cerebral palse Flashcards
Cerebral palsy describes a group of permanent disorders of the development of movement and posture, causing activity limitation, that are attributed to progressive disturbances occurring in the developing fetal or infant brain
true or false?
false, non-progressive
what are the prenatal risk factors?
Being small for gestational age
Being of low or very low birth weight
Multiple gestation
Developing infection
Having evidence of stroke or having neonatal encephalopathy
the Maternal risk factors are
Chorioamnionitis
Fever during labor
Coagulopathy or bleeding
Placental infarction and thyroid disease
true or false?
true
there are no postnatal risk factors for CP
true or false?
false, Social disadvantage
Trauma
are postnatal risk factors
what are the subtypes of CP ?
hemiplegia
quadriplegia
monoplegia
diplegia
what are the kinds of CP ?
spastic
ataxic
and dyskinetic
. Abnormal pattern of posture and/or movement
. Increased tone (not necessarily constantly)
. Pathological reflexes (hyper-reflexia or pyramidal signs e.g. Babinski response)
. It may be unilatera (hemiplegia) or bilateral
are related to which type of CP?
spastic
spasticity is velocity independent
true or false?
false, dependent
a state of disinhibition of the stretch reflex will lead to what?
spasticity
_ Abnormal pattern of posture and/or movement
_ Loss of orderly muscular co-ordination, so that movements are performed with abnormal force, rhythm and accuracy
are related to which CP?
ataxic
Abnormal pattern of posture and/or movement
− Involuntary, uncontrolled, recurring, occasionally stereotyped movements of affected body parts
are related to which CP?
dyskinetic
what are the subtypes of dyskinetic CP?
dystonic CP and Choreo-athetotic CP
dominated by both hypokinesia and hypertonia
is?
dystonic CP
dominated by both hyperkinesia and hypotonia is?
Choreo-athetotic CP
give examples of visual impairments of CP
strabismus
refractive errors
reduced visual acuity
abnormal saccadic movements
increased risk of aspiration in CP is caused by what?
orometer impairments
most important factors associated with urinary incontinence were quadriparesis and impaired cognition
true or false?
true
increased tone or contractures of the gastrocsoleus complex only will lead to?
equines foot deformity
combination of spasticity of the posterior tibialis muscle and the gastrosoleus complex will lead to?
equinovarus deformity
knee extension is common in CP
true or false?
false, knee flexion
Passive hip abduction of less than 35 degrees and a hip flexion contracture of more than 20 degrees are concerning signs of ?
hip dysplasia
hip to be adducted, flexed, and internally rotated, placing it at risk for ?
hip posterior dislocation
what is the windswept deformity in CP?
adduction deformity of the elevated hip and an abduction deformity of the opposite hip
the windswept is characterized by?
hip obliquity
for UL deformities in CP
1-the shoulder is adducted and IR
2-the elbow has flexion contracture
3-forearm pronation
4- flexion of wrist with ulnar deviation
true or false?
true
for hand deformity in CP:
1- fingers are flexed with swan neck
2- ABD of carpometacarpal joint
3- hyperextension of the metacarpophalangeal and interphalangeal joints
true or false?
false, ADD of carpometacarpal joint
(Thumb in palm) deformity
scissoring gait is primary because of?
increased adductor tone
crouched gait with lordosis and APT is caused by?
increased iliopsoas tone
(hip flexor)
increased femoral anteversion will cause in toing with false genu valgus and external tibial rotation
true or false?
true
decrease hamstring ROM will cause?
crouched gait
co-contraction of hamstring and quadriceps will cause?
stiff knee gait
internal tibial torsion will cause out toeing
external tibial torsion will cause in toeing
true or false?
false
varus with increased supination
valgus increased pronation
true or false?
true
One of the most important problems in children with CP is unidirectional movements, low variability, and inability to mimic.
true or false?
false
what are the assessments of functional level and motor development?
Gross Motor Function Measure and Gross Motor Function Classification System
*Manual Ability Classification System
*Pediatric Functional Independence Measure(WeeFIM)
*Pediatric Evaluation of Disability Inventory
*Bayley Scales of Infant and Toddler Development
*Denver Developmental Screening Test
which test is used to assesses the quantity of the movements rather than the quality ?
GMFM
Items span the spectrum of gross motor activities in 3 dimensions
true or false?
false, five dimensions
what are the 5 dimension of gross motor development?
A:Lying and Rolling,
B:Sitting,
C:Crawling and Kneeling,
D:Standing, and
E:Walking, Running and Jumping
There are two versions of the GMFM.(TheGMFM-88 andGMFM-66
true or false?
true
the GMFM is done with 2 hours
true or false?
false, 45-60 mis
GMFC is assessing child development from rolling to walking
true or false?
false, from sitting to walking
which test helps in idea of what equipment or mobility aids a child in future?
GMFC
how many levels of GMFC ?
5 levels
in level 3 of GMFC the child uses AD only outdoors and wheelchair for long distance and uses one railing while climbing
true or false?
false, child will use AD indoors and outdoors
in level 1 and 2 of GMFC child can walk indoors and outdoors, but in level 2 there is limitation in crowded areas
true or false?
true
children walk for short distances with a walker but rely more on using wheelchair
which level of GMFC is this?
4th level
children are no longer independent
which level of GMFC is this?
5th
assessments of reflexes and reactions, the corrected age should be considered
true or false?
true
what are the scales used for the level of spasticity?
MAS and MTS
dystonia refers to increase activity in resting and speed dependent
true or false?
false, it is not speed dependent
Coxavalga, increased femoral anteversion, and acetabular dysplasia are the major problems of hip in CP
true or false?
true
orthopedic assessment should be carried out at 12–18 months and should be repeated every 8 months
true or false?
false, every 6 months
what are the Hip Dislocation Evaluation Criteria?
Abduction limitation
Length Difference (Galeazzi sign))
Asymmetrical thigh or gluteal creases
Ortolani Test
Barlow Test
in ortolani test the hips are flexed and adducted
in borlow test the hips are flexed and abducted
true or false?
false, ortalani=flex+abd
barlow=flex+add
increased internal rotation will result increased in anteversion
true or false?
true
The Duncan-Ely test is for what?
assessing of any rectus femoris contracture
which test is done to detect the hip flexors flexibility?
thomas test
Manual Ability Classification System (MACS)
Assisting Hand Assessment Scale
*Melbourne Assessment of Unilateral Upper Limb Function
*Jebsen Taylor Hand Function Test
*Zancolli Hand Deformity Classification
*Shriners Hospital Upper Extremity Evaluation
are what?
UE assessments
scale-combined video records, time-distance characteristics, and instrumented analysis
are assessments for?
GAIT
in which position we can assesst the trunk muscle weakness?
sitting position
what are ICF finds?
function
activity
and participation
how many treatments we can use for CP ?
15 treatments
what concept was based on observations of how abnormal tone interfered with the child’s ability to develop functional activity is?
bobath
quality of tone has always been central to which treatment?
bobath
The Bobath concept aims to?
*normalize the muscle tone
*inhibit primitive and abnormal reflexes
*to facilitate normal movements
Main Principles in Bobath Concept:
*Facilitation
*Stimulation
*Communication
true or false?
true
the proximal key points are farther to the source problem
true or false?
false, closer
proximal key points influence the posture control in all three planes usually at the head or trunk
true or false?
true
Distal key points, Located away from the source of the problem, usually at the upper and lower extremities level
true or false?
true
involve stimulation of the muscle activity to produce a desired motor response
is related to?
fascilitation
tapping and intermittent compression to provide proprioceptive and tactile stimulation are techniques used in?
facilitation of muscle tone in goal-directed activity
what is the process of intervention that reduces dysfunctional muscle tone?
inhibition
Techniques: traction and light joint compression are used in?
inhibition
we can use inhibition technique with hypotonicity
true or false?
false, we cant
therapist administers goal-directed pressure to defined zones on the body in a patient who is in a prone
which technique is this?
vojta
SMART activities are for which technique?
goal directed therapy
Goal directed therapy is more “task oriented”,
true or false?
true
what intervention is most commonly used in the presence of hemiplegia as a result of CP?
constraint induced movement
how can improving the coordination of both arms be achieved?
bimanual training tech
walk earlier and more efficiently than those children who did not ?
use treadmill training
treadmill can help clinicians overcome space constraints, reduce physical demands, and establish a convenient set-up for gait evaluation
true or false?
true
achieve a large amount of movement in a limited time by?
robotic trianing
ecologically valid opportunities for active learning, which are enjoyable and motivating yet challenging and safe is provided by?
virtual reality
which tech using horse for improving 3-dimensional mobility in CP is?
hippotherapy
Hippotherapy can be described as a low frequency, high repetition treatment strategy
true or false?
true
Gains in strength improve functional motor performance especially with opened kinetic chain exercises
true or false?
false, closed kinetic chain
Mobilization of the muscle through the entire fiber, from its origo to its insertion
is ?
stretching technique
what the electrotherapy are used in CP?
NMES
FES
ES
*To guide musculoskeletal development,
*To create long-term stretching effect,
*Ensuring proper body alignment
are achieved by?
verticalization tech
verticalization should be used with hypertonic and spastic conditions
true or false?
false, hypotonic and spastic
Orthotics are used to?
*Increase functional capacity,
*Help mobility,
*Reduce energy consumption,
*Maintain and correct posture,
*Prevent joint limitation and contracture development,
*Prevent complications after surgical procedures
what are the Medical Treatments in Cerebral Palsy?
Botulinum Toxin (Type A)
Surgery
Selective Dorsal Rhizotomy
Intrathecal Baclofen Pump
Adductor, iliopsoas and medial hamstring muscles are the main muscles involved in?
soft tissue release surgery
The outcomes are best in patients who are at low GMFCS levels and have limited hip displacement for soft release surgery
true or false?
true
2nd and 3rd GMFC are best for SDR
true or false?
true
SDR provides short-term reduction of spasticity
true or false?
false, long term
(ITB) is used for the management of spasticity and dystonia in pediatric populations
true or false?
true
which tech is used for reducing spasticity?
Botulinum Toxin (Type A)