Clinical Management Of Movement Disorders Flashcards
Is diplegia more UE or LE involved???
Whole body involved but LE» UE
Describe paraplegia…
B LE inv but no UE, only some trunk
UPDATE:
you should not choose this as answer on test as stated by dr P..
T or F…
Spasticity occurs only in the PNS?
F. It’s the CNS
T or F??
With spasticity you will feel an atypical firm end feel earlier on in the PROM
True!
T or F…
All individual with diplegia have spasticity?.
True!
Does athetoid quadriplegia have more UE or LE involvement?
UE»LE , will have fluctuation in tone due to athetoid nature
Is hemiplegia more UE or LE biased?
UE» LE
pts wit hemiplegia typically have sensory neglect on uninvolved side?
NOOOOO it’s on the involved side. Can have sensory deficits from face all the way down to LE
T or F…
A criterion based test can qualify a kiddo for services?
False! Only norm referenced tests can qualify kiddo for services
What is the age range for the Gross Motor Function Classification System (GMFCS – E & R)
0-18 y/o, it focuses on what the child can do rather than their impairments. REALLY good for kiddos with CP
What are the 5 lvls of the Gross Motor Function Classification System (GMFCS – E & R)?
- Walks without limitations
- Walks with limitations
- Walks with AD
- Self mobility with limitations, may use powered mobility aid
- Transported in manual wheelchair
With regards to lvl 1 GMFCS between 6th-12th birthday…
T or F?
A kiddo would use a handrail when neg stairs?
False! A level 2 would utilize the handrails. Grade 1 can walk run jump skip independently in any environment
What population is the Functional mobility scale used for?
Kiddos wit CP ages 4-18 years, has a scale 1 to 6, focuses on mobility
T or F?
A higher score on the Functional Mobility Scale indicates less developed ambulation skills?
FALSE, A higher score on the Functional Mobility Scale indicates improved functional ambulation skills
Where in the range will a pt with spastic hypertonicty demonstrate increased tone?
Early? Mid? End?
Mid range, this is different from athetoid which is end range tone
What level of the GMFCS is described…
No use of handrails on stairs, walks independently anywhere, can complete higher level motor tasks such as running, skipping, jumping. usually pts w/ hemiplegia
GMFCS level 1
What level of the GMFCS is described…
kiddo will have trouble/minimal ability w/ higher level motor skills like running, skipping, jumping. When neg stairs they req a handrail. child can independently walk but might display difficulty walking long distances or over uneven terrain.
GMFCS level 2
What level of the GMFCS is described…
in indoor setting child will amb w/ handheld AD, outside will use wheeled AD. Child will use these AD’s independently. child can neg stairs w/ handrail AND supervision
GFMCS level 3
What level of the GMFCS is described…
Child uses wheeled mobilty w/ physical assistance unless its powered.
GFMCS level 4
What level of the GMFCS is described…
child needs extensive adaptations to be mobile. needs assistance to move or powered wheelchair. must be strapped into chair as minial core posturing is there
GFMCS level 5
T or F…
A pt with a spastic/hypertonic presentation will move in end range?
FALSE!
Spastic hypertonia will move in midrange vs end range.
What 2 higher senses are affected by a spastic quadriplegia presentation?
vison and auditory deficits will appear
T or F…
Spastic quadriplegia will present throughout the entire body?
TRUE!!
can be flx and/or ext biased.
What are some musculoskeletal issues that can be a secondary injury to Spastic quadriplegia?
scoliosis, kyphosis, hip dislocation, over use/wear n tear injuries
This is bc inc tone takes a toll on the body over time. A lot of pressure is being applied chronically, with minimal ability to se;f correct.
T or F….
a patient with spastic quadriplegia is more likely to have a cognitive deficit too?
TRUE!!
spastic quadriplegia tends to come with cognitive deficits.
Whats the most common tonal pattern for pt’s with spastic hemiplegia?? (UE vs LE)
UE flx tone
LE ext tone
What a defining characteristic of a pt with spastic hemiplegia LE’s??
Their involved side leg will be shorter than uninvolved.
pt’s with spastic hemiplegia will have what sensory input impaired?
Vision!
since they cannot integrate L + R side of the body.. they dont work together.
EX- pt cannot catch ball with 2 hands.
What 3 dx’s are under the Dyskinetic umbrella?
- Athetosis (larger/slower, spastic movements)
- Chorea (smaller, jerky, faster movements)
- Dystonia
Explain what a fixing strategy is and ex of a pt w/ dyskinetic disorder doing it…
Fixing is a compensatory movement done by pt to help their stability. It can be physical (elbow on wheelchair)(abnormal facial expressions), visual (looking at something in distance or above)
What sensory input is commonly affected in pt’s with dyskinetic disorders?
hearing loss due to less o2 to brain in early development
pt’s with a hypotonic (flaccid/atonic) presentation will likely have trouble with which of the following?
a. initiating movement
b. sustaining movement
c. terminating movement
d. All of the above
e. (a) and (c) only
d. All of the above
trouble initiating due to decreased strength and it takes a lot to motivate them to consider it worth moving.
trouble sustaining movement due to decreased endurance.
trouble terminating movements due to a lack of eccentric control.
Due to a general lack of stability… pt’s with hypotonic conditions will most likely rely on what anatomical structures for support??
pt will ikely hand out on ligaments and joints in mechanical lock positions.
this requires minimal effort on their part and allows them to be stable
Define ataxia and the anatomical structure implicated.
Ataxia is impaired/clumsy/uncoordinated movement and balance.
this is result of dmg to the cerebellum. pt will have trouble with initiating, sustaining, and terminating movement.
