Cerebral Palsy Flashcards
In early development, which develops first between gross and fine motor functions?
Gross motor functions. The prerequisite for stable and balanced mobility after birth is achieving bilateral stability, first in the torso then in the limbs.
What part of the brain controls locomotion?
Motor cortex.
Strong deviations in cervical spine apart from positioning in gmfcs 3/4/5
Hight tone systemic presentations do get treated with Botox and perhaps systemic medication regiments but this may affect breathing and is risky.
Do active extension devices work for all cases of spasticity?
No not at all. Some cp presentations will tolerate stretch and some will provoke spasticity.
What can be used for helping to control hip subluxation during the night?
Keep hips in abducted position with orthotic device. Saw one of cp webinar, pneumatic pillow between thighs connected to kafo medial joint only and afo with ankles in functional position.
What ia the most common seen deformity across gmfcs 1-5?
Foot and ankle deformities. Maybe not fixed, but deviations none the less.
Name four types of cerebral palsy…
Unilateral and bilateral spastic CP (85%)
Dyskinetic CP (20%)
Ataxic CP (5%)
How is spastic cp classified?
Unilateral SP (US-CP; Unilateral spastic CP) - Hemiparesis.
Bilateral SP (BS-CP; Bilateral spastic CP) - Diparesis and tetraparesis.
How many levels are on the GMFCS scale?
5
Explain GMFCS 1
Can run, jump and climb stairs without issue, but speed, balance or co-ordination
are impaired.
Explain GMFCS 2
Can walk and climb stairs using a rail but issues with walking on uneven or inclined
surfaces or walking in crowds or confined spaces.
Explain GMFCS 3
Can walk on level surfaces with assistive device
but a manual wheel chair used most of the time.
Explain GMFCS 4
Capable of walking with a walking frame but mostly
relies on wheeled mobilty at home and when out.
Explain GMFCS 5
Little or no voluntary control of movement. Maintaining anti- gravity head and trunk postures difficult. All areas of motor
function limited. Usually needs to be transported.
Why is GMFCS after 6years of age so important?
Generally, a child or young person over the age of 5 years will not improve their GMFCS-E&R level so, if for example, a child is classified at a Level IV at the age of 6 then it is likely that they will need to use a mobility device throughout their life.
What is Dyskinetic Cerebral Palsy (Dyskinesia)
People with dyskinetic forms of cerebral palsy have variable movement that is involuntary (outside of their control). These involuntary movements are especially noticeable when a person attempts to move.
How many types of Spastic hemiplegia are there and can you describe each?
Type 1 – weak or paralysed/silent dorsiflexors (= dropfoot)
Type 2 – type 1 + triceps surae contracture
Type 3 – type 2 + hamstrings and/or Rectus Femoris spasticity
Type 4 – type 3 + spastic hip flexors and adductors
Name Common Postural/Gait Patterns Bilateral Spastic Cerebral Palsy
Type 1. True Equinus.
Type 2. Jump Gait (With or Without Stiff Knee)
Type 3. Apparent Equinus (With or Without Stiff Knee)
Type 4. Crouch gait (With or Without Stiff Knee Gait)
Types of treatment in spastic cp…
Ortho surgery
Botox
Baclofen pump
List the 4 levels of the MACS classification system.
MACS level 1: Objects are handled easily and successfully.
MACS level 2: Handles most objects with reduced quality and speed.
MACS level 3: Handles objects with difficulty - will need help to prepare or modify activities.
MACS level 4: Handles a limited selection of easily managed objects in appropriate situations (continuos assistance required).
Name the four signs of sensorimotor disorders:
Spasticity
Dystonia
Athetosis
Ataxia
Describe symptoms of spastic hemiparetic cp
Hypertonia in arm and leg (unilateral).
Reduced growth of the affected limbs.
Walking upright possible but delayed.
Abnormal movement patterns.
Describe symptoms of spastic cp diparesis
Hypertonia especially in the legs
Pelvis-leg and pelvis-torso as well as torso rotation impaired
No reciprocal (alternating) crawling
Difficulty moving upright against gravity (unstable stance)
Describe symptoms of spastic cp tetraparesis
Impairment of the entire body - spasticity in upper and lower limbs
Insufficient head control
Balance problems
No voluntary movements
Questionable ability to stand
Primary reflexes preserved
Describe symptoms of dystonia
Hypotonia (reduced muscle tension over torso and head)
Hypertonia (increased muscle tension in affected limbs. Cramping posture.)
Hypotonic torso (no control of torso/and or head. Newborns difficulty breastfeeding and movement problems).
Symptoms of athetosis
Slow involuntary convoluted and twisting movements of :
Fingers
Toes
Limbs
Torso
Neck, face and tongue
Symptoms of ataxia
Disharmonious, shaky movements
Impaired fine motor skills
Gait and stance problems
Difficulty controlling strength of movements
Hardly any rotational movements
