Cerebral Palsy Flashcards

1
Q

Cerebral palsy

A

Permanent disorders of the development and posture that are attributed to non-progressive disturbance occurring pre-natally or post natally

The disease doesn’t worsen with age but it gets more obvious as the child develops

Can also be accompanied by sesnsation, perception, cognition, communication and behavior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How does CP happen

A

Multi factorial due to a static lesion in the developing brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Risk factors of CP

A

Prematurity
Low or high birth weight
Infection
Infarction
Developmental defect (lissencephaly- smooth brain)
Multiple gestation (twins, triplets etc)
Placental pathology (inflammation of placenta)
Trauma (prenatal, perinatal, early postnatal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What’s the most prevalent type of CP

A

Spastic (M>F)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Classifications by impairment

A

Anatomical distribution
- hemiplegia (one side of body affected)
- diplegia (the legs are more affected than arms)
- quadriplegia (arms, legs, and trunk are affected)

Type of impairment
- spastic
- dyskinetic (Ataxic, athetoid, dystonic)
- mixed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Spastic

A

Velocity- dependent resistance to passive elongation
Damage to the cortex or white mater to and from sensorimotor cortex
Most common
UMN
Diplegia most common distribution of spastic CP
- scissor gait, toe walking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Dyskinetic

A

Ataxic
- intention tremor, lack of muscle control and poor coordination of voluntary mvmts

Athetosis
- slow, continuous, involuntary writhing movements

Dystonic
- invultnary sustained muscle contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Classification by function

A

Gross motor function classification system (GMFCS)
- aligned with the ICF model
- focused on what the child CAN do in regards to self-mobility
- 5level classification system with 5 age groups
- helps describe severity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

GMFCS levels (ex of 6-12 years)

A

Level 1- walk without restriction
Level 2- walks without restriction but limitations outdoors and in community
Level 3- Walks with mobility devices
Level 4- Children transported or use power mobility outdoors
Level 5- Self mobility limited even with the use of supporting technology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Associated impairments

A

Cognitive
Sensory
Behavioral
Speech and language
Perceptual dysfunction
Problems with motor planning (apraxia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Assessment

A

Motor
GMFM-88 and 66

Spasticity
Modified ashworth scale
Modified Tardieu sale

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

GMFM- 88 and 66

A

Observational instrument measuring gross motor function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Intervention goals

A

Address impairments and participation restrictions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What impairments do we address when providing interventions

A

Bone development/ deformity (hip dysplasia, scoliosis, torsion)
Balance
Coordination
Motor planning
ROM (flexbitily and contractures)
Strength
Tone (spasticity)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What participation restrictions

A

Transfers, gait, stairs
Sports
Play

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

PT interventions specifically

A

Education for families
Stretching
Exercise (strengthening, ROM, balance and coordination)
Splinting
Orthoses
Assistive/Adaptive device perscription and training (crutches, walkers, standers, wheelchairs)
Gait training
Transfer training
Functional Training

17
Q

AFOs for CP

A

Solid- blocks talocrural and subtalar (decrease knee Hyperextension)
Hinged- allows for controlled ankle DF while still limiting PF (decrease knee Hyperextension)
Ground- Reaction- blocks mvmt at talocrural joint and limits mvmts at subtalar jt (increases knee extension)

18
Q

Medical Interventions

A

Bony realignment
Botox injections (reduce spasticity)
Intrathecal Baclofen (reduce spasticity)
Selective dorsal rhizotomy (reduce spasticity)
Serial casting (increase ROM)
Soft tissue lengthening and tendon transfers (increase ROM)
Percutaneous muscle/tendon release (increase ROM)
Recontruction (hip)

19
Q

GMFC Levels

A

l- walk independent on flat and stairs
2- walk independently, need handrail for stairs
3- handheld mobility indoor, manual wheelchair long distance
4- physical assistance or power chair
5- physical assistance