Cerebral palsy Flashcards
Cerebral palsy
A group of permanent disorders of movement and posture, causing activity limitations that are attributed to non-progressive disturbances that occurred in the developing fetal or infant brain
When do most lesions occur for CP?
Second half of gestation
Strokes in first 28 days after birth
Potential causes of CP
Drugs
Maternal trauma
Radiation
Placental inflammation
Infection/viruses
Non-motor issues in CP
Cognitive delays IQ<70
Behavioral issues
Impaired speech, hearing, vision
Seizure disorders
Constipation and urinary incontinence
Perceptual problems - visual, spatial, sensory-perceptual
Cortex lesion symptoms - CP
Spasticity
Basal ganglia lesion symptoms - CP
Athetosis and dyskinesia
Cerebellum lesion symptoms - CP
Ataxia
Classifications of CP
Monoplegia - 1 limb
Diplegia - LE involvement > UE; less cognitive
Hemiplegia - UE and LE on one side; less cognitive
Triplegia - 3 limbs
Quadriplegia - all 4 limbs equally impaired; cognition; oromotor; visual
Clinical signs of CP
Impaired voluntary muscle control/coordination
Cognitive delays
Behavioral disturbances
Communication disorders
Sensory/perceptual disturbances
Seizure disorders
Visual deficits
Orthopedic changes
Soft neurological signs of CP
Mild muscle regulation dysfunction
Atypical tone
Choreiform dyskinesia
Dysdiadochokinesia
Balance difficulties
Fine motor disability
Difficulty coordinating R and L UEs or LEs
Assessment measures for CP
Movement assessment of infants
Alberta infant motor scale (birth-18 months)
General movement assessment
Test of infant motor performance (32 weeks gestation)
Harris infant neuromotor test
6 minute walk
MAS
TUG
Berg
Pediatric reach test
Reactive/anticipatory postural reactions/actions
CP MSK impairments
Hypertonia: passive and active stiffness, neurally mediated reflex stiffness
Skeletal malalignment
Weakness: decreased neuronal drive, atypical co-activation, secondary myopathy
Insufficient force generation
Neural and muscle level changes: loss of type II fibers and lengthened sarcomeres
Loss of selective muscle activation/control: slower movement speed, atypical reciprocal activation
Muscles at most risk of tightness for CP
Shoulder adductors
Elbow, wrist, and finger flexors
Hip flexors and adductors
Knee flexors
Ankle plantarflexors
