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Cerebral palsy Flashcards

1
Q

definition: describes a group of permanent disorders of the development of movement and posture, causing activity limitations that are attributed to non-progressive disturbances that occurred in the developing fetus or infant brain

A

cerebral palsy

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2
Q

What is the most common motor disability of childhood?

A

cerebral palsy

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3
Q

How is cerebral palsy a neurologic condition?

A

Evidenced by defect or lesion in single or multiple locations in the immature brain

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4
Q

(true/false) CP is progressive

A

False (it is not)

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5
Q

(true/false) CP is easy to diagnose

A

False

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6
Q

1 in _____ children are identified with CP

A

345

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7
Q

What population is CP most prevalent in?

A

infants born before 28 weeks of gestation; boys; black children

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8
Q

What is the most common co-occurring developmental disability is children with CP?

A

chronic pain

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9
Q

(true/false) Children with CP are prone to have epilepsy and seizures

A

true

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10
Q

(true/false) 2 of 3 children with CP will walk

A

true

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11
Q

(true/false) 3 of 4 children with CP will talk

A

true

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12
Q

(true/false) 1 of 2 children with CP will have typical intelligence

A

true

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13
Q

How is CP classified?

A
  1. location of impairments (monoplegia, diplegia, hemiplegia, quadriplegia)
  2. movement abnormality (spastic, dyskinetic, ataxic, hypotonic)
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14
Q

What locations in the brain are involved with spasticity?

A

motor cortex and/or white matter

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15
Q

What region of the brain causes dyskinesia if damaged?

A

basal ganglia

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16
Q

What region of the brain is damaged if a child has ataxia?

A

cerebellum

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17
Q

definition: slow, continuous writhing movements that prevent maintenance of a stable posture

A

athetosis

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18
Q

definition: dominated by involuntary sustained or intermittent muscle contraction with repetitive movements and abnormal postures

A

dystonia

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19
Q

Level ___ of the Gross motor function classification system – Walks without restrictions; limitations in more advanced gross motor skills

A

Level I

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20
Q

Level ___ of the Gross motor function classification system – Walks without assistive devices; limitations walking outdoors and in the community

A

Level II

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21
Q

Level ___ of the Gross motor function classification system – Walks with assistive mobility devices; limitations walking outdoors and in the community

A

Level III

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22
Q

Level ___ of the Gross motor function classification system – Self-mobility with limitations; children are transported or use power mobility outdoors and in the community (ex: gait trainer)

A

Level IV

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23
Q

Level ___ of the Gross motor function classification system – Self-mobility is severely limited even with the use of assistive technology

A

Level V

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24
Q

Most children fall into what level of the gross motor function classification system?

A

Level I

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25
What age range is the gross motor function classification used for?
3-12 y/o
26
The average number of PT cases/visits are greatest for what level of the gross motor function classification system?
Level III* and IV
27
___% of CP cases have a genetic component
14%
28
___% of CP cases have prenatal factors causing CP commonly during the ___ and ___ trimesters.
34%; 2nd and 3rd trimesters Prenatal factors: malnutrition, intrinsic developmental problems of the fetus, poor maternal prenatal condition, and maternal infection
29
___% of CP cases have postnatal factors causing CP
6% Postnatal factors: accidental and non-accidental brain injury (improper car restraints, falls, physical abuse), stroke, surgical complications, Sz, infections
30
(true/false) Prematurity is a cause of CP.
FALSE (but it is associated with CP) Premature factors: intracranial hemorrhage
31
What are modifiable risk factors that can cause CP?
Tobacco use drug exposure diabetes preeclampsia chorioamnionitis
32
What causes prenatal brain damage?
- Disturbances to the migration of embryonic cells that form the brain - Poor myelination
33
How can the migration of embryonic cells forming the brain be disturbed?
Primarily genetic and environmental factors: - alcohol - drugs - maternal infection and inflammation - environmental toxins
34
Poor myelination can occur secondary to _____.
hemorrhage
35
___% of perinatal risks cannot be prevented by and obstetrician
90%
36
Perinatal risks often occur due to preexisting ____ pathology.
CNS pathology
37
What are some perinatal risks leading to brain damage?
- Vacuum extraction and forceps - Intracranial hemorrhages - Acute intrapartum hypoxia-ischemia - Infection - Jaundice - Seizures - Hypoglycemia
38
In babies with CP that are born at full term, they are more likely to be at a NON-AMBULATORY level of the GMFCS if they experienced ____.
asphyxia
39
Infants born at full term with CP and asphyxia are more likely to have ___.
spastic quadriplegia
40
What brain damage is common in children with CP that were born prematurely?
white matter damage
41
(true/false) CP in preterm babies can be related to rupture of the membranes leading to infections
true
42
What medications can impact an infants developing brain in preterm infants?
steroids
43
___% of CP cases are due to PREVENTABLE causes in developing countries.
63%
44
(true/false) Developed countries are more able to keep extremely premature infants alive.
true
45
What tools are used to detect cerebral palsy in those before 5 months old?
- neonatal MRI - Prechtl Qualitative Assessment for General movements - Hammersmith infant neurological examination
46
What tools are used to detect cerebral palsy after 5 months?
- MRI - HINE - developmental assessment of young children
47
(true/false) Kids with CP do not have self-propelling wheelchairs
true
48
(true/false) 90% of children with CP do not survive into adulthood
FALSE
49
Children with severe CP have a ___% chance of living to 20 y/o
40%
50
Children with mild CP have a ___% chance of living to 20 y/o
99%
51
What are predictors of decreased life expectancy in children with cerebral palsy?
- lack of mobility - feeding difficulties
52
___% of children with CP will grow to live independently
31%
53
___% of those with CP will have paid employment
28%
54
Children in GMFCS Level ___ had highest overall participation
Lvl I
55
What are predictors of inability to live independently in those with CP?
- intellectual disability - Sz - wheelchair dependency
56
What CP population is more likely to ambulate?
hemiplegic and ataxic CP
57
What CP population is least likely to ambulate?
dyskinetic and bilateral CP
58
What is the strongest predictor of ambulation among all types of CP?
cognitive function and independent sitting by 2 y/o
59
Nearly all children with cerebral palsy who will walk will do so before __ y/o.
8 y/o
60
What are areas of concern in adults with CP?
- fatigue - pain - deteriorating mobility - reduced physical and mental health
61
Mobility in those with CP (increase/decrease) in those over time.
decrease --> even in those who classify as Level I GMFCS.
62
Those who classify as GMFCS level ____ are at a higher risk for decreasing their mobility due to changing demands
level III
63
Children with CP who walked independently by the age of ___ has a higher likelihood of a long standing and efficient gait.
3 y/o
64
Those classified as GMFCS level V are going to have a decrease in mobility due to what?
stiffness and deformity
65
What are MSK deformities seen in adolescents/adults with CP?
subluxation/dislocation of the hip abnormalities of the foot patella alta pelvic obliquities contractures scoliosis OA overuse syndromes Fx
66
Employment rates are (lower/higher) in adults with CP than in people with other disabilities
lower
67
(true/false) Improvements with interventions are increased when done in the patient's home
true
68
(true/false) infants with hemiplegic CP who received CIMP have better hand function both short and long term
true
69
Infants with regular surveillance and intervention have (decreased/increased) rates of hip displacement, contracture, and scoliosis
decreased rate
70
What are typical impairments in those with cerebral palsy?
abnormal WB and malalignment
71
What are common locations of contractures in those with cerebral palsy?
Shoulder ABD elbow wrist flexors finger flexors hip FLX and ADD Knee FLX ankle PF
72
What can limitations in motor skills potentially result in?
- learning disabilities - difficulty with socialization - difficulty with independence
73
a. What ICF level is the primary focus during a child's preschool phase? b. what developmental assessments should be used?
a. examination of participation b. peabody and GMFM
74
What should interventions focus on improving in the preschool population?
Improving force generation (stairs, functional activities, playground equipment, theraball)
75
What developmental aspect most commonly causes spasticity?
Growth spurts (commonly in preschool phase)
76
What PT approaches can be used for hypoextensibility?
Stretching Casting night splints orthotics (solid AFO, hinged AFO, supramalleolar orthosis) --> Billy shoes are highly recommended due to being able to fit an orthotic inside
77
Casting to treat hypoextensibility helps improve ______ ROM.
ankle
78
Orthoses to treat hypoextensibility is effective in restricting ______ to improve gait.
PF
79
It is recommended that surgical interventions focusing on preventing subluxation or dislocation of the hip should be held off until the child is at least ___ y/o.
6 y/o
80
What is a complication for surgical interventions focusing on preventing subluxation or dislocation of the hip?
Decreased force production
81
(true/false) surgical interventions focusing on preventing subluxation or dislocation of the hip ALTERS neuro patterns.
False
82
What developmental assessments are most appropriate for examination and evaluation of school-age and adolescent children?
- GMFM - BOTSMP - School function assessment
83
What does baclofen do?
Inhibits presynaptic excitatory neurotransmitter release
84
What ICF classification should transition to adulthood focus on?
function
85
___% of adults with CP had musculoskeletal problems
76%
86
What are red light interventions for cerebral palsy?
- craniosacral therapy - hip bracing - hyperbaric oxygen - NDT - sensory integration

Pediatric PT (14 decks)

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