CP 1 Flashcards
Cerebral Palsy:
- cerebral cortex damaged
- paralysis, especially that which is accompanied by involuntary tremors
Little’s disease:
congenital spastic stiffness of the limbs
Symptoms of Little’s disease:
- weakness of muscles (hypotonia), difficulty walking
- convulsions, athetosis, exaggerated reflexes
- not reaching motor milestones
Causes of Little’s disease:
- birth trauma
- fetal anoxia
- maternal illness
Athetosis:
- movement disorder
- ongoing continuous movement of limbs
- often affects hands
- ability for manual dexterity and fine skills are often compromised
Little’s disease is not always associated with ____ _____.
cognitive impairment
Key words in Bax’s definition of CP.
- group
- permanent
- non-progressive
- fetal or infant brain
- development
- secondary musculoskeletal problems (from dystonia, athetosis)
CP is a ____ descriptive term, not a _____ _____.
- clinical
- aetiological diagnosis
What are the 2 ways to classify CP?
- by type
- by ability and function
Describe CP by type.
- traditional
- motor and associated impairments with anatomical and radiological findings
Who uses CP by type?
PTs
Describe CP by ability and function.
- biopsychosocial
- functional capacity in everyday setting for gross and manual motor skills
Who uses CP by ability and function?
OTs
What are the 3 motor abnormalities and what % proportion do they make up?
- spasticity 70-80%
- dyskinesia 10-20%
- ataxia 5-10%
What are the 3 types of spasticity?
- diplegia
- quadriplegia
- hemiplegia
What are the 2 types of dyskinesia?
- dystonia
- athetosis
Quadriplegia:
all 4 limbs
Diplegia:
legs are primarily affected
Hemiplegia:
one side of the body affected
Dystonia:
- constant static awkward postures
- neck is stuck in a awkward position
What part of the brain is affected with spasticity?
white matter
What part of the brain is affected with dyskinesia?
basal ganglia
Ataxia:
- hypertonic, take a long time to get to walk
- not very good reflex
- spread legs far apart, bend over
- flat footed, wide base of support
- shuffle gait
What part of the brain is affected with ataxia?
- cerebellum
- responsible for coordination
Need to be ____ tone to have CP. Need _____ ____.
- spastic tone
- physical examination
Non-motor characteristics of CP:
- sensory problems: hearing or vision impairments
- seizures (50%), sleep disorders
- attention, behaviour, communication and/or cognitive
Which of the following is NOT a non-motor characteristic associated with CP? Seizures, attention, pain, hearing impairments
- pain
- kids with dystonia can get diffuse musculoskeletal pain
- secondary complaint
When we perform functional motor assessment, what are things to keep in mind?
- pick the right age group
- pick the right level
- facilitate the best possible function
In gross motor function classification system we note…
child’s current abilities and strengths in sitting, standing and walking
In gross motor function classification system, we divide into ___ age groups.
5
In gross motor function classification system, there is ___ levels for each age.
5
In manual ability classification system, we assess the ability to…
use hands for daily function
We use the manual ability classification system for what age range?
4-18
How many levels of classification are there for the manual ability classification system?
5 levels for classification
GMFCS level 1:
- walk, climb stairs without limitation
- running jumping
- speed, balance, coordination are impaired
GMFCS level 2:
- climb stairs holding onto railing
- limitations walking on uneven surfaces and inclines, walking in crowds, confined spaces
GMFCS level 3:
- level surface with assistive mobility device
- may climb stairs with railing
- manual wheelchair
GMFCS level 4:
- walk short distance with walker
- wheeled mobility
GMFCS level 5:
- physical impairment restricts voluntary control of movement and ability to maintain antigravity head and trunk postures
- all areas of motor function limited
- no means of independent mobility
MACS level 1:
handles objects easily and successfully
MACS level 2:
- handles most objects
- somewhat reduced quality and/or speed of achievement
MACS level 3:
- handles objects with difficulty
- needs help to prepare and/or modify activities
MACS level 4:
handles a limited selection of easily managed objects in adapted situations
MACS level 5:
- does not handle objects
- severely limited ability to perform even simple actions
CP is a _____ _____ term, not a ______ _____.
- clinical descriptive
- aetiological diagnosis
What is the causal factor for CP?
- no one causal factor
- synergism of many things that often starts in utero
What are the 3 time periods?
- antenatal
- perinatal
- postnatal
Antenatal:
in-utero
Perinatal:
when you’re being born
Postnatal:
- after you’re born
- approx to 1 year of age
Name risk factors in antenatal period. What % of CP does it make up?
- prematurity and low birth weight
- intrauterine infections
- multiple gestation
- pregnancy complications
- 70-80% of CP
Name risk factors in perinatal period. What % of CP does it make up?
- birth asphyxia
- complicated labour and delivery
- 10% of CP
Name risk factors in postnatal period.
- non-accidental injury
- head trauma
- meningitis/encephalitis
- cardio-pulmonary arrest
Name protective factors in obstetrical care that can cause CP.
- magnesium sulfate
- antibiotics
- corticosteroids
Describe how low birthweight is associated with high risk of CP.
- 1500g
- 2500g risk goes back up to normal population
- associated with amount of time in-utero and growth problems
- twins at higher risk of CP
existing cases in a population ____, vs the # of new cases relative to a birth cohort (___ _____ _____)
- stable
- can change rapidly
Prevalence is important for…
service provision and resource allocation
Estimated ___ per _____ live births (Western world).
2/1000
Those born < 1500 g in Ireland prevalence:
39/1000
Those born >2500 g prevalence:
1.3/1000
