Cerebral Palsy

Question 1

Cerebral Palsy

Answer 1

Range of developmental movement disorders resulting from a nonprogressive lesion or
disorder of the brain
● Head, neck, trunk, arms, and legs can be affected

Question 2

Progression of Atypical Movement
Patterns

Answer 2

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

Question 3

Primary Impairments

Answer 3

● 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

Question 4

Secondary Impairments

Answer 4

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

Question 5

Postural Mechanism

Answer 5

 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

Question 6

Balance reactions:

Answer 6

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:

Question 7

Hypotonia, Hypertonia, Fluctuating muscle tone

Answer 7

 Decreased muscle tone
 Child appears floppy and relaxed

 Increased muscle tone
 Child appears stiff or rigid

 Between hypotonia and hypertonia

Question 8

Involvement of extremities

Answer 8

 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

Question 9

Types of movement disorders

Answer 9

 Spastic
 Dyskinetic
 Ataxia
 Mixed

Question 10

Spastic Cerebral Palsy

Answer 10

● Characterized by hypertonia and muscle spasticity

Question 11

Dyskinetic Cerebral Palsy

Answer 11

Abnormal movements that lead to atypical and unintentional movement in other muscle groups of the body

Question 12

Athetosis

Answer 12

Fluctuation of muscle tone from low to normal, with
little or no spasticity and poor coactivation

Question 13

Choreoathetosis

Answer 13

Constant fluctuations from high to low and jerky movements

Question 14

Dystonia

Answer 14

sustained twisted postures triggered by movement

Question 15

Ataxic Cerebral Palsy

Answer 15

● Small shifts in muscle tone
● Typically, all extremities involved
● Appear clumsy, with decreased balance and coordination
● Decreased equilibrium reactions and lack of proximal stability

Question 16

Mixed Cerebral Palsy

Answer 16

Combinations of high and low tone

Question 17

Muscle and Bone

Answer 17

● 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

Question 18

Cognition, Hearing, and Language

Answer 18

● 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

Question 19

Sensory Implications

Answer 19

● Visual impairments
● Hearing impairments
● Tactile and proprioceptive deficits
 Difficulty with fingertip force regulation
● Tactile hypersensitivities
● Difficulty understanding environment
● Abnormal oral movement patterns
● Difficulty eating

Question 20

Upper Extremities or Hands

Answer 20

Decreased ability to maintain posture when attempting to use hands
● Deficits depend on the type and distribution of abnormal tone

Question 21

Vision

Answer 21

● 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

Question 22

Physical and
Behavioral Implications

Answer 22

● Seizures
● Compromised cardiac and respiratory function
● Decreased endurance
● Learned helplessness
● Social isolation
● Undesirable social behaviors

Question 23

Roles of the OT and COTA

Answer 23

● Assessment
 Observation, interviews, and standardized assessment tools
● Intervention
 Handling and positioning: medical based,(CAM), (CIMT), modalities, robotics, Kinesio taping, splinting and casting

Question 24

Therapeutic Modalities

Answer 24

● Heat
● Cryotherapy
● Electrical stimulation

Question 25

Orthotics and Casting

Answer 25

● Improvement of hand function
● Prevention of joint contracture
● Address pain
● Restrict arm or hand movement