CP exam Flashcards
what makes diagnosis of CP
combination findings from neurological assessment, neuroimaging, assessment of movement and posture
< 5 months corrected age
MIR 86-89% sensitivity
general movement assessment 98%
HINE 90%
> 5 months corrected age
MRI 86-89%
Hine 90% sensitivity
developmental assessment 83%
Hammersmith Infant Neurological Examination (HINE)
a diagnostic tool
3-24 months AGE
10-15 mins
identify and detect as early as 5 months
key tools for accurate, early idenfitication: GMA, HINE, MRI
Gross Motor Classification Scale Expanded and Revised level 1
walks independently without restriction
may see differences
GMFCS level 2
walks without devices
some awkwardness but can walk on their own feet
usually with cane or walker to support them
GMFCS level 3
walks with mobililty device
are also wc user for distances
GMFCS level 4
self mobility with limitations, may use powered mobility
wheel chair users but able to use it independelty
can be power or manual wc
GMFCS level 5
self mobility is severely limited even with the use of supporting technology
full time wheel chair users
need a lot of support for posture or body control
childrens assessment of participation and equipment (CAPE) and Preferences for activitives of children (PAC)
CAPE
- 55 items
- 30-45 mins
- child completed or assisted version
- AGES 6-21
have you done this activity in the last 4 months
if yes how often
with whom do you do this most often
where do you do this most often
how much do you like doing this activity
common MSK impairments
muscle tightness/hypoextensibility
contractures
bony alignment problems
osteoporosis/osteopenia
fractures
degenerative joint disease
scoliosis
reduced force production capability due to decreased muscle volume, fascicle length, and speed of contraction
make test:
patient exerts maximum, voluntary effort against FIXED resistance (CHILDREN)
break test:
patient exerts MAX voluntary effort against INCREASING resistance
KEY TAKEAWAYS
GMA and HINE are diagnostic tools for CP
GMFCS is a classification tool
the GMFM was used to develop the GMFCS
all ICF components should be considered when identifying needs and goals
where to start administration of ECAB for a GMFCS level 1/2
item 8
where to start for administration of ECAB for GMFCS 3/4/5
item 1
where to start administration of ECAB for hemiplegia/monoplegia
item 4
Edinburgh Visual Gait Score
reliability - moderate to excellent (60-92%)
validity - good correlation with GMFM and 3D gait analysis
MCID 2.4
clinical diagnosis of CP is made by
child does not reach early milestones and exhibits abnormal muscle tone or qualitative differences in movement patterns
GMA
looks at the general movements of the awake infant
has been highly affective at detecting CP by age 3 months
typical movement - spontaneous and figidity from birth to 20 weeks
general movements that are absent or abnormal are at higher risk for CP
common gait tests and measures - participation and function
patient specific functional scale
PEDI CAT
GMFM
TUG
dyanmic gait index ( as young as 6 yo)
common gait tests and measures - body functino and structure tests
3D gait analysis
Edinburgh visual gait scale
endurance/speed
motor control (SCALE)
ROM and strength
gold standard for gait
3D gait analysis
is required for surgical intervention
edinburgh gait score
valid and reliable measure of gait deviatoins
17 observations of each leg
higher score = greater deviations
