EXAM 3: pediatric inpatient rehab Flashcards
pediatric diagnoses that you will see in inpatient rehab
top 2:
TBI, non traumatic BI
SCI (traumatic and non)
strokes: AVN
CP
cancer
GBS
polytrauma
limb loss/amputation
leading cause of death or disability in children/adolescents in USA
brain injury
475,000 people age 0-14 sustain a _ annually
MOI: ?
TBI annually
MOI:
falls
MVAs
bicycle accidents
what are primary goals during IPR?
- promote neurorecovery (standing, WB, e-stim to LEs)
- improve functional mobility/recovery (transfers, shower chair, etc.)
- prevent secondary complications (contractures, wounds, 2ndary injuries)
- assess and order appropriate DME
- perform caregiver training in prep for discharge
What are 2 questions to ask during eval: subjective regarding
developmental history
prior typical development?
-ADHD, autism, non-verbal…
pertinent PMH, PSxH?
-shunt placed, etc.
What are questions to ask during eval: subjective regarding
HOME environment
-house vs apt
-stairs, steps, rails
-floor of bedroom/bathroom
-bathtub vs. walk in shower
-who else lives at home?
pediatric SCI is less than _ % of overall SCI incidence
4%
In adolescents, _ per 1 million in 2012 had SCI
8 per 1 million
With increasing age, ratio of male to female pediatric SCI injury
increases to -
4 male: 1 female
non traumatic causes of pediatric SCI are more common. What are they?
congenital anomalies, spinal cord tumors, infections, vascular malformations
● Traumatic: falls, sports-related injuries, MVA, child abuse
Objective for initial eval of pediatric SCI should include:
ROM
spasticity
strength: MMT (age 8), functional
sensation
UMN reflexes: babinski, flexor withdrawal
DTR: patellar, Achilles
posture: supine, sitting, standing
initial eval objective: mobility eval includes
-bed mobility
-sitting balance (bilateral UE, 1 UE, none, reaching) –> tailor or ring sitting
-transfers: bed to chair, toilet, shower
-sit to stands
-standing balance
-gait
-stairs
-floor mobility for younger kids (quadruped, creeping)
What are 4 good outcome measures to use for pediatric inpatient rehab setting?
- pediatric balance scale
- 6 min WT
- 10 meter WT
- TUG
goals for patients in pediatric inpatient rehab setting are _ focused
mobility focused
*patient/family goals?
*age and development?
*what patient must achieve for safe discharge? CAR TRANSFERS
what are MOIs of anoxic brain injury?
MOI: drowning, cardiac arrest, acute respiratory failure
what is the 2nd most common type of cancer in children?
brain tumors
5.14 per 100,000 in US
over 3000 kids a year diagnosed in USA
pediatric stroke brain injury population:
_ per 100,000 in US
2-13 per 100,000 in US
risk factors for pediatric brain injury strokes
sickle cell disease
thrombophilia
trisomy 21
what principles of neuroplasticity still apply for pediatric population?
- intensity matters
(HR, face flushed, RR, ask to sit down, how much assist are you giving them?) - specificity matters
- salience (PLAY)
maximal independence for pediatric SCI population may take YEARS due to
- developmental milestones
- cognition
- body growth and proportions
goals need to be set according to expectations for their AGE!
If patient is not potty trained at age 3 prior to SCI, are you going to put that as a goal?
NO
ASIA classification is difficult to classify in children _ years or younger
6 years or younger
what is a common co-morbidity with pediatric SCI population?
TBI
what are 3 compensatory strategies to teach ped SCI patient?
- head hips relationship
- momentum (hand over hand assist, take away then see if they need correction, then MASS REPETITION)
- locking out of elbows (put hand over elbow, show them over and over)
