Cerebral Palsy Flashcards
Cerebral Palsy
Range of developmental movement disorders resulting from a nonprogressive lesion or
disorder of the brain
● Head, neck, trunk, arms, and legs can be affected
Progression of Atypical Movement
Patterns
Decreased ability to control coactivation of agonist and antagonist muscles
-Impaired reciprocal innervation of agonist and antagonist muscles
● Development of compensations and atypical movement patterns
Primary Impairments
● Direct result of a lesion in the cerebral cortex of the (CNS) that is
nonprogressive
● CNS damage occurs prenatally, perinatally, or within the first 2 years
● Not hereditary, progressive, or contagious
● Delayed progression of motor development skills
Secondary Impairments
Those that occur in systems/organs over time due to the effects of one or more of the primary impairments
-Abnormal muscle tone
Impaired initiation of movement
Repetition of atypical movement patterns
Impaired coactivation
Postural Mechanism
Normal muscle tone
Normal postural tone
Integration of primitive reflex movement patterns
Righting, equilibrium, and protective extension reactions
Intentional, voluntary movements against the forces of gravity
Ability to combine movement patterns in the performance of functional activities
Balance reactions:
assist in maintaining or regaining
posture
Static posture: not moving
Dynamic posture: moving
Equilibrium reactions: stable or balanced
Righting reactions: ability to sense that the head is out of alignment with trunk
Protective extension reactions:
Hypotonia, Hypertonia, Fluctuating muscle tone
Decreased muscle tone
Child appears floppy and relaxed
Increased muscle tone
Child appears stiff or rigid
Between hypotonia and hypertonia
Involvement of extremities
Monoplegia: involvement of one extremity
Hemiplegia: upper and lower extremities on one side
Diplegia or paraplegia: both lower extremities
Quadriplegia and tetraplegia: all limbs affected
Types of movement disorders
Spastic
Dyskinetic
Ataxia
Mixed
Spastic Cerebral Palsy
● Characterized by hypertonia and muscle spasticity
Dyskinetic Cerebral Palsy
Abnormal movements that lead to atypical and unintentional movement in other muscle groups of the body
Athetosis
Fluctuation of muscle tone from low to normal, with
little or no spasticity and poor coactivation
Choreoathetosis
Constant fluctuations from high to low and jerky movements
Dystonia
sustained twisted postures triggered by movement
Ataxic Cerebral Palsy
● Small shifts in muscle tone
● Typically, all extremities involved
● Appear clumsy, with decreased balance and coordination
● Decreased equilibrium reactions and lack of proximal stability
Mixed Cerebral Palsy
Combinations of high and low tone
Muscle and Bone
● Weakness, abnormal muscle tone, and
movement patterns can lead to:
Muscle tissue contractures
Bone deformities
Joint dislocations or misalignment
● Lack of functional mobility and weight bearing
lead to:
Pain
Risk for skin breakdown
Decreased bone density
Pathologic fractures
Cognition, Hearing, and Language
● Decreased speech production
● Poor articulation
● Decreased speech intelligibility
● Dysarthria: disorder of speech that is secondary to decreased muscle coordination, paralysis, or weakness
● Decreased receptive and expressive language skills
Sensory Implications
● Visual impairments
● Hearing impairments
● Tactile and proprioceptive deficits
Difficulty with fingertip force regulation
● Tactile hypersensitivities
● Difficulty understanding environment
● Abnormal oral movement patterns
● Difficulty eating
Upper Extremities or Hands
Decreased ability to maintain posture when attempting to use hands
● Deficits depend on the type and distribution of abnormal tone
Vision
● Strabismus: misalignment of eyes
● Exotropia: one eye drifts temporally
● Esotropia: one eye drifts nasally
● Hypertropia: one eye drifts upward
● Hypotropia: one eye drifts downward
● Nystagmus: constant movement of eyes in a repetitive and uncontrolled way
Physical and
Behavioral Implications
● Seizures
● Compromised cardiac and respiratory function
● Decreased endurance
● Learned helplessness
● Social isolation
● Undesirable social behaviors
Roles of the OT and COTA
● Assessment
Observation, interviews, and standardized assessment tools
● Intervention
Handling and positioning: medical based,(CAM), (CIMT), modalities, robotics, Kinesio taping, splinting and casting
Therapeutic Modalities
● Heat
● Cryotherapy
● Electrical stimulation
Orthotics and Casting
● Improvement of hand function
● Prevention of joint contracture
● Address pain
● Restrict arm or hand movement
