Cerebral Palsy Gait and Orthotics Flashcards

1
Q

What is drop foot?

A

The foot falls into equinous during swing, however dorsiflexion is seen during stance.

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2
Q

What is true equinous?

A

The ankle remains in plantarflexion throughout stance and swing.

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3
Q

What is apparent equinous?

A

The child may remain on their toes, however the ankle is plantargrade.

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4
Q

What is jump knee?

A

Increased knee flexion in early stance with normal knee extension later in stance. Hip has normal movement.

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5
Q

What is knee recurvatum?

A

The knee is in hyperextension during stance

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6
Q

What is stiff knee?

A

Decreased knee flexion during swing

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7
Q

What is crouch gait?

A

Increased hip and knee flexion with ankle dorsiflexion in stance

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8
Q

What is the main difference in presentation between spastic hemiplegia and diplegia?

A

Hemiplegia has more distal involvement, whereas dipegia has more proximal involvement

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9
Q

What are the five gait patterns of spastic hemiplegia?

A
I: Drop foot
IIa: True equinous
IIb: True equinous/knee recurvatum
III: True equinous/jump knee
IV: equinous/jump knee/hip IR, flex, adduction
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10
Q

What are the five gait patterns of spastic diplegia?

A
I: True equinous
II: Jump gait
III: Apparent equinous
IV: Crouch gait
V: Asymmetrical gait
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11
Q

What are the roles of orthotics in cerebral palsy management?

A
  • Help prevent deformity and contractures
  • Decrease impact of spasticity
  • Reduce pain
  • Correct gait pattern
  • Improve balance
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12
Q

What are the three difference types of orthotics?

A
  1. Foot stabilising splint (FSS)
  2. Ankle foot orthotic (AFO): static or dynamic
  3. Ground reactive ankle foot orthotic (GRAFO)
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13
Q

When is a foot stabilising splint used? How long is it worn each day?

A

When excessive valgoid posture is present (calcaneal eversion and forefoot pronation). Worn in shoes for 6-8 each day.

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14
Q

What do static AFOs control?

A

Control triplanar aspects of foot position, by maintaining the ankle at 90 degrees.

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15
Q

What is required for a dynamic AFO to be effect?

A

Good hip and knee extension and adequate range in the gastrocnemius

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16
Q

What rockers are present with dynamic AFOs?

A

Second rocker is present, third partially

17
Q

When are GRAFOs mainly used? In what population?

A

Post surgery.

Crouch gait in spastic diplegia.

18
Q

What the precautions of orthotic use?

A
  • Limited muscle length excursion and weakness
  • Pressure areas
  • Compliance with wear
  • Monitoring effectiveness