case study 6: CP Flashcards
What can be worn at the ankle for children with CP?
Ankle foot orthosis: AFO
custom/prefabricated brace for ankle and WB support for stance and ambulation
What categories are in the Apgar score?
- breathing effort
- heart rate
- mm tone
- reflexes
- skin color
(scored 0-2)
What is a normal Apgar score, and what is an abnormal Apgar score?
normal: 7+
abnormal: 6 and below
Low Apgar scores (6 and below) at __ and __ minutes is associated with CP
1 and 5 minutes
Name the 5 level classification system based on self-initiated mobility for kids with CP
*Grade A evidence: this system is a valid and reliable tool to measure gross motor function and evaluate change over time in children w/ CP
Gross motor Function Classification System (GMFCS)
*sitting, walking, wheeled mobility are primary forms of mobility in GMFCS
Why would a knee immobilizer be worn for this patient?
for external support during stance
for hamstring stretching
Name the federal legislation that establishes school-aged services for students (3-21 years) with disabilities
Individuals with disabilities education improvement act PART B (IDEA)
Name the federal legislation that establishes EARLY INTERVENTION services for infants and toddlers (0-3 years) with disabilities and their families
Individuals with disabilities education improvement act PART C (IDEA)
For infants/toddlers who receive IDEA PART C services…what is NAME of the multidisciplinary assessment of family resources, priorities, concerns, strengths/needs of child, services needed, and individualized service plan to meet these needs?
IFSP: individualized family service plan
How often is IFSP plan evaluated and reviewed?
evaluated: at least 1x/year
reviewed: at least every 6 months
Why would someone use a posterior wheeled walker?
It is designed to promote upright posture, decrease forward lean during walking, and UE support for walking balance
*wraps behind user, open in front of user so they can lean back for support to promote EXTENSION
What is preeclampsia?
pregnancy complication (usually after 20 weeks) where mom has HYPERTENSION and protein in urine leading to big time complications including morbidity/mortality of mom and unborn child
What is the positioning device called that enables supported standing in supine for individuals unable to maintain independent standing?
supine stander
The prevalence of CP is significantly higher in babies born before _____ weeks gestation
before 28 (extreme premature)
What are the three systems classifying kids with CP based on functional abilities?
GMFCS (walking, wheeled mobility)
MACS (hand, ADLs)
CFCS (communication abilities)
all scored 1-5, 5 is most limited ability
What are the 4 categories for classification of CP based on motor involvement/clinical presentation?
- hemiplegia
- diplegia (LEs)
- triplegia (usually BLE, 1 UE)
- quadriplegia/tetraplegia
What are the 4 classifications of CP based on muscle tone?
- spastic: can lead to contractures
- dyskinetic: (athetoid, choreoathetoid, dystonic)
- ataxic: uncoordinated, abnormal, unstable movement not due to weakness or involuntary mm activity
- mixed: most common is spastic-dyskinetic CP
What are the precautions during PT interventions with this patient with CP?
- monitor skin integrity with AFOs (heels)
- be close to child during gait and transfer training
- safe guarding due to potential impulsivity of child
What is the term used to describe a group of permanent disorders of movement and posture attributed to non-progressive disturbances that occurred in the developing fetal or infant brain?
cerebral palsy
Although the brain lesion in static in children with CP, the MSK impairments are ______
progressive
primary impairments of CP include ___, reduced ___ control, reduced selective ____ ______ control, and impaired ____ processing.
primary impairments of CP include spasticity, reduced postural control, reduced selective voluntary motor control, and impaired sensory processing.
primary impairments may lead to secondary impairments such as….
- contractures
- skeletal deformities
- decreased strength
- limited endurance
- over time, at risk for osteopenia and osteoporosis
T or F: individuals with CP may also have cognitive delays, seizure disorders, urinary incontinence, constipation
true (more prevalent in people with CP)
For children with CP who are non-ambulatory, _________ reduce spasticity and improve bone density, hip stability, social interaction, and alertness.
*grade B evidence
supported standing programs
