Examination and PT management of CP Flashcards
What is CP?
Cerebral palsy (CP) describes a group of permanent disorders of the development of movement and posture , causing activity limitation, that are attributed to NON-PROGRESSIVE disturbances that occurred in the developing fetal or infant brain .
The motor disorders of cerebral palsy are often accompanied by disturbances of sensation, perception, cognition, communication, and behavior, by epilepsy, and by secondary musculoskeletal problems.
What are the types of spastic cerebral palsy? (80%)
Spastic Diplegia - LE primarly
Spastic Hemiplegia - One sided
Spastic Quadriplegia - both UE and LE
What are the types of dyskinetic cerebral palsy?
Athetoid - Sluggish, writhing movements
Dystonic - repetitive and patterned movements that are sustained, such as twisting of the limbs and trunk
Choreiform movements - jerking or weighing movements
What birth rate had the highest prevalence of CP?
birth weight of 1,000 to 1,499 grams
What birth (gestational age) had the highest prevalence of CP?
less than 28 weeks
What are the levels within the gross motor function classification system (GMFCS)?
lvl 1: walks w/out limitations
lvl 2: walks w/ limitations
lvl 3: walks using hand-held mobility device
lvl 4: self mobility w/ limitations; may use powered mobility
lvl 5: transported in a manual wheelchair
What is the GMFCS E&R?
Includes general lvls but also includes age milestones
- Before 2nd birthday
- 2nd and 4th birthday
- 6th and 12th birthday
- 12th and 18th birthday
What are the levels within the Manual Ability Classification System (MACS)?
MACS Level I
Objects are handled easily and successfully
MACS Level II
Handles most objects but with some reduced quality and/or speed
MACS Level III
Handles objects with difficulty: the child will need help to prepare and/or modify activities
MACS Level IV
Handles a limited selection of easily managed objects and always requires some help from others
MACS Level V
The child is not able to handle objects or to complete even simple actions with their hands
What are the levels within the Eating and Drinking Ability Classification System (EDACS)
Level l: Eats and drinks safely and efficiently
Level II: Eats and drinks safely but with some limitations to efficiency
Level III: Eats and drinks with some limitations to safety, maybe limitations to efficiency
Level IV: Eats and drinks with significant limitations to safety
Level V: Unable to eat or drink safely—tube feeding may be considered to provide nutrition
What are the levels within the Communication Function Classification System (CFCS)
Level l: Effective sender and receiver with unfamiliar and familiar partners
Level II: Effective but slower paced sender and/or receiver with familiar and/or unfamiliar 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 familiar partners
What does the CFCS, GMFCS, MACS and EDACS have in common?
Lower the level the increased function available
What are some predictive markers for CP from the Seesahai et al. systematic review?
Abnormal general movement assessment (GMA) at 3-5 months was highly specific for CP
Absent fidgety movements highly specific for moderate to severe CP
Normal GMA in a 3 month old had similar negative predictive value for CP
How does early intervention impact CP patients?
If intervening sooner and potentially with increased frequency, there is the opportunity to decrease overall health care costs over the lifespan as well as improving functional mobility and potentially quality of life for the child and their caregivers
Does a PVL mean the patient will have CP?
Not the sole predictor of the potential risk of cerebral palsy
What are some PT exam considerations for patients that have CP?
Cognition and potential intellectual disability
Processing time and motor control
Available range of motion and strength testing
Speed of movement and muscle tone or overactivity
Hypotonia and postural control
Dystonic movement patterns
