CP medical management Flashcards
Describe common neurological procedures used with individuals with CP
Describe common orthopedic procedures used with individuals with CP
Discuss patient medical management for individuals with CP and our role as a PT on the team
pain in adolescents with CP
Have you experienced pain in the last month?
64% girls and 50% boys, avg age 15 yrs (N = 230) have had pain
Pain most frequent in feet, ankles, knees and low back (Levels I-IV)
what are the secondary pathologies in children with CP?
- pain (67-82%)
- walking dysfunctions
- orthopedic injuries
- falls
- fracture
- fatigue
what neurological procedures are used for CP
- oral baclofen
- baclofen pump
- botox injections
- selective dorsal rhizotomy
what is baclofen?
Synthetic GABA
stimulates gaba receptors in SC-GABAa
decreases excitation of alpha motor neurons
can be administered
- orally (PO)
- Intrathecal (TB)
what are the advantages and disadvantages of oral baclofen
Advantages:
decreases muscle tone/spasticity
Disadvantage:
adequate does to decrease spasticity
drowsiness
what are the advantages and disadvantages of intrathecal baclofen pumps?
advantages:
Muscle tone decreases in LE’s
Decreased “overflow”
Some improved function
Simplified seating and postioning
Disadvantages:
Size
Refills (every 2-6 months depending on the dose)
Catheter pulling out of intrathecal space
Infections
what is Botulinum Toxin (Botox)?
Injected into selected muscles
Relaxation 3-7 days; longevity 4-6 months
Complications:
Local irritation
Potential for antibody production
Muscle weakness/atrophy
Cost
what is Selected Dorsal Rhizotomy?
Electrical stimulation to afferent dorsal rootlets (L2 - L5) to identify which rootlets elicit a spastic response (ie, uninhibition of the stretch reflex)
Selected rootlet neurectomy to uninhibited rootlets
Spasticity permanently alleviated without loss of other posterior root functions
