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Paediatrics > Biomechanics > Flashcards

Biomechanics Flashcards

1
Q

Who is the Biomechanical Approach used for?

A

It is used for children with neurologically based movement disorders eg., cerebral palsy, MS that require artificial and external support for correct positioning

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2
Q

What are the two aims of the biomechanical approach?

A
  1. Increase proximal stability to improve opportunity for distal functioning.
  2. Improve participation in occupational roles by positioning for function.
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3
Q

What are the main changes in body shape that occur from sleeping on your stomach?

A
  • Flattened chest
  • Side neck flexion
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4
Q

What are the main changes in the spine that occur from sleeping on your side?

A
  • Scholiosis
  • Kyphosis
  • Lordosis
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5
Q

What is the ideal night time sleeping position?

A

Supine

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6
Q

What the the key areas that require support when sleeping in supine?

A
  • Along the trunk (either side)
  • Underneath the knees
  • Underneath the head and neck
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7
Q

What is the goal of OT for children with flexible postures?

A

To facilitate and correct in seating.

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8
Q

What is the goal of OT for children with fixed postures?

A

Accomodate in seating and intervene in night time positioning to correct (NOT during the day)

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9
Q

Describe the three steps of the formal seating process

A
  1. Seating assessment
    - Assess the child in supine first and then in sitting on a plinth.
    - Determine child’s ROM
    - As new grads, ALWAYS complete with supervision and assistance from a senior OT
  2. Seating trial
    - Determine appropriate options
    - Trial these options with the child
    - Decide what works best
  3. Seating prescription
    - Write an application to get funding
    - Provide equipment
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10
Q

What are the 7 key areas that need to be considered when positioning?

A
  1. Pelvis
  2. Hips
  3. Knees
  4. Feet
  5. Trunk
  6. Shoulder and arms
  7. Head/neck
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11
Q

What is the ideal seating position for the pelvis?

A

Pelvis at the back of the seat, neutral to provide a stable base

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11
Q

What are some intervention options for posterior tilt? (5)

A
  • Correct seat depth (may be too long or too short)
  • Correct the height of the foot plates
  • Sacral pads
  • Anterior sloped seat (only when the child has trunk control)
  • If fixed, use shaped back rests for comfort
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12
Q

What are some intervention options for obliquity? (1)

A
  • 4x point pelvic strap
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13
Q

What are some intervention options for rotation? (2)

A
  • Pelvic blocks
  • Anti-thrust cushions if child has extensor thrust
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14
Q

What are some things to consider when utilising a pelvic strap?

A
  • Width is important, too wide decreases functional movement whilst too narrow will cut
  • Must allow for anterior pelvic tilt
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15
Q

What is the ideal seating position for the hips?

A

Thighs horizontal and supported by seat surface

16
Q

What are some intervention options for hip flexion? (1)

A
  • Tray
17
Q

What are some intervention options for hip abduction? (2)

A
  • Gullies in seat cushion
  • Lateral thigh blocks
18
Q

What are some intervention options for hip adduction? (2)

A
  • Gullies in seat cushion
  • Pommel
19
Q

What are two things to consider with seating bases?

A
  • Firm support increases arousal
  • Medium density foam conforms and supports - reducing postural stress and hypertonicity
20
Q

What is the ideal seating position for the knees?

A

70-90 degrees flexion

21
Q

What are some intervention options for knee flexion greater than 70 degrees? (2)

A
  • Calf supports
  • Stabilising feet on footplates (heel loops, cups, straps etc)
22
Q

What are some intervention options for knee extension (1)

A
  • Stabilising feet on footplates (heel loops, cups, straps etc)
23
Q

What needs to be considered when positioning feet?

A

The feet are supported and protected

24
Q

What are some intervention options for foot instability (dorsi/plantar flexion, inversion, eversion, torsion etc.) (2)

A
  • Consider why the feet are positioned like this - what need is it meeting?
  • Straps (however should be used sparingly when other options are exhausted as it can be restrictive)
25
Q

What is the ideal seating position for the trunk?

A

Upright and symmetrical

26
Q

What are some intervention options for asymmetry of the trunk? (2)

A
  • Lateral support (curved side cushion)
  • Thoracic supports
27
Q

What are some intervention options for a flexed spine/kyphosis? (5)

A
  • Correct seat depth
  • Height of foot plates
  • Correct armrests
  • Sacral pads
  • Tray
28
Q

What are some intervention options for lordosis? (1)

A
  • Pelvic strap
29
Q

What is the objective of positioning the shoulders and arms?

A

Neutral shoulders and arms

30
Q

What are some intervention options for shoulder retraction? (2)

A
  • Curved back cushions
  • Custom contoured back
31
Q

What are some intervention options for shoulder protraction? (1)

A
  • Firm and countered back support
32
Q

What are some intervention options for dangling of the upper limbs? (2)

A
  • Adjust the height and position of the armrests
  • Tray
33
Q

What should be considered when administering trays for positioning?

A
  • Trays should not be used exclusively
  • Should able to be removed for interaction when possible
  • Trays should be long enough for the entire arm to be supported and not fall off of the edge.
  • Transparent trays are preferred so children can see the world below them too
  • Consider what might happen if the the chair can be tilted
34
Q

What is the ideal seating position for the head and neck?

A

Head aligned with the trunk, eyes in the horizontal plane

35
Q

What are some intervention options for hyperextension of the head? (2)

A
  • Proximal control
  • Head and neck support
36
Q

What are some intervention options for side flexion and rotation of the head? (2)

A
  • Proximal control
  • Head and neck supports with extended lateral support

Paediatrics (10 decks)

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