CP classification & prognosis Flashcards
classification of CP
topography
type of muscle tone
function
hemiplegia topographic distribution
38% of cases
often small, unilateral hemorrhage or pediatric stroke
affects one side of body
diplegia topographic disrtibution
37% of cases
often bilateral hemorrhage
lower limbs affected more often
tetraplegia topographic distribution
24% of cases
often large HIE
affects 3 limbs and trunk and head
quadriplegia topographic distribution
24% of. cases
often large HIE
affects all 4 limbs, trunk, and head
diskinetic muscle tone
basal ganglia
involuntary movement
~6%
dystonia - twisting, repetitive
athetosis - slow, continuous, writhing movements
chorea - quick, dance-like, irregular, unpredictable
choreoathetosis - combination of chorea and athetosis
ataxic muscle tone CP
~5%
cerebellum
shaky movement
poor balance
balance and coordination impairments
will appear unsteady
movements that require a lot of control are super challenging (writing, dressing)
spastic muscle tone
motor cortex
muscles appear stiff
most common 86%
movement system diagnoses
fractionated movement deficit
force production deficit
motor coordination deficit
prognostic predictor for ambulation w or w out assistance later in childhood
sitting independently (without arm support) by 24 months
key takeaways
cerebral palsy can be classified by topography, type of muscle tone, and motor function
the GMFCS has 5 levels and can be used as a prognostic tool but it not appropriate as an outcome measure
one early gross motor milestone that is most predictive of walking is sitting independently by 2 yo
GMFCS levels 3-5 have dip in function starting around age 7 or 9
likely due to secondary impairments
it is possible for child to move up or down GMFCS level not OM
GMFCS level 4 differences
y
younger child may be able to walk for short distances at home with physical assistances
as they age their ability becomes less likely
