CP long case

Question 1

GMFCS?

Answer 1

Gross Motor Function Classification Score
Level I: Ambulatory in all settings

Level II: Walks without aides, but has limitations in community settings

Level III: Walks with aides

Level IV: Mobility requires wheelchair or adult assist

Level V: Dependent for mobility

Question 2

Manual Ability Classification System

Answer 2

Level I: Handles objects with ease.

Level II: Handles most objects; some limitations in ability and speed of achievement.

Level III: Handles objects with difficulty, needs help preparing and/or modelling activities.

Level IV: Handles limited number of easily manipulated objects, in adapted situations.

Level V: Does not handle objects, severely limited ability for simple actions.

Question 3

Communication Function Classification System (CFCS)

Answer 3

Level I: Effective sender and receiver with unfamiliar and familiar partners.

Level II: Effective but slower paced sender and/or receiver with unfamilial and/or familiar partners.

Level III: Effective sender and receiver with familiar partners.

Level IV: Inconsistent sender and/or receiver with familiar partners.

Level V: Seldom effective sender and receiver even with familial partners.

Question 4

children with right sided hemiplegia are more likely to have what kind of deficits, due to the location of the damage?

Answer 4

language

Question 5

children with right sided hemiplegia are more likely to have what kind of deficits, due to the location of the damage?

Answer 5

language

Question 6

major management areas for CP

Answer 6

1. Intellect
2. Behaviour
3. Vision
4. Speech
5. ADL
6. Feeding and nutrition
7. Seizures
8. Mobility
9. other (urinary incontinence, constipation, management of menses, chest infections, pressure sores)

Question 7

What can be the impact to families?

Answer 7

disruption to family routines, family financial considerations, (private health insurancw, visits to multiple specialists, cost of hospitalisations and surgical procedures, aids, home mods, drugs, benefits recieved) social supports (social worker, extended family, respite care, involvement of the CPA - cerebral palsy alliance)

Question 8

What examination should be looking for

Answer 8

1. dysmorphic fx
2. parameters
3. posture (fisting, increased extensor tone, assymetric tonic neck reflex), hemi/quad
4. movement: involuntary (choreoathetoid movements, involuntary/voluntary, posturing of arms while walking
5. assymetry (hemiatrophy -
6. behaviour (lack of interaction with the environemnt
7. eye signs
8. Bulbar signs (disarthria, drooling)
9. Interventions (nasogastric tube, gastrostomy tube, scars of orthopaedic procedures)
10. clothing (nappies in a child over 4 years old)
11. Peripheral aids