Cerebral Palsy Flashcards
1
Q
Cerebral palsy
A
- damage to one or more areas of the brain which leads to paralysis, spasticity, or abnormal control of movements or posture
- even though the damage is static, it might impact how the rest of the body develops
- muscles are activities in inefficient ways
- most prevalent of persistent motor dysfunction
- 1 in 345 children
- more common in males
- incidence is higher among African American children and children from low-middle income families
2
Q
What is Cerebral Palsy video
A
- variations in muscle tones
- can impact speech and articulation because of all the muscles involved
- CPs have a hard time with midrange movements
3
Q
Types of cerebral palsy
A
- spastic cerebral palsy (80%)
- dyskinesia cerebral palsy
- ataxia cerebral palsy
- mixed = more than one type (most common mix is spastic and dyskinetic)
4
Q
Spastic cerebral palsy
A
- hypertonic in muscles and resistance to stretch (fully flexed or fully extended)
- hypertonicity = more muscle tone
- excessive stiffness when the child attempts to move or maintain a posture
- poor control/gradation of voluntary movement
- limited ability to regulate force
- damage to motor cortex and pyramidal tracts of brain
- classified by location of impairment
5
Q
Spastic diplegia
A
- impacts lower extremities (impacts standing, walking, crawling)
- upper extremities less affected or not affected
- tight hip and leg muscles cause legs to pull together, turn inward, and cross at the kneed (also called scissoring)
- difficulties with walking
- commonly linked to prematurity
6
Q
Spastic hemiplegia
A
- involvement of upper/lower extremities on one side of the body
- arm is generally more impacted than leg
- commonly linked to prenatal brain bleed (a stroke) = bleed on the left side of the brain causes impairment on the right side of the body and vice versa
7
Q
Freddy Video
A
- right spastic hemiplegia CP
- posture with hemiplegia and CP is rotation
- impacts shoulder flexion, elbow flexion, pronation of forearm, wrist flexion, and its thumb has tendency to get in between the index finger and the long fingers
8
Q
Spastic quadriplegia
A
- involvement of all limbs, neck, and face
- most significant impairments = impacting most muscles of the body
- caused by widespread damage to the motor cortex
- generally utilize a wheelchair (and uses AAC)
- comborbidity of many secondary issues
9
Q
Dyskinetic cerebral palsy
A
- impacts the entire body
- fluctuation of tone from low to high
- excessive of tone from low to high
- excessive abnormal movement = initiating movement in one extremity causes atypical, abnormal movement in another
- damage to basal ganglia
10
Q
Ataxic cerebral palsy
A
- problems with balance and coordination
- difficulties with walking and fine motor coordination
- shakey movements, wide gait, difficulty with fine motor skills
- damage to cerebellum
11
Q
Secondary impairments associated with CP
A
- chronic pain
- intellectual impairment
- unable to walk
- experience hip displacement
- unable to verbally speak
- epilepsy
- behavior disorder
- incontinence
- sleep disorder
- vision impairment
- unable to eat orally (will eat via G-tube)
- hearing impairment
12
Q
Causes of cerebral palsy
A
- congenital cerebral palsy
- acquired cerebral palsy
13
Q
Congenital cerebral palsy
A
- related to events before or during birth
- low birth weight
- premature birth = prior to 32nd and 37th weeks
- multiple births = twins and triplets
- assisted reproductive technology (infertility treatments) = generally explained by preterm birth of multiples
- infection during pregnancy
- jaundice
- medical conditions of the mother
- birth complications = detachment of placenta, umbilical cord (stuck around the neck = traumatic birth)
14
Q
Acquired cerebral palsy
A
- occurs during the first 2 years of life
- due to infection or injury (ex: meningitis, abuse, accident, skaken baby)
15
Q
Diagnosing cerebral palsy
A
- generally diagnosed the first year of life
- child is not meeting age appropriate motor milestones
- diagnosed by developmental pediatrician or pediatric neurologist
- diagnosed via physical exam and brain imaging (MRI)
16
Q
Lincoln Video
A
- hand preference under age 3 is not typical
- cognition is not generally impacted
17
Q
Many individuals with CP will be seen across the lifespan
A
- NICU (may or may not have diagnosis)
- 0-3 = early intervention programs at home
- 3-5 = early childhood settings
- 5-21 = school based settings
- transitional and adult programming
- may be seen in homes, clinics, hospitals, school or community based setting
- hippotherapy or aquatic therapy
18
Q
Things to consider
A
- treatment is individualized and based upon the age an skills of the child
- the goal is always to help the child and family participate in meaningful activities to the fullest extent possible
19
Q
Sensorimotor problems to consider
A
- abnormal muscle tone
- spasticity = increase muscle tone with AROM/PROM
- hypotonicity
- fluctuating
- atypical or abnormal reflexes (are integrated in a delayed manner)
- poor sensory processing
- hypertonicity = increase in resting state
- joint hypermobility or stiffness
20
Q
Medical based treatment
A
Medication to manage tone:
- Baclofen = by mouth or pump (administered to the whole body), it relaxes the muscle tone throughout the body (good option for quadriplegic BUT not hemiplegic)
- Botox = injections to specific muscles (helps relax muscles; great option but for only short period of time)
Orthopedic surgery:
- muscle releases = incisions in muscle or tendon (helps loosen the muscles)
- tendon transfer = green transfer is flexor carpi ulnaris transferred to extensor carpi radialis brevis to correct wrist flexion deformity
- hip displacement (hip surgeries)
- spinal surgeries
- selective dorsal rhizotomy = neurological surgery of lower spine
21
Q
Dr. Zimmerman’s go to model
A
- PEO model
*how can we modify the environment?
22
Q
Impact on ADLs
A
- its goal = to increase independence in self-care, dressing, ADLs
- utilize adaptive equipment
23
Q
Impact on participation in school/work
A
- person = how can we improve child’s ability to perform task?
- environment = can it be modified for success?
24
Q
Participation in leisure
A
- access to toys (such as Switched Adapted Toy Program)
- access to social
- access to playgrounds
- access to extracurricular activities
25
Out of My Mind movie
- Phoebe Rae Taylor = an authentic actress with CP
