Cerebral Palsy Neuro Conditions Flashcards
What are participation restriction for CP patients?
environmental access, peer related activities, sports/recreational activities, family routines
What is the PSFS?
patient specific functional scale
How is CP defined?
describes a group of permanent disorders of the development of movement and posture, causing activity limitation, that are attributed to nonprogressive disturbances (lesion) that occurred in the developing fetal or infant brain
What are symptoms that often accompany the motor disorder of CP?
distrubance of sensation, perceotionm cognition, communication, and behavior, by epilepsy and by secondary MSK problems
What are the areas of the brain typically implicated in the diagnosis of CP
motor cortex, basal ganaglia, and cerebellum
Why would a person with spastic diplegia CP have more involvement of their legs than their arms and face?
Hemorrhages impacting tracts closer to the vulnerable periventricular region will affect the legs more
Which type of CP is least common based on TOPOGRAPHIC distribution?
tetraplegia or quadriplegia
what are the three types of risk factors for CP?
prenatal
perinatal
postnatal
What are the types of lesions?
hemorrhage
hypoxic ischemic encephalopathy (HIE) often from birth asphyxia
perventricular white mmatter injury
malformation of the CNS
What are the clinical signs of hypoxic-ischemic encephalopathy?
lethargic, decreased activity, hypotonia, weak suck, incomplete Moro, bradycardia
What causes HIE?
lack of O2 and substrate delivery to brain from decreased blood flow– birth or parental aphyxia
What are HIE associated factors/comorbitieis?
cognitive delays, behavorial issues, speech difficulties, auditory problems, seizure disorders, vision issues, urinary incontence, constipation, sensory impairment, growth distrubances and sleep disturbances
How is CP classified?
by topography, type of muscle tone and function
What are the topographic distribution classifications of CP?
hemiplegia or hemiparesis 38%
diplegia 37%
tetraplegia or quadriplegia ~24%
what is the most common topographic distribution of CP?
hemiplegia or hemiparesis
What are the types of CP classified by muscle tone and brain area?
spastic 85-91% motor cortex or white matter dyskinetic 4-7%basal ganglia ataxic 4-6cerebellar lesion mixed atonic/hypotonic (early infancy)
What are the positive signs of spastic CP?
spasticity and hypertonicity
hyperreflexia
retention of some primitive reflexes
clonus
What are the movement system diagnoses of CP?
fractionated movement deficit
force production deficit
motor coordination deficit
** most all types and dsitrubtions have some degree ot the above, the most prevalent impairment will guide where treatment begins
How many levels are there in the GMFCS and what does it stand for?
gross motor function classification system
5 levels
Describe Level I of GMFCS for children 6-12?
level 1= Walks without restriction. Children walk at home, school, outdoors, and in the community. Climb stairs without using a railing. Balance and coordination are limited but can perform gross motor skills.
Describe Level II of GMFCS for children 6-12
Level II– Walks without assistive devices but climbs stairs holding onto railing. May have difficulty walking long distances, balancing on uneven terrain, inclines, or crowded spaces. May walk with assistive or mobility device for longer distances. Minimal gross motor skills.
Describe Level III of GMFCS for children 6-12
Level III-Walks with assistive devices in most indoor settings. Climb stairs using railing or with supervision and or assistance. Wheelchairs are used for longer distances and may propel themselves for short distances.
describe level IV of GMFCS for children 6-12?
Self-mobility with limitations. Require physical assistance or powered mobility in most settings. May walk for short distances at home with assistance or use body support walker or powered mobility. In school or community settings children are transported in manual wheelchairs or use powered mobility.
Describe Level V of GMFCS for children 6-12?
Severely limited self-mobility even with the use of supporting technology. Children are transported in manual wheelchairs in all settings. Limited in ability to maintain antigravity head and trunk postures and control leg and arm movements.
At what age should an experience PT or pediatrician be able to diagnose CP?
6 months
What are the things that children need to have the potential for future independent walking with or without support in CP?
head control by 9 months
rolling supine to prone by 18 months
sitting without arm support by 24 months
reciprocal creeping by 30 months
integration of primitive reflexes by age 2
What types of CP have a 100% ambulation potential?
hemiplegia and dyskinesia/ataxia
What does CAPE and PAC stand for and what are they used for in CP?
CAPE= children's assessment of participation and enjoymen PAC= preferences for activities of children
What tests could you use to measure general participation/ goal setting for CP?
patient specific funcitonal scale (PSFS)
general goal attainmnet scale (GAS)