8 - Cerebral palsy Flashcards by Marilou Gélinas

Cerebral = ?
Palsy = ?

= Brain

= Decrease muscle control (paralysis of the brain)

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Definition of cerebral palsy

Non-progressive but not unchanging disorder of movement and/or posture, due to and insult or abnormality of the developing brain. Speech and senses like hearing and vision can also be impaired

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Is it contagious?

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Is it hereditary?

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Is it life-threatening?

NO, life expectancy is similar to able-bodied individuals

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Males born very preterm also appear to be more vulnerable to ____ injury and ____ hemorrhage than females

White matter, intraventricular

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Sex hormones such as ____ provide protection against hypoxic-ischemic injury, and the neonatal brain is also influenced by these hormones

Estrogens

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Incidence of brain lesion

90% before or during birth VS 10% after birth

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Causes of brain lesions before or during birth (5)

Maternal infections (aids, rubella, herpes)
Chemical toxins (alcohol, tobacco, drugs)
Injuries affecting fetal development
Damage to the brain or oxygen deprivation during deliveries
Genetic disorders, chromosomal abnormality, faulty blood supply

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Causes of brain lesions after birth (3)

Brain infections (meningitis)
Cranial traumas (accidents, shaken baby syndrome)
Oxygen deprivation (near drowning)

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Other factors of brain lesions (2)

Age of the mother (under 20 or over 34)

- Premature + low birth weight babies

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No.1 cause of brain lesion (CP)

damage to the brain or oxygen deprivation during deliveries

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Early signs of cerebral palsy (4)

Before 3 years of age
Motor skills not developing normally (coordination + balance)
Abnormal muscle tone (hypotonia or hypertonia)
Favour one side of body

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Types of CP - 2 ways to classify

Classification by number of limb affected

Classification by movement disorder

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Classification by number of limb affected (5)

Quadriplegia
Diplegia
Hemiplegia
Triplegia
Monoplegia

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Quadriplegia

All 4 extremities

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Diplegia

Lower extremities more frequent than upper

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Hemiplegia

The entire left or right side is affected

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Triplegia

3 extremities (usually both legs + 1 arm)

Monoplegia

1 extremity

Classification by movement disorder (3)

Spastic CP
Athetoid CP
Ataxic CP

Spastic CP

“tug-of-war” or co-contraction

Athetoid CP

mixed muscle tone, constant motion

Ataxic CP

look unsteady and shaky

Region of the brain for spasticity

Motor cortex/premotor cortex

Region of the brain for athetosis and tremors

Basal ganglia

Region of the brain for ataxia

Cerebellum

Types of motor disorders related to CP - 1. Spasticity (def)

Abnormal muscle tightness and stiffness

Types of motor disorders related to CP - 1. Spasticity (cause)

Caused by damage to the motor cortex + cortical tracts (basal ganglia + cerebellum)

Types of motor disorders related to CP - 1. Spasticity (interventions)

- surgical lengthening of tendon (toe walking + knee flexion) - dorsal rhizotomy

The long tracts represent neurons that pass up and down the spinal cord and modify the action reflex arc. Injury to these tracts usually causes the arc reflex to become ___

hyperactive (spastic)

Types of motor disorders related to CP - 2. Athetosis (def + damage where)

Constant, unpredictable, and purposeless movement caused by fluctuating muscle tone Damage to basal ganglia

Types of motor disorders related to CP - 2. Athetosis (problems + incidence)

Problems with: facial expression, eating, speaking, head control, fingers + wrist control +/- 25% of people with CP

Most common form of CP

Spasticity

Most people with athetosis are ____

quadriplegic

Types of motor disorders related to CP - 3. Ataxia (def)

Disturbance of balance and coordination characterized by hypotonia and decrease postural tone

Types of motor disorders related to CP - 3. Ataxia (incidence + damage where)

10% of people with CP | Results from disorders of the cerebellum + vestibular system

Fitness and CP - for same workload as able-bodied individuals:

Higher HR, blood pressure and lactate concentration | Decrease mechanical efficiency (increase energy)

Effects of exercise training (limited information) | improvement of: (5)

- sense of wellness - body image - capacity to perform ADLs - decrease spasticity + athetosis - resistance training is controversial

According to the latest studies, resistance training increases spasticity (and in turn decrease ROM) by ___% in participants with CP

???

Effects of 12 week progressive resistance training on walking ability (first result)

Significant improvement in muscle strength in trained group vs control group

Effects of 12 week progressive resistance training on walking ability (second result)

No improvement in walking ability in both groups

Effects of 12 week progressive resistance training on walking ability (last results)

No change in muscle spasticity (muscle tone) and ROM in both groups

Abnormal gait - spastic CP (2)

Scissors gait | Hemiplegic gait

Abnormal gait - ataxic CP

Ataxic or cerebellar gait