Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Neuro Rehab 1 > CP Part 3 > Flashcards

CP Part 3 Flashcards

1
Q

what is the focus of PT management of CP

A

participation
- address impairments as it impacts that

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what has been the philosophical shift of the view of PT’s role in managing CP

A

shift to a wellness approach from “fixing”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what does Rosenbaum’s Tyranny of Normal mean

A

not focusing on the fix, accept as they are

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are the two main components of a PT examination

A
  1. observation
  2. clinical & standard tests/measures (BSF)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is a critical component of observation in the PT exam

A

individual and parent/caregiver observations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are 2 components that should be observed in the PT exam

A
  1. overall functional and/or developmental abilities
  2. equipment (currently used vs prescribed)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are 5 functional/developmental abilities that should be observed in the PT exam

A
  1. communication
  2. behavior
  3. eating/drinking
  4. motor (gross/fine)
  5. ADLs (IADLs as applicable)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are 9 BSF impairments to assess in the PT exam

A
  1. ms tone (extremities, trunk)
  2. reflexes (DTR, developmental/primitive)
  3. ROM (passive, active - taking care w alignment)
  4. selective control
  5. strength
  6. sensation (gross screen)
  7. integ (screen)
  8. cardiorespiratory
  9. pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

how are developmental reflexes screened in the BSF PT exam

A

are they present, are they integrated
- if older ask for tasks and see if patterns that may indicate a reflex (rather than testing explicitly for that) -> more informative on restriction of motor control

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

how is ms tone examined in CP

A

tardieux
- modified ashworth not reliable in CP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

how is ROM assessed in a PT exam

A

goniometry not reliable
- standardize approach w individual instead

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

why is goniometry not a reliable assessment of ROM in CP

A

movement disorder
ms tone
skeletal alignment may not be conducive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

how is selective control assessed in PT exam

A

ACOM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how is strength assessed in a PT exam

A

functional testing - STS, developmental positions
- doc conc/ecc contractions & # of reps (standardize per individual)

use make test
- MMT or HHD might not be reliable
- eval ACOM to determine if MMT/HHD is appropriate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what makes assessing strength in CP so challenging (3)

A

age
cognition
selective control

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

how is sensation assessed in PT exam

A

clinical exam procedures, modified prn (age, comprehension)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

how is integ assessed in PT exam

A

pending screen
- note/doc explicitly what skin you were able to observe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

how is cardiorespiratory assessed in PT exam

A

6MWT** - very valid/reliable

field tests
- shuttle run/walk
- shuttle wheel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

how is pain assessed in PT exam

A

self report (where and # pain)
r-FLACC for nonverbal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is the r-FLACC assessment for and what does it stand for

A

nonverbal pain scale (both children and adults)

revised (respiratory) -
Face
Legs (positioning, relaxation)
Activity (quiet, squirming)
Cry
Consolability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what are 5 activities assessed in the PT exam

A
  1. functional mobility (transfers, bed mobility, wheeled mobility, amb)
  2. trunk control
  3. balance
  4. gait
  5. developmental skills (depending on age)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what are 2 tools to assess trunk control

A

GMFM
SATco

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

how is the GMFM used to assess trunk control

A

trunk as unit
quiet sitting
reaching

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what is the SATco and what does it determine

A

segmental assessment of trunk control
- used to measure ability to maintain trunk control while sitting during static, active, and reactive states

determines highest level of trunk support at which child loses postural control
- evaluator shifts hands from at neck down to pelvis (in stages as assessing)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what should the evaluator be looking out for other than the trunk when assessing trunk control

A

use of UE to create trunk stability
- either on table or up in air

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what are tools used to assess balance

A

clinical exam

tests/measures:
- pedi berg
- pedi TUG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what are 7 common gait analysis findings in CP

A
  1. abnormal timing/phasing
  2. lower amp (EMG) -> weakness
  3. co-activation vs reciprocal inhibition
  4. mechanoelastic changes in spastic ms -> shortening
  5. gastroc - atypical firing
  6. limited DF (slows gait)
  7. impaired hip motions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what ms plays a significant role in genu recurvatum

A

gastroc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what gait finding is especially common in cases of severe CP

A

impaired hip motions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

what is the role of gastroc/PFs w gait

A
  1. control ground rxn forces during loading response
  2. control tibial progression over planted foot
  3. knee stability, foot posture @ stance
  4. propulsion for swing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what is higher PF strength correlated with

A

higher GMFM scores

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

what are 3 tools to assess development (atypical vs typical)

A
  1. AIMS
  2. TIMP
  3. PDMS-2
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what is the AIMS and what does it test for

A

Alberta Infant Motor Scale
- predictive of motor outcomes @18mo esp if used at 4mo

for very young infants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

what is the TIMP and what does it test for

A

Test of Infant Motor Performance
- geared toward younger children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

what is the PDMS-2 and what does it test for

A

Peabody Developmental Motor Scale - 2nd ed

both gross and fine motor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

what tool is used to assess gross motor skill

A

GMFM (Gross Motor Function Measures)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

what are 4 measures to assess function/activity

A
  1. PEDI (pediatric eval disability inventory)
  2. weeFIM
  3. TUG (balance)
  4. TUG downstairs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

what can be used to assess participation

A

pediatric quality of life inventory
elements of PEDI

several measures are validated for population

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

what is involved in a PT eval

A

analysis of data
- impairments
- activity limitations
- participation restrictions

identify causal relationships

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

what does a PT dx guide

A

prognosis
intervention/POC

41
Q

what is a main consideration when developing a prognosis for improved activity

A

levels of GMFCS

42
Q

what is prognosis for improved activity influenced by (4)

A
  1. individual assets
  2. co-morbid health conditions (ie sz disorder)
  3. impairments of BSF
  4. family support
43
Q

what are 4 ways that the GMFCS is utilized in pt POC

A

develop prognosis
informative to parents
planning (goal setting)
judging progress over time

44
Q

according to Montgomery, what was a positive prognosis for ambulation

A

head control in prone by 9mo AND (I) sitting by 24mo

45
Q

according to Montgomery, what was a negative prognosis for ambulation

A

retention of primitive reflexes 18-24mo
lack of (I) sitting by 3yo

46
Q

utilization of Montgomery today

A

still relevant, but use gross motor curves more often now

47
Q

what did Begnuche say was a predictive ability to walk

A

ability to sit to stand & stand to sit is predictive of ability to take 3 steps independently 1yr later

48
Q

in general what was Montgomery looking at when predicting ability to walk

A

head and sitting control

49
Q

what are the implications of Begnuche’s prognosis for ambulation

A

may assist w understanding when child may be read for task directed training for amb

50
Q

what is a con of Begnuche’s prognosis for ambulation

A

more research is needed

51
Q

what is participation influenced by (4)

A

activity limitations overall
hand function
cognition
communication

52
Q

what does the research show w participation in children w CP

A

less socially and physically active than non-disabled peers
- lower self-esteem, lower perceived confidence

53
Q

why is participation so important

A

participation in leisure activities enhances quality of life & overall health

54
Q

what are the 4 F’s of valued components of leisure

A

fun
freedom of choice
fulfillment
friendships

55
Q

what are 4 key “active ingredients” for a PT intervention

A
  1. early dx & begin interventions asap
  2. interventions should incorporate exploratory learning
  3. child initiated & executed movement - child makes things happen!
  4. include problems to solve, variation of problems/solutions, failures and successes and LOTS of practice
56
Q

what are 6 general goals of PT interventions

A
  1. maximize functional movement
  2. maintain optimal fitness
  3. address participation
  4. promote and maintain MS integrity
  5. prevent secondary impairment
  6. promote physical fitness
57
Q

what is the lifespan approach of PT interventions in infancy

A

within context of family
- enriched environments
- teaching/coaching

58
Q

what is the importance of enriched environments in infancy PT interventions

A

promote learning

(+) impact on brain plasticity
- capitalize on this to foster new neuronal connections

59
Q

what are 3 components to teach in an infancy PT intervetnion

A
  1. impairment level as affects postural control & daily care
  2. experiences to move and explore body abilities
  3. equipment early to participate (ie adapted stroller, walker, power mobility)
60
Q

what is the lifespan approach to PT interventions in early childhood

A

abilities w/i wider context
- impairment
- function/activity
- participation

61
Q

what are main differences in school age/teenagers w CP vs TD peers

A

lower QOL for motor/social functioning in CP

psychosocial issues such as poor self-esteem, social interaction, coping skills

62
Q

what is a consideration of lower QOL and psychosocial issues seen in teens w CP

A

may complicate transition to adulthood

63
Q

what are 2 strategies for treating teens w CP

A

compensation
environmental accommodations

64
Q

what are 5 pros to a strategy of compensation w environmental accommodations for teens w CP

A
  1. inc independence
  2. prevent disability
  3. prevent secondary complications (ie w growth)
  4. health and wellness/inclusive fitness
  5. “ownership” of care and advocacy
65
Q

what are 3 major considerations of PT interventions as transition to adulthood

A
  1. dec # of available supports & programming
  2. lack of continuity of care
  3. lack of medical professionals w experience
66
Q

what are 3. significant issues that adults w CP experience

A

pain
physical function
social functioning

67
Q

why do you see 1/2 of adults w CP who were walking at 18yo, aren’t walking anymore

A

d/t accessibility issues, inc effort to walk, by choice

68
Q

amb adults w CP have lower levels of what

A

physical fitness & less physically active than able-bodied peers

69
Q

what is a consideration when treating an adult w CP

A

have access to fewer health care resources than they did as teens

70
Q

why is research on specific PT interventions difficult

A

children changing d/t development or interventions

71
Q

what is the optimal dosing for a specific PT intervention

A

still to be determined

72
Q

what is the NAPA model for PT specific interventions

A

intensive surfaces for shorter time, then maintained over time

73
Q

what is important when setting up a PT interventions for children to promote optimal learning

A

implement interventions in a natural setting

74
Q

what are 4 principles of activity/context-focused PT interventions

A
  1. identify constraints hindering performance (ie factors in task, environment, child)
  2. change identified constraints w/i task and/or environment
  3. treatment in natural environments
  4. compensatory strategies when necessary to prevent disability
75
Q

what are examples of impairment focused PT interventions (5)

A

stretching
casting
splinting
strength training
sensorimotor training

76
Q

when should impairment focused interventions be implemented

A

as needed to aid activity/participation and health/wellness/fitness

77
Q

what are 4 ways to prevent contractures formation/exacerbation

A

passive stretching
sustained load
integration into daily routines
overnight stretching

78
Q

what types of interventions are used to work on strengthening

A

functional activities

79
Q

what are 5 functional activities that can be used as strengthening interventions

A
  1. transitional movements against gravity
  2. treadmill use
  3. tri/bicycle riding
  4. ascending/descending stairs
  5. ambulation (target eccentric PFs)
80
Q

what is the importance of using functional activities to strengthen

A

specificity of practice

81
Q

what CP population and age range was progressive & functional resistance training in LEs found most effective

A

GMFCS I-III
younger children

82
Q

what are 8 functional resistive exercises utilized in progressive & functional resistance training (LEs)

A

STS
heel raises
squats
step-ups
stairs
half-knee rises
isometric ex w cuff wts
leg presses

83
Q

what are the benefits of NMES and FES (3)

A

dec spasticity
inc strength
improve gait (via FES on PFs or DF)

84
Q

how can NMES or FES be implemented as a PT intervention

A

reduces spasticity on a temporary basis
- can use session to dec tone and inc activation of antagonist ms

85
Q

what does the research show about use of CIMT with UE function

A

improved movement quality/efficiency of UE compared to SOC

86
Q

what is bimanual HABIT training

A

Hand Arm Bimanual Intensive Therapy
- structured, bimanual training for children w CP

87
Q

recent studies have shown what (+) impacts of CIMT and HABIT

A

(+) impact on impairment level (BSF, activity, participation) not just on functional levels

88
Q

what does the evidence show about treadmill training

A

tough to get conclusive results b/c varied protocols but:
(+) endurance
(+) gait speed
(+) community amb

89
Q

what are the benefits of BWSTT or PBWS

A

offers learning opportunities
safe, task-specific gait training
- provides learning opportunity in a safe and controlled environment

90
Q

what are 6 examples of assistive tech

A

orthotics
ADs
wc/seating systems
positioning devices
communication devices
environmental control units

91
Q

what role does orthotics play in various levels of CP

A

GMFCS I-III: improve movement patterns, gait

GMFCS IV-V: provide alignment, prevent deformity

92
Q

what 2 things do w/c provide pts

A

postural support
independent mobility

93
Q

what are 2 examples of positioning devices

A

standers
sidelyers

94
Q

what are 4 goals of LE orthoses

A
  1. promote biomechanical alignment
  2. prevent contracture, hyper-extensibility, & deformity
  3. enhance standing postural control and balance
  4. reduce energy cost of standing & walking
95
Q

what gait impairment are GRAFOs good for

A

people w crouched gait
- facilitates ext via ground rxn force

96
Q

what does a PLS AFO encourage

A

DF - spring forward

97
Q

what motions are hinged AFOs good for

A

STS

98
Q

what is a post walker better for

A

better opportunity for ext through trunk

99
Q

CP is a chronic developmental disability which is affected by (3)

A

growth
maturation
life management

Neuro Rehab 1 (27 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions