Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

My cards > Cerebral Palsy > Flashcards

Cerebral Palsy Flashcards

1
Q

Definition

A
  • Nonprogressive, but changing motor impairments that affect muscle tone
  • Occur secondary to early development lesions in motor control areas of the brain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Most causes of CP are a result of…

A

prematurity and LBW

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

3 physiologic classifications of cerebral palsy

A

pyramidal (cortical injury)
extrapyramidal (basal ganglia/cerebellar injury)
mixed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Presentation of pyramidal CP

A

spastic
hyperreflexic
clasp-knife hypertonia
susceptible to contractures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Presentation of extrapyramidal CP

A

athetosis (writhing hands)
lead-pipe rigidity
chorea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

In addition to musculoskeletal impairment, people with CP may also display…

A

decreased stereognosis and proprioception
ophthalmic abnormalities
incontinence
GI symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Classifications of CP based on movement disorder

A

spastic
dyskinetic
mixed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Spastic CP presentation

A
  • 65% of those with CP
  • flexors, adductors and IR activity greater than antagonists
  • increased DTR
  • clonus
  • abnormal postural reflexes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Types of dyskinetic cerebral palsy (4)

A

Athetosis
Dystonia
Chorea
Ataxia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Athetosis presentation

A

25% of those with CP

  • writhing motions of appendices
  • postural reflexes
  • dysarthria
  • dysphagia
  • involuntary movement
  • signs increase with anxiety
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Dystonia presentation

A

15-25% of those with CP

  • Sustained muscle contractions, twisting and repetitive movement
  • abnormal posture
  • no joint contractures/deformities b/c of continuous movement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Chorea presentation

A

25% of those with CP

  • excessive spontaneous movement
  • unable to maintain voluntary muscle contraction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Ataxic presentation

A
  • uncoordinated voluntary movement
  • wide gait and recurvatum
  • hypotonia
  • mild intention tremor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Apraxia

A

inability to perform coordinated voluntary gross and fine motor skills (mildest form of ataxia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Mixed CP presentation

A

20%

both spastic and dyskinetic components

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Effects of CP’s impaired motor function on exphys

A 
decreased daily PA
increased adiposity
low muscle force
lower power
decreased efficiency
decreased respiratory function
17
Q

Special considerations working with those with CP

A
  • strenuous exercise can cause transient increase in spasticity and discoordination
18
Q

GXT responses of those with CP

A
  • inefficiency of their mobility leads to higher than expected response values (HR, BP, blood lactate) for a given submax workload than those w/o CP
  • peak responses lowered by 10-20%
  • work capacity 50% of an AB person
19
Q

Common drugs treating CP

A 
Anti-spastic (baclofen)
Anti-parkinsonian (L dopa)
Anticonvulsants (clonazepam, valproate)
Neuroleptics (haloperidol)
Muscle relaxants (dantrolene, diazepam)
Botulinum A toxin
20
Q

Side effects of drugs for CP

A

Drowsiness, dizziness, weakness, fatigue, dry mouth, blurred vision, fatigue, depression, blurred vision, nervousness, diarrhea, ataxia

21
Q

When is CP diagnosed?

A

Appears to be a progressive rather disorder, but is actually static. Recognized around 2 or 3 as the nervous system matures and motor skills are learned. Clues to diagnosis- hyper/hypotonia, scissoring of legs, asymmetrical posture, persistent primitive reflexes, delayed postural reflexes, delayed achievement of motor milestones.

22
Q

Goal of exphys with CP patients

A
  • improve function (normally walking)

- facilitate care

23
Q

What particularly do people with CP run a risk of dislocating? What can you do as a clinician to prevent this?

A

Hip dislocation

- soft tissue release in adductors/iliopsoas

24
Q

Measurements of functional ability (by impairment)

A
  • Involuntary movement
  • Speed/progression of movement
  • Spasticity- Tardieu
  • Postural control
  • Force- dynamometry
  • ROM- gonio
  • Balance - functional reach
  • Energy cost- Physiological cost index ([HR during walking - resting HR]/ walking speed)
25
Q

Considerations when testing cardiovascular fitness with arm ergometry

A
  • forearm must not go above horizontal
  • may need to strap in trunk to create proximal stability
  • careful when strapping an affected limb in, often doesn’t have the ROM that the unaffected side does and can cause injury!
26
Q

What modalities can you use for w/c patients who have some leg function?

A
  • arm ergometer
  • nustep (can increase resistance without increasing cadence)
  • Schwinn air-dyne (resistance static, can only increase cadence)
27
Q

What gait abnormality should you watch out for when treadmill testing people with CP?

A

increase in adductor spasticity

increased genu valgus, may fall . always have a spotter in place!

28
Q

Why is strength testing often invalid in persons with CP?

A

spasticity

muscles might co contract

29
Q

Is a 1-RM test appropriate?

A

No, load might cause spastic response. Aim for an 8 RM when assessing muscular strength

30
Q

Special considerations when strength training people with CP

A
  • persons with athetosis might benefit from the guided movement machines offer
  • free weights pose a threat! do not use
  • may have dysfunctional grip. consider wrapping to augment grip
  • provide a long learning period for these people, d/t differences in cognitive ability, previous experience, and amounts of spasticity/athetosis/incoordination
31
Q

General considerations when training people with CP

A
  • underestimate the client
  • if the program is too demanding they may not be able to perform their ADL’s and will quit coming
  • begin with cardiovascular activity, 50-65%
  • follow with stretching in SUPINE for safety, 3-5 stretches for 15-20s
  • strength training 1-2 sets of 10-12 reps
  • emphasis on SLOW, controlled eccentric phase, 2sC-4sE count, to avoid antagonistic muscle tone
32
Q

Is an incline appropriate when treadmill training?

A

No, d/t plantarflexion contractures and limited dorsiflexion

33
Q

Benefits in order of importance of an exercise program for people with CP

A
  • Risk reduction for secondary chronic diseases
  • maintain/improve BMD
  • maintain/improve strength
  • maintain/improve CRF
  • maintain/improve flexibility, mobility, balance, coordination
  • decrease spasticity/athetosis
  • weight management
  • reduce anxiety, stress, promote well being and increased participation in individual pursuits/community engagement

My cards (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions