways. But common symptoms include muscle tension and difficulty with movement or posture.

Treatment for CP involves a team approach. And regular exercise can help manage your symptoms. A healthcare provider may recommend cerebral palsy exercises, including stretching and strengthening. These activities are designed to help release tight muscles and improve movement and coordination. They also can encourage independence and well-being for children and adults with CP. 

Can cerebral palsy symptoms improve with exercise?

While there are several types of CP, spastic cerebral palsy is the most common. Various exercises may improve symptoms of spastic CP, which can include:

• Impaired voluntary movements

• Stiffness and exaggerated reflexes and muscle tension, commonly in the hamstrings, calves, and wrist flexors on one or both sides of the body (spasticity)

• Muscle weakness 

• Muscle spasms, contractures, and jerky movements

• Difficulty with everyday movements, including standing and walking

• Gait issues, including toe walking, bent knees, and crossed legs

• Vision, hearing, or speech problems 

• Learning difficulties 

• Seizures

Because CP affects everyone differently, comprehensive treatment is critical. Targeted exercises –– to improve functional movement –– might be one part of your treatment plan. Your healthcare providers may also recommend:

• Physical or occupational therapy 

• Speech therapy 

• Medications 

• Surgery 

• Alternative therapies 

What are the best exercises for people with spastic cerebral palsy?

The best exercises for people with spastic CP depend on several factors. These include which of the wide-ranging symptoms you have and your symptom severity. Generally, experts recommend a combination of the following exercises: 

• Stretching to reduce muscle tension 

• Strengthening exercises to build muscle strength and improve physical function 

Aerobic activity also can decrease sedentary time and increase cardio fitness. A complete fitness routine can improve your range of motion, strength, and coordination to help with everyday movements. 

First, talk to your healthcare provider about the best cerebral palsy exercises for you. You might practice those moves with a physical therapist, personal trainer, or other professional. Here are six stretching and strengthening exercises to consider. 

1. Seated calf stretch

Contractures are the stiffening and tightening of muscles that worsen with lack of movement. They are common in people with spastic CP who have increased muscle tone and tension. And they often affect the calves, making it hard to walk or keep your feet flat on the ground. 

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Regularly stretching your calf muscles can help you maintain flexibility for standing and walking. The seated calf stretch might be a good place to start. 

• Step 1: Sit upright with your legs extended.

• Step 2: Loop a long towel around the ball of your right foot while holding the ends in both hands.

• Step 3: Keep your right knee straight as you use the towel to pull your foot toward you.

• Step 4: Hold the stretch for 15 to 30 seconds, then relax.

• Step 5: Complete 3 to 5 times on each side.

2. Hamstring stretch

Contractures often affect muscles –– such as the hamstrings –– that cross two joints. The hamstrings are a group of three muscles at the back of the thigh. They run along the hip and knee joints. 

Tight hamstrings can make it difficult to stand up straight and fully extend your knees. This towel hamstring stretch can help loosen stiff muscles. 

• Step 1: Sit on the floor with your left leg bent and your right leg extended. 

• Step 2: Loop a long towel around the ball of your right foot while holding the ends in both hands. Lie down. 

• Step 3: Keep your right knee straight as you use the towel to lift your leg toward you.

• Step 4: Hold the stretch for 15 to 30 seconds, then relax.

• Step 5: Complete 3 to 5 times on each side.

3. Sit-to-stand

The sit-to-stand targets the thighs and glutes. Lower-body strengthening exercises like this can help people with CP improve functional strength and physical performance with daily activities.

• Step 1: Sit in a sturdy chair. 

• Step 2: Scoot to the edge of the seat.

• Step 3: Lean forward and push through your legs to extend your knees and stand up. You can use your arms to help you push up from the chair if needed. 

• Step 4: Maintain your standing balance for 3 to 5 seconds. Then, shift your hips back and slowly lower your buttocks onto the chair. 

• Step 5: Complete 2 to 3 sets of 10 repetitions.

4. Standing march

The standing march can help with balance and weight-bearing. It may strengthen the hip flexors, making it easier to lift your legs with each step. This can prevent foot-dragging and improve your gait or walking pattern. 

• Step 1: Stand in front of a counter or other sturdy surface you can hold. 

• Step 2: Hold the surface for support and shift your weight to your left side. Try to keep your body upright without leaning.

• Step 3: Lift your right leg in front of you, bringing your knee up to hip level or as high as it can go. 

• Step 4: Slowly lower your leg back to the starting position. Repeat on the other side to complete one repetition. 

• Step 5: Do 10 repetitions, alternating between your right and left sides. 

• Step 6: Complete 2 to 3 sets of 10 reps. 

5. Side leg raise

When you have CP, weak or spastic hip muscles can increase the risk of dislocating a hip. Exercises that strengthen hip abductor muscles at the sides of the hips –– such as lateral or side leg raises –– can provide stability. Strengthening the hip abductors can also decrease leg-crossing, called a scissoring gait, while walking.

• Step 1: Stand next to a counter or behind a stable chair you can hold. 

• Step 2: Hold the surface for support and shift your weight to your left side. Try to keep your body upright without leaning.

• Step 3: Lift your right leg out to the side. Keep your hips and feet pointing forward.

• Step 4: Hold briefly before slowly relaxing your leg back to the starting position. 

• Step 5: Complete 2 to 3 sets of 10 repetitions on each side.

6. Step-up

Exercises that work multiple muscle groups can help you build strength and stability for daily function. Step-ups engage the hip flexors, quadriceps at the front of your thighs, and glute muscles to power your lower body. Some people do this exercise with an aerobic step platform. But you can try it at a set of stairs with secure railings. 

• Step 1: Stand straight before a staircase with stable railings on both sides. Grasp both railings. 

• Step 2: Bend your right knee as you lift your leg to step up and climb the first step. 

• Step 3: Push through your right leg to step up and bring your left foot to meet your right.

• Step 4: Lift your foot and extend your leg behind you to step down with your left foot. As you lower your left leg, your right knee will bend. Step down with your right foot to return to the starting position. Try to keep these movements slow and controlled. 

• Step 5: Do 2 to 3 sets of 10 repetitions, leading with your right leg. Then, do the same number of reps and sets leading with your left leg.  

Safety tips for exercising with cerebral palsy

Many people with CP become fatigued quickly with physical activity. Exercises for cerebral palsy should be tailored to your current abilities. For example, people who can walk might focus more on lower-body strengthening exercises. Those with more limited mobility might need more stretching and limb movement exercises.

Talk to your doctor about these and other safety tips for exercising with CP. 

• Start with supervised training. It's important to work with your healthcare provider when starting a fitness routine to manage CP. They can suggest physical therapists or other professionals to guide your training. You'll learn proper exercise form and other helpful tips. Depending on your symptoms, you might stick with supervised exercise or practice at home, too. 

• Focus on low-intensity movement. Moderate or high-intensity exercise may not be feasible for people with significant mobility concerns. Beginning with low-intensity activities can reduce fatigue, soreness, and injury risk. This approach also helps people with CP increase daily movement without overdoing it. 

• Adjust your exercise plan slowly. You can boost your exercise intensity with your healthcare provider's approval. The key is to increase intensity –– including exercise volume, weight, or repetitions –– gradually. 

• Practice single-joint movements one side at a time. Do single-joint exercises –– such as knee extensions or leg presses –– one side at a time. And do the same number of reps on both sides. 

• Listen to your body. Be sure to work your muscles within their active range of motion. You can challenge yourself without forcing exercises or stretches beyond your ability.

In all cases, exercise for cerebral palsy should focus on two goals: decreasing sedentary behavior and maximizing available movement.

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Written by:

Kristen Gasnick, PT, DPT

Kristen Gasnick, PT, DPT, practices outpatient rehabilitation focusing on orthopedic injuries and post-operative recovery.

Edited by:

Lauren Savage, MA

Lauren Savage, MA, is a health editor at GoodRx, where she focuses on movement, exercise, and healthy aging. She aims to provide readers with the information they need to live healthier, more active lifestyles.

Reviewed by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

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