CP Flashcards
define pyramidal vs extrapyramidal.
pyramidal - learning new skills -> motor
extrapyramidal - automatic, reflexes
spastic CP is what type of injury?
white matter injury
name the 4 types of movement classification.
spastic, ataxia, hypotonic, dyskinetic
what is more involved in diplegia?
LE
when can children be formally diagnosed with CP?
1-2 years
what type of problems do you figure out from birth - 5 years
prenatal and perinatal problems
during an interview, what info do you get from 6-21 years?
focus on functional skills, environment specific, needed for participation, transition to adulthood
_______ is not inherent in CP.
Cognition
what impacts learning oppurtunities?
independent mobility
what are the most associated impairments?
speech, vision
medications for seizures?
dilantin, tegretol, vagal nerve stimulator
caution for a seizure pt?
vestibular stimulation
age specific considerations for participation
birth-12 years
play and parent care giver child interactions
when do you use MMT and dynamometry for strength?
6-21 years
scoliosis increases with….
severity of CP
3 pelvic alignment abnormalities
obliquity - leg length inequality
posterior pelvic tilt
anterior pelvic tilt
why can a pt present with a hip subluxation/dislocation?
due to decreased WB forces from young age – leading to hip instability
critical ROM for hip stability:
at least 30 degrees of abd
avoiding hip flexion contraction of 20-25 degrees or greater
why can a pt present with a hip subluxation/dislocation?
due to decreased WB forces from young age – leading to hip instability, and atypical muscular pull
what is decreased dorsiflexion ROM due to?
shortened gastroc - hypertonicity
what else happens at the foot?
equinovalgus (flatfoot)
how is the sensory function in these children?
lacking
how is the sensory function in these children?
lacking, delayed
jumping causes what motions?
hip, knee flexion, PF in stance
gait abnormalities
knee hyperextension, decreased flexion in swing
R1 of tardieu is…
point of first catch at dynamic end point and tested with fast velocity
R2 of tardieu is…
passive ROM length
how do these pts compensate for weak musculature?
co-contraction or fixing muscles
difference between goals of GMFCS level I, II, III and IV+V
gross motor skills
early continuous postural management
interventions during infancy
education to families, proper positioning, postural stability, smooth mobility
interventions during preschool
independent mobility/functional independence, development of locomotor, cognitive, communication, fine motor, self care and social abilities
interventions during school age, adolescent, adulthood
maintain achieved level of activity, participation in age appropriate activities or interests, health promotion and physical activity, prevent secondary impairments
position you want CP pt in..
prone lying or where the muscles are most lengthened
what will positioning allow for?
improves function and participation
prevents secondary impairments
physiological effects of supported standing
improved bone stability, hip stability, improved lower extremity ROM, improved spasticity
positives of AFOs
controls PF, maintains longitudinal arch, prevents hyperextension
negatives of AFOs
eliminates movement of ankle, causes disuse atrophy
what does serial casting allow for?
decrease resistance to passive stretch
increased dorsiflexion ROM
tendon lengthening is for what muscles…
hamstrings, psoas, rectus femoris, adductors, gastroc
tendon transfers for UE
extensor muscles
patellar tendon advancement; posterior or anterior tibialis advancement
what is a derotational osteotomy?
achieving better alignment of head of femur in acetabulum or better alignment of the tibia
who benefits from a selective dorsal rhizotomy?
GMFCS III & IV
what do you need to work on post surgery dorsal rhizotomy?
strength
spasticity meds
botox
baclofen
intrathecal baclofen
what is not effective for increasing ROM, spasticity, or improving walking efficiency in children?
passive stretching
what type of strength training is more effective? isokinetic or isotonic?
isotonic
_____ doesn’t increase spasticity.
strengthening
children with significant motor involvement can utilize…(form of exercise)
upper extremity cycling
for those who can ambulate, what type of exercise should be performed?
functional physical training
functional physical training program allows for significant improvement in…
aerobic endurance, walking distance, ambulation
who benefits from functional physical training?
ages 8-13, GMFCS 1 & II
NMES < -> FES?
NMES
what is used to improve gross motor function and functional mobility in children with CP following orthopedic surgery?
body weight supported treadmill training
who benefits from CIMT?
hemiplegic pts to improve hand function
using repitition, verbal guidance, and rhythm is used in -
conductive education
what is neurodevelopmental treatment approach used for?
reduce spasticity through therpautic handling during functional motor activities
