Cerebral Palsy

Question 1

Is ID more common among individuals w/ CP?

Answer 1

Yes, about 50%

Question 2

What does Cerebral Palsy (CP) means ?

Answer 2

• Cerebral = brain

- Palsy = decrease in muscle control

Question 3

Is CP progressive?

Answer 3

It’s non-progressive but symptoms can changes

Question 4

CP - Remember

Answer 4

• Not contagious
• Not hereditary
• Not life-threatening

Question 5

CP - Incidence

Answer 5

• 2 to 2,5 / 1 000 births
• 15 000 people in QC
• 50 000 people in CAN
• More males than females (1,33 > 1)

Question 6

Why incidence hasn’t declined in the last 60 years?

Answer 6

Increase survival rate of pre-term babies

Question 7

CP causes - Before or during birth

Answer 7

• 90%
• Maternal infections
• Chemical toxins
• Injuries affecting fetal development
• Damage to the brain/ oxygen deprivation during deliveries
• Genetic disorder, chromosomal abnormality, faulty blood supply

Question 8

CP causes - after birth

Answer 8

• 10%
• Brain infections
• Cranial traumas
• Oxygen deprivation

Question 9

CP causes - other

Answer 9

• Age of mother
• Premature babies
• Low birth weight babies

Question 10

CP causes - age of mother (less than 20 yo)

Answer 10

• Maternal infections

- Chemical toxins

Question 11

CP causes - age of mother (more than 35 yo)

Answer 11

• Genetic disorder, chromosomal abnormality, faulty blood supply
• More physiological

Question 12

CP causes - number 1

Answer 12

Damage to the brain/ oxygen deprivation during deliveries

Question 13

Early signs

Answer 13

• Before 3 years of age (walk)
• Abnormal development of motor skill (coordination and balance)
• Abnormal muscle tone
• Favour one side of the body

Question 14

Early signs - Walking pattern

Answer 14

• Toe walking
• Foot dragging
• Favor one side when standing up

Question 15

Early signs - type of muscle tone

Answer 15

• Hypotonia

- Hypertonia

Question 16

Types of CP - classification by number of limbs affected (5)

Answer 16

• Quadriplegia (4 limbs)
• Diplegia (2 limbs)
• Hemiplegia (one side of the body)
• Triplegia (3 limbs)
• Monoplegia (1 limb)

Question 17

Types of CP - classification by mvt disorder (3)

Answer 17

• Spastic CP = Co-contraction
• Athetoid CP = mixed muscle tone, constant motion
• Ataxic CP = unsteady and shaky

Question 18

Spastic CP

Answer 18

• Abnormal muscle tightness and stiffness

- Spastic muscles interfere with voluntary mvt

Question 19

Spastic CP - incidence

Answer 19

Spasticity (65% of people w/ CP)

Question 20

Spastic CP - Causes

Answer 20

• Damage to the motor cortex and cortical tracts

Question 21

Spastics CP - Interventions

Answer 21

• Surgical lengthening of tendon

- Dorsal rhizotomy

Question 22

Athetosis (athetoid) CP

Answer 22

Constant, unpredictable and purposeless mvt

Question 23

Athetosis (athetoid) CP - incidence

Answer 23

25% of people with CP

Question 24

Athetosis (athetoid) CP - Causes

Answer 24

• Fluctuating muscle tone (hyper-hypo)

- Damage to basal ganglia

Question 25

Athetosis (athetoid) CP- Problems

Answer 25

- Problems w/ facial expression, eating, speaking, head/ fingers/ wrist control - Most are quadriplegic

Question 26

Ataxia CP

Answer 26

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

Question 27

Ataxia CP - Incidence

Answer 27

10% of people with CP

Question 28

Ataxia CP - Causes

Answer 28

Disorders of the cerebellum and vestibular system

Question 29

Most common CP

Answer 29

Spastic

Question 30

Most severe CP

Answer 30

Athetoid

Question 31

Fitness and CP

Answer 31

- Higher HR, blood pressure and lactate concentration | - Lower mechanical efficiency of their mvt = higher energy

Question 32

Fitness and CP - causes

Answer 32

- Spasticity + athetosis | - Poor exercise habits

Question 33

Effects of Exercise training (4)

Answer 33

Improvement: - sense of wellness - body image - capacity to perform ADL - lower spasticity and athetosis

Question 34

Resistance training increase spasticity by how many pourcent?

Answer 34

0%

Question 35

Resistance training and walking in children with CP - Study summary (4)

Answer 35

- 3 times / week for 60 min for 12 weeks - 26 subjects per groups (6 to 13 yo) - Training group: leg press machine and 3 exercises - Control group : conventional PT program

Question 36

Resistance training and walking in children with CP - Results

Answer 36

- Improvement in muscle strength in trained group (knee extensor, hip abductors, total) - No improvement in walking ability in both group - No improvement in muscle spasticity and ROM in both

Question 37

Resistance training and walking in children with CP - Possible reason for lack of improvement in walking

Answer 37

Lack of specific exercise