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Pediatrics > Cerebral Palsy > Flashcards

Cerebral Palsy Flashcards

1
Q

What is CP?

A

category of disability
chronic non progressive disorders of movement and posture

abnormality or injury to the developing brain

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2
Q

What are the grades of IVH?

A

Grade I: isolated without germinal matrix hemorrhage
Grade II: IVH without ventricular dilation
Grade III: IVH with ventricular dilation
Grade IV: IVH and parenchymal hemorrhage

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3
Q

What is GMFCS Level I?

A

walk inside and out without limitation
perform gross motor skills like running and jumping

speed, balance and coordination are impaired

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4
Q

What is GMFCS Level II?

A

walk indoors and out and climb stairs with railing

limitations walking on uneven surfaces and inclines and crowded or confined spaces

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5
Q

What is GMFCS Level III?

A

walk indoors or out on level surface with AD
may climb stairs with railing

may need wheelchair for long distances or on uneven terrain

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6
Q

What is GMFCS Level IV?

A

May walk short distances with walker

may be more reliant on wheeled devices at home/school/in community

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7
Q

What is GMFCS Level V?

A

restricted voluntary control of movement and ability to maintain anti gravity head and trunk postures

children have no means of independent mobility

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8
Q

What are the Age 90 Scores for each level?

A

Level I: 4.8 years
Level II: 4.5 years
Level III and IV: 3.5 years
Level V: 2.9 years

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9
Q

How are the Gross Motor Development Curves used?

A

aid prognosis
determine consistency of motor pattern with other children in level
evaluation of intervention

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10
Q

Hemiplegia is a _________ prognosis for ambulation.

A

good

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11
Q

diplegia is a ________ prognosis for ambulation.

When will they ambulate by?

A

fair

4 years old

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12
Q

Quadriplegia is a __________ prognosis for ambulation.

What percent and when will they ambulate by?

A

poor

10% are functional

ambulation by age 7 or 8

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13
Q

What does persistent tonic neck reflexes indicate?

A

decreased likelihood of walking

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14
Q

If a child with CP were to sit independently by 2 years, what would that indicate?

A

achieve walking by age 8

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15
Q

What are typical primary impairments of CP?

A

insufficient force generation
decreased selective control
abnormal muscle tone
abnormal muscle extensibility
persistent neonatal reflexes
decreased balance and/or reactions (righting, protective extension, equilibrium)

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16
Q

What are typical secondary impairments of CP?

A

orthopedic changes
pain
decreased cardiorespiratory endurance
skin breakdown

17
Q

Which children with CP are most at risk for scoliosis?

A

children with hemiparesis and spasticity that are non ambulators

18
Q

When should the therapist be thinking about scoliosis for a child with CP?

A

Before the child has it, ensure proper positioning and try to decrease asymmetrical patterns of movement

19
Q

Why is hip dislocation a common complication of CP?

A

decreased weightbearing results in shallow acetabulum
spasticity/contracture of hip flexors, adductors, and IR
excessive femoral anteversion

20
Q

Why would a child need to be in a stander if they have not yet started standing on their own by 1 year?

A

to begin weightbearing so that the hip anteversion is decreased

21
Q

When might you see hip retroversion?

A

patients that are positioned in hip ER

would see more than normal ER and less than normal IR

22
Q

What would you expect to see in tibial torsion in a child with CP?

A

excessive internal tibial torsion

lateral malleolus would be more anterior than medial malleolus

23
Q

What is normal tibial torsion and when is it reached?

A

15 degrees of external (medial in front of lateral mal)
age 10

24
Q

What is the clinical test for tibial torsion?

A

thigh foot angle

25
Q

What is a common complication at the ankle for children with CP and why does it occur?

A

valgus deformity

plantar flexion with eversion

overpull of gastrocs and peroneals

26
Q

What would you see in gait with a valgus deformity?

A

midfoot pronation (collapse through midfoot to touch the ground) and external foot progression angle

27
Q

What is a varus deformity at the ankle?

A

dorsiflexion and inversion–anterior tib
plantarflexion and inversion–post tib

28
Q

What would you expect to see in gait with a varus deformity?

A

land on lateral border of foot
internal foot progression angle

29
Q

What is another common orthopedic complication for children with CP?

A

leg length discrepancy–especially with hemiplegia

30
Q

What are some interventions for CP?

A

PROM
orthoses
alignment and weightbearing
AD
modalities
strengthening
functional activities

31
Q

What are the goals of intervention for children with CP?

A

maximize function and participation
empower families and patients
prevent/predict/minimize orthopedic complications
improve muscle strength

Pediatrics (4 decks)

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