Exam 2-2 Flashcards
SDR positive outcomes
Reduced spasticity Improvement of deformities Reduced rate of subsequent orthopedic surgery Speech improvements Emotional improvements
What are the three ways in which medical team can change tone
Medications
Surgery
Compression garments and splinting
What is the sequence of coordinated movements
Physiological flexion Active extension Active flexion Balance of flexion / extension Lateral control Rotation and diagonal movements
The sequence of coordinated movements happens
Cephalo-caudally (head time toe) so head could be ahead of trunk
Why do children w sit
So they don’t have to worry about keeping their balance , rely on this for added trunk and hip stability for easier toy manipulation and play
Consequences of w sitting
Could lead to future orthopedic problems
Won’t developers appropriate trunk rotation or weigh shifts
Could prevent developing mature movement patterns
Could prevent developing hand dominance
Identify the sequence of abnormal development
Original pattern Compensation (fixing) Habit Contractures Deformity Surgery
A biomechanical attempt to gain artificial stability
Fixing
Children with cp may develop fixing patterns because
They have poor trunk control and want to have a sense of balance
Consequences of fixing in the head and neck with hyper extension and tongue retraction
Poor head control Poor eye control Poor sucking/swallowing Limited UE use Poor breath capacity
Consequences of fixing through shoulder with humeral extension / adduction / internal rotation
Limited head control
Limited hand /UE use for fine motor
Limited tongue jaw cheek and lip mobility
Limited respiration with sound
Limited creeping crawling and protective extension
Consequences of fixing through the lower trunk with lumbar extension and ring sitting
Poor dynamic sitting balance
W sitting develops
Poor dissociation between legs
Limited LE use
Consequences of fixing in hips and LEs through hip extension and adduction
Poor functional sitting balance
Limited use of LEs
Poor respiratory coordination and sustained exhalation
Basic treatment principles of NDT
Normalize tone as much as possible Facilitate normal posture and movement Improve the variety of movements Apply during functional Tasks
NDT treatment sequence
Symmetry : balance of flexion and extension
Unilateral control: lateral weight shift and control
Diagonal control: rotation
Inhibitory techniques to address tone (7)
WB with WS slow movement Rotation Elongation Traction Shaking Movement with same rhythm
Facilitory techniques to address tone (7)
WB with resistance Fast movement Compression Alternate tapping Intermittent support Tapping Movement with changing rhythm
Near source of the problem, allows handler more control of the client
Proximal handling
Away from source of problem, client will perform majority of the work
Distal handling
Guides rather than controls, hands follow the movement and gently resist abnormal responses, emphasis on facilitation with subtle nonitrusice inhibition
Light pressure
Allows for control when guiding, sends proprioceptive info into muscles joints and bones
Deep/firm pressure
Guides the client but the client does not rely on it being there, focus is facilitation
Intermittent touch
Guides movement, client relied on it being there
Sustained touch
Encourages the client to have maximum control, requires sustained co activation around the joints
Slow movement
Ca encourage balance reactions and protective responses, can guide client through a transitional movement pattern they may normally resist
Fast movement
Releases restricted fascia and elongates shirt muscles, reducing hypertonicity
Sustained joint traction
Used to facilitate holding or ability to sustain a position, barely felt by client
Sustained joint compression
Can facilitate co activation around the joints, giving a client the stimulus needed to maintain a posture upright against gravity
Intermittent compression
