Cerebral Palsy

Question 1

What 3 methods are used for classification children with cerebral palsy?

Answer 1

1. Topographic (Quadra-, di-, hemiplegia)
2. Type of Movement Disorder (spastic, dyskinetic, ataxic, mixed)
3. Functional Ability (GMFCS)

Question 2

What are the the 5 levels of the GMFCS?

Answer 2

Level 1 - speed, balance, coordination are impaired.
Level 2 - limitations walking on uneven surfaces, inclines, crowds, or confined spaces.
Level 3 - walk in/outdoors on level surface with device, climb stair with railing, can propel WC manually.
Level 4 - may amb short distances with walker or rely more on wheeled mobility.
Level 5 - no means of indep mobility, limited voluntary control of movement to maintain posture or head against gravity.

Question 3

At what age, on average, will a child with CP reach their motor potential?

Answer 3

Level 5 - before age 3
Level 1 - by age 5
- levels 1, 2 do not demonstrate functional decline.
- levels 3, 4, 5 peak at age 7 and then decline.

Question 4

What is SDR?

Answer 4

• selective dorsal rhizotomy

Question 5

How is postural control affected?

Answer 5

• dysfunction in responding to postural challenges and difficulty fine tuning postural activity.
• children with CP use cranial-caudal recruitment of postural muscles

Question 6

How is motor learning impaired?

Answer 6

• difficulty analyzing their own movement and utilizing feedback to improve performance
• motor memory is frequently impaired.

Question 7

How is strength impaired?

Answer 7

• unable to generate normal voluntary control.
• inappropriate co-activation of antagonist muscle groups
• disproportionate type 1 vs type 2 fibers (weak and fatigue easily)

Question 8

Which 2 CP (types or classifications?) are most likely to walk?

Answer 8

• hemiplegic and ataxic CP

Question 9

Which 2 CP (types or classifications?) are least likely to walk?

Answer 9

• dyskinetic and bilateral CP

Question 10

What is the strongest predictor of walking abilities for children with CP?

Answer 10

• cognitive functioning

- Independent sitting by 24 months is best predictor of ambulation for 15 meters by 8 years old

Question 11

What are the CP classifications that involve movement?

Answer 11

Spastic
Dyskinetic
Ataxic
Mixed

Question 12

What are the types of CP classifications that involve location

Answer 12

Quadriplegia
Diplegia
Hemiplegia
Triplegia