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Intro to PT > Intro to PT Chapter 13 > Flashcards

Intro to PT Chapter 13 Flashcards

1
Q

US children begin walking

A

10-13 months

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2
Q

Some take first step as early as

A

8 months

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3
Q

Some take first step as late as

A

18 months

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4
Q

PT should design exercise in a way that. (Kids)

A

makes it fun, makes it look like we’re playing

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5
Q

Children develop emotionally, cognitively,
socially, and physically

A

through play

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6
Q

`

Best place for any physical therapy intervention

A

natural environment

Such as couch, stairs, or laundry baskets

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7
Q

A non-progressive condition (children)

A

can present as
progressive due to growth

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8
Q

PTs and PTAs work closely with the team (center)

A

keeping the
family at the center

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9
Q

Parents and caregivers who are active in therapy
sessions

A

tend to have better carry-over at home, which
improves outcomes

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10
Q

Main Pillars of FCC

A

 Respect and dignity for family and their values
 Family engagement
 Information sharing in a reciprocal manner
 Collaboration that is ongoing and engages all parties to meet
family’s needs

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11
Q

EHCA

A

Education for all Handicapped Children Act - 1975

    • All children (6-21) regardless of disability, entitled to free public ediucation
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12
Q

IDEA

A

Individuals with Disabilities Education Act 2004

- 2004. Amendments and reauthorizations of EHCA
 Entitlements for children, birth to 5 years old
 Stipulates family-centered focus and care in “least restrictive” environment

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13
Q

Setting Specific Services

Pediatric PTs serve children and families across the continuum of care and across the lifespan

A

 Neonatal Intensive Care Unit (NICU)
 Acute care, including the pediatric intensive care unit
 Inpatient rehabilitation
 Clinic-based outpatient services
 Home-based early intervention requiring an
Individualized Family Service Plan (IFSP)
 School-based services requiring an Individualized Education Plan (IEP)

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14
Q

Early Intervention (children)

A

Children 0-3 and within schools 3-21 as part of IDEA program

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15
Q

Individualized Family Service Plan

A

0-3
includes support services for the family and any therapeutic services the child may recieve. Specifies the duration, frequency and location of the intervention.

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16
Q

Individualized Education Program

A

document governing the provision of services within school setting.

child’s therapeutic goals, as they relate to the educational environment, but also goals for assitive technology to promote independence.

PT- OT-psychologist- family-educator-social worker-speach and language pathologist.

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17
Q

Focus of pediatric physical therapy should always be

A

on the child and family as a unit and on using functional and play activities that are meaningful to the child.

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18
Q

Common Pediatric Conditions

torticollis

A

Wry kneck - kneck muscles contract abnormally

-Congenital Muscular Torticollis - sternocleidomastoid muscle on one side

-Acquired Torticollis - trauma, inflamation, infection or neurlogic issues

PT= active and passive ROM
Postioning
Environmental adaptations

Surgery

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19
Q

Musculoskeletal (MSK) Conditions

May develop in utero

A

(e.g. torticollis) or later into
adolescence (e.g. adolescent idiopathic scoliosis)

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20
Q

Musculoskeletal (MSK) Conditions

May lead to secondary impairments

A

in different systems
such as cardiovascular and pulmonary, and
neuromuscular; or even functions such as cognition

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21
Q

Musculoskeletal (MSK) Conditions

Developmental Hip Dysplasia (DHD)

A

Bracing or casting helps align the hip joint properly to promote normal development.

Pavlik Harness - common in infants.

Pt- encourage active kicking
position in plavik: prone and sitting; avoid side-lying
avoid baby walkers and bouncers.

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22
Q

Musculoskeletal (MSK) Conditions

Adolescent Idiopathic Scoliosis (AIS)

A

Lateral curvature of the spine

PT- Stretching and strengthening of spinal musculature
Breathing and aeromic activities
Pain management

Med- Bracing for angles >24
Surgery for angles >40

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23
Q

Musculoskeletal (MSK) Conditions

Arthrogryposis

A

Nonprogressive congenital condition involving multiple joint contractures in two or more regions at birth. Typically symetrical.

PT- Soft tissue mobilization
ROM strengthening
Gait training
Assistive tech
Environmental Mod

Med- Surgery - splinting/bracing

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24
Q

Musculoskeletal (MSK) Conditions

Club Foot (Talipes Equinovarus)

A

including forefoot and midfoot adduction, hindfoot varus, and fixed ankle platerflexion.

PT-Positiong in Ponseti brace: prone and supported sitting
ROM
Strengthening

Med: seral casting
ponseti bracing
Surgery

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25
Q

Musculoskeletal (MSK) Conditions

Juvenile Idiopathic Arthritis (JIA)

A

Autoimune disease - inflammation and stiffness in joints. Periods of exacerbation and remission.

PT- Pain Man
Inflammation man
Joint protection strategies
AROM AAROM PROM
Functional training
Strengthening
Aerobic exercise

Med: NSAID
Corticosteriod
DMARDs

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26
Q

Musculoskeletal (MSK) Conditions

Legg-Calve Perthes Disease (LCPD)

A

Ischemic Necrosis opf the growing femoral head. deformity. 4-8 year old. decreased range of hip abduction and internal rotation. - limping

PT- Hip active and passive ROM
Hip strengthening
Gait training
Balance exercises.

Med- NSAID
Surgery

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27
Q

Musculoskeletal (MSK) Conditions

Slipped Capital Femoral Epiphysis (SCFE)

A

Abrupt or gradual slip of femoral head at the epiphysis. 10-16 30-60% bilateral. obesity and edocrine . Decreased hip flexion, internal rotation - limp.

PT- Maintaining ROM
Activity modification
Gait training with crutches
Return to prior level of function PLOF

Med - surgery

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28
Q

Musculoskeletal (MSK) Conditions

common treatments

A

Some may be addressed with orthotics, casting, and/or surgery in conjunction with PT

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29
Q

Musculoskeletal (MSK) Conditions

Limping is an example of a complex presentation

A

might be the result of a range of MSK conditions requiring PTs to have astute differential diagnosis skills

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30
Q

Musculoskeletal (MSK) Conditions

Plagiocephally

A

asymmetric head shape - one of the possible effects of Congenital muscular torticollis.

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31
Q

Neuromuscular Conditions

impact

A

Primarily impact neural connectivity to some capacity, ultimately impacting motor function

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32
Q

Neuromuscular Conditions

result

A

May result in an atypical gait pattern, difficulty
with total body movements, or as spasticity, all of which can significantly impact a child’s ability to fully participate with peers

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33
Q

Neuromuscular Conditions

Autism Spectrum Disorder (ASD)

A

Developmental disorder characterized by early onset deficits in social communication and interaction, repetitive behaviors, obsessive interests, rigid adherence to routines, and altered reactions to ssensory input. Poor balance, cordination, motor imitation, and use of sensory information start at 2.

PT- Deep pressure and sensory input
Play skills and interaction based intervention
Strength, cordination and balance
Body and safety

Med- Pharmacologic intervention
CBT
Applied behavior analysis

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34
Q

Neuromuscular Conditions

Brachial Plexus Birth Palsy

A

Injury to nerves in the brachial plexus in neonates. Weakness of the ipsilateral UE. Most recover 6-8 weeks after birth. If not in 3 months - permanent.

PT- PROM
Tactile stimulation
Strengthening
Positioning

Med- Pharmacologic
Splinting/bracing
surgery

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35
Q

Neuromuscular Conditions

Cerebral Palsy

A

Lifelong nonprogressive condition- injury to CNS - abnormal muscle tone, loss of selective muscle control, altered muscle balance, increased reflexes, persistent primitive reflexes, changes in muscle strength, and abnormal gait patters. May include vision and hearing deficits, cognitive disabilities and seizure disorders.

PT - Prevention of secondary comlications (contractures)
Posture and positioning for function
Increasing aerobic capacity
Gait training with or without AD
Pain man
Casting, bracing and orthotics

Med: Surgery (tendon, muscle length)
Pharmacologic interventions.

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36
Q

Neuromuscular Conditions

Cuncussion/Mild Traumatic Brain Injury (mTBI)

A

impacting brain tissue and causing chemical imbalances in the brain. - blunt trauma - acceleration - deceleration. Alterations in mental state for up to 24 hours.

PT -Monitor rest and recovery period
Balance and cordination
Vestibular rehabilitation
Return-to sport program including graduated strenth and endurance retraining

Med: CBT
Pain and symptom management

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37
Q

Neuromuscular Conditions

Developmental Coordination Disorder (DCD)

A

affects a child’s ability to plan, coordinate, and execute motor tasks. Clumsiness - delays in motor milestones. Writing, dressing playing sports. diag age 5 or later.

PT- task-specific training
Neuromuscular training
Motor imagery training
Teaching motor skills through task analysis
Strengthening
balance
body awareness

Med:
Task oriented CBT

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38
Q

Neuromuscular Conditions

Spina Bifida

A

Incomplete formation of the spinal cord/meniges - loss of motor function, sensory impairments and bowel and bladder dysfunction. diag in utero.

PT- Age-appropriate gross motor skills
Strengthening
ROM
Gait training w/wo AD
Prevent contracutres
training with mobility devices.

Med - Surgical closure/repair prenatually or postnatally as needed.
Cath - bladder
Man hydrocephalus using a shunt
Orthotic devices.

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39
Q

Neuromuscular Conditions

Gross Motor Function Classification System (GMFCS)

A

Defines patterns of function in children with CP.

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40
Q

Neuromuscular Conditions

More on Cerebral Palsy

A

the most common condition
seen by pediatric PTs/PTAs.

 It is non-progressive, although growth often results in the worsening of functional impairments

 Activity limitations and participation restrictions vary significantly depending on the part of the brain impacted.

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41
Q

Cardiovascular and Pulmonary

Conditions

Affecting a child’s heart and lungs

A

may be severe enough to require surgery in the first days of life, or mild enough to be monitored; may impact physical activity.

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42
Q

Cardiovascular and Pulmonary

Congenital heart defects:

A

 Cyanotic (insufficient oxygen delivery to the body; blood in the heart shunts right to left) or

 Acyanotic (inefficient delivery of blood to the body; blood in the heart shunts left to right).

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43
Q

Cardiovascular and Pulmonary

Asthma

A

Inflammatory disorder of the airways - wheezing, shortness of breath, chest tightness and coughing

PT- Aerobic conditioning and fitness
Chest PT

Med - Pharmacologic

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44
Q

Cardiovascular and Pulmonary

Cystic Fibrosis (CF)

A

Genetic disease- lungs, sinuses, exocrine and endocrine bpancreas, small and large intestines, bones, hepatobilary system, glands and vas deferens - increased secretions - obstructive lung disease. chronic lung infections. male infertility. Diag by sweat test, stool studies and genetic testing

PT- Airway clearance tech - percussion, postural drainage, positive expiratory pressure, active cylcle of breathing technique, autogenic drainage
Aerobic conditioning and resistance training

Med- Pharm
Gene therapy
Diet recomendations
Enteral tube feeding
Surgery - lung transplant.

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45
Q

Cardiovascular and Pulmonary

Hypoplastic Left Heart Syndrome (HLHS)

A

Cyanontic congenital heart defect. Underdeveloped left ventricle. Low systemic circulation. Even though HLHS involves a left-sided heart issue, the cyanosis comes from the mixing of oxygenated and deoxygenated blood Diag - fetal echocardiogrraphy

PT - Development of motor milestones
Early mobility post surgery, including prone positioning as soon as medically appropriate.

Med - Surgical treatment in stages. At birth…4-6 months, 18 months, 3 years old.
Pharm intervention

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46
Q

Cardiovascular and Pulmonary

Ventricular Septal Defect (VSD)

A

Acyanotic heart defect - opening in the interventricular septum. Blood flows from the higher pressure left ventricle into the lower pressure right ventricle. May cause Shortness of breath, fatigue, poor weight gain Pulmonary hypertension, Heart failure.

PT Aerobic endurance
Participation in sports

Med- Surgical closure of the defect.
Pharm intervention.

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47
Q

Cardiovascular and Pulmonary

A parant’s perception of the serverity of child’s condition

A

may play a larger role in developmental outcomes than the disease itself.

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48
Q

Integumentary Conditions

Pediatric patients with burns are NOT just mini-adults

A

 Different body surface area proportions (i.e. a child’s head is larger in proportion to their body vs adults)

 Greater fluid loss and risk for hypothermia

 Children may experience lifelong decreases in tolerance to physical activity

 Children are at increased risk for contractures due to rapid growth

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49
Q

Integumentary Conditions

Pediatric burns - both children and adults enter

A

hypermetabolic state.

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50
Q

Integumentary Conditions

PTs/PTAs may be involved

A

with early mobilization, stretching programs, scar management, and exerciseprotocols for these patients

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51
Q

Systemic/Metabolic Conditions

Impact structure and function of many body systems

A

so
PTs/PTAs are typically part of a large interdisciplinary
team

52
Q

Systemic/Metabolic Conditions

Diabetes

A

disorder of insulin production or abnormal response to insulin (type1, type 2)

PT- individualized exercise program
Pain management
Balance and coordination (due to changes in distal sensation)
Management of skin breakdown

Med- Pharm

53
Q

Systemic/Metabolic Conditions

Fetal Alcohol Syndrome (FAS)

A

Growth deficits and developmental delays. - diag subjective history and clinical characteristics. Deficits with attention, processing, language, visual-spatial awareness, learning, memory, cognition, and behavior. Mild to severe.

PT- Prone
Min environmental stimuli
Calming techniques
Movement activities
Educating caregivers - recognizing stress cues.
Fine and gross motor coordination.

Med- Pharm

54
Q

Systemic/Metabolic Conditions

Hemophelia

A

Inherited disorder with deficiency or lack of Coagulation factor VIII. Bleeding. Bruising.

PT- Aerobic endurance
Weight bearing activities
Encourage noncontact sports
Timing PT intervention and physical activity with prophylaxis management

Med- Bleeding man
Factor replacement
Surgical - prevent joint degeneratyion
Splinting/bracing

55
Q

Systemic/Metabolic Conditions

Neonatal Abstinence Syndrome (NAS)

A

Acute withdrawal symptoms in a neonate due to opiod exposure in untero. Irratablility, inability to sleep, high-pitched cry, shakiness, hypertonia, hyperreflexia, seizures, poor feeding, GI issues, fever. Diag: drug testing

PT: Prone positioning
Therapeutic touch
Calming techniques
Movement activities
Minimize environmental stimuli
Educating caregivers on engaging infants and recognizing stress cues
Fine and gross motor control

Med: Decreased stimulation
Adequate nutrition
Pharmacologic intervention

56
Q

Systemic/Metabolic Conditions

Obesity

A

Childhood obesity has been increasing in prevalence, and is associated with impaired gross motor development, changes in bony alignment, pain, adult obesity, cardiovascular disease, and Type 2 diabetes

PT: Lifestyle modifications
Weight reduction through aerobic exercise

Med: Dietery considerations
Psychological support
Pharmacologic intervention

57
Q

Systemic/Metabolic Conditions

Pediatric PTs/PTAs may be involved in
multidisciplinary clinics

A

with the role of postural analysis, gross motor skill assessment, and the creation of individualized progressive exercise programs to create lifelong healthy habits

58
Q

Genetic Conditions

A

 Result from a spontaneously or inherited change in
normal DNA sequence
 Include a wide variety of physical presentations based
on the location and extent of the DNA change
 Often affect multiple body systems

59
Q

Genetic Conditions

Emerging gene modification therapies

A

changed the outcomes in some patients and PTs/PTAs are in the position to regularly assess and document changes in capacity and rate of change to determine efficacy

60
Q

Genetic Conditions

Down Syndrom

A

Extra copy of 21 (trisomy21)
unique facial and physical features. physical and intellectual deficits, including motor, speach, language, cognitive and social delays.

PT- Aerobic exercise and fitness program for wieght control and increasing bone density
Progressive resistance exercises
Balance and cordination
Postural control
Motor skill acquisition.

Med- Lifetime dietary regimen
Orthoses for stability and alignment of the lower extremities

61
Q

Genetic Conditions

Duchenne Muscular Dystrophy (DMD)

A

Progressive weakness of theskeletal and heart musculature due to deficient or absent dystrophin protien activity.

diag 2-5 WC by 13 toe walking ,frequent falls, girth of calf muscles.

PT: Submaximal exercise - avoid high-impact, high-intensity, eccentric activity

ROM, bracing
Power mobility and standing program
Education on energy conservattion and pacing

Med: pharm intervention
No curative treatment
Ventilation and nutrition support
Minimize effects of long term steroid use
Gene based therapy.

62
Q

Genetic Conditions

Marfan Syndrom

A

Inherited connective tissue disorder. gene that makes fibrilin1. cardiovascular, skeletal and ocular manifestations. Joint hypermobility. Hypotonia, scoliosis, pes planus,

PT: Designing low intensity, low impact exercise programs
pt education regarding restricting high-intensity, high-impact competititve activities
Joint protection
Monitoring for scoliosis

Med: pharm intervention
Prophylactic surgical repair of heart abnormalities.

63
Q

Genetic Conditions

Mitochondrial Disorders

A

Inherited disorders - mitochondria fail to produce enough energy. May be at birth but can be any age. affect any part of the body.

PT: Energy conservation techniques
Progressive resistance exercieses
Aerobic endurance exercise

Med: Pharm intervention
Stress management

64
Q

Genetic Conditions

Spinal Muscular Atrophy (SMA)

A

progressive degeneration of spinal cord and brainstem motor neurons. skeletal muscle atrophy and weakness. symetrical. Begins proximal and moves distal. Death before age 2 without treatment.

PT: Muscular and aerobic endurance
Contracture management
Standing programs
ROM/positioning
Airway clearence techniques
Prescribing assistive devices to maintain function

Med: Orthoses for stability and alignment
Pharmacologic intervention
Ventilation and nutrition support as needed
Gene based therapy SMN1 Gene

65
Q

Genetic Conditions

Sickle Cell Anemia

A

Inherited form of anemia - sickle-shaped red blood cells. Get caught in capillaries. Greater risk for stroke.

PT: Pain management
Aerobic endurance - monitor hypoxia
pt education - importance of movement to pain levels
Airway clearance as needed

Med: Pharm intervention
Blood transfusion
Medical management of sickle cell crisis

66
Q

The ICF Model of Assessment

International Classification of Functioning,
Disability, and Health (ICF) model:

A

 Incorporates concepts of enablement and
disablement processes

 Considers impact of disorder or disease on
impairments (in body structure and function), activity limitations, and participation restrictions

67
Q

The ICF Model of Assessment

Pediatric therapists cannot consider impairments of body structures and function in isolation;

A

they put them in context with the strengths and needs of the child and family.

68
Q

The Ecological Model of Assessment

Ecological Systems Theory (child)

A

important to consider not only child and family but the micro, meso and macro systems the children and families interact with.

69
Q

The Ecological Model of Assessment

assessement

A

if we fail to consider the family’s cultral beliefs and values, resources, access to care, and ss on, we may be missing a critical pieces of information in our assessment.

70
Q

Cycle of Assessment

A PT evaluation is not a singular event

A

it is a cycle requiring continual reassessment

71
Q

ICF and Ecological model

Body Function and Structure

A

Characteristics:
Reflex development
Joint motion
Muscle length and strength
Respiratory status
Postural stability

Ecological system level
Child
Microsystem

72
Q

ICF and Ecological model

Activities

A

Characteristics:
Locomotion
Communication
Oral motor function
Social and emotional

Ecological system level
Child
Microsystem

73
Q

ICF and Ecological model

Participation

A

Characteristics:
Community recreation
School participation
Employment
Access to facilities

Ecological system level
Mesosystem

74
Q

ICF and Ecological model

Environmental and Personal factors

A

Characteristic
Housing
Health care access
Race, ethnicity, culture, etc.
Structural or governmental policies

Ecological System Level
Child
Macrosystem

75
Q

Cycle of Assessment

Nonstandardized assessments

A

Pt’s ability to analyze movement, posture and/or functional skills.

indentify specific impairments impacting activity.

priortize the body systems and impairments requiring intervention.

76
Q

Cycle of Assessment

Standardized testing

A

formal tests. - does it meet the needs of the child

Validity, reliability, appropriateness

77
Q

Cycle of Assessment

screenings

A

used to determine whether a child needs further evaluation

78
Q

Cycle of Assessment

Assessments

A

comprehensive profile of child’s physical, cognitive, social, emotional, communication, and/or adaptive abilities to assist in determining their therapeutic needs.

79
Q

Standardized tests and measures

6-minute walk test

A

Desc: identify deficits needing further testing
Comp: Impairment screening
ICF level - Impairment
Utilization: Screen for endurance issues in children able to walk.

80
Q

Standardized tests and measures

Denver II developmental Screening test

A

Component: Developmental screening

Desc: Identify delays in developmental milestone acquisition.

ICF Level: Activity

Utilization: Screen for developmental milestone delays in language, cognition, fine motor, and gross motor domains.

81
Q

Standardized tests and measures

Peabody Developmental Motor Scales, ed 2 (PDMS-2)

A

Comp: Norm-referenced

Desc: Designed to compare a child’s performace with the average performance of peers. ften used to determine if a child is eligible for services.

ICF - Activity

Utilization: Compares child’s functional abilities with those of age-matched peers on stationalry (balance) skills, locomotion, object manipulation, and fine motor slkills.

82
Q

Standardized tests and measures

School Function Assessment (SFA)

A

Comp: Criterion - referenced

Desc: Designed to measure performance against a fixed set of predetermined criteria. Evaluative assessment often used to measure performance or track changes over time.

ICF- participation

Utilization: Measures a child’s performance on functional tasks relevant to academic and social aspects of school programming.

83
Q

Standardized tests and measures

Gross Motor Function Mesure (GMFM)

A

Comp: predictive assessment

Desc: Designed to categorize individuals based on their expected future status.

ICF: Activity

Utilization: A motor assessment for children with CP, trisomy 21, and TBI. The subsequent GMFM curves have been predictive for age at walking or plateau of skills.

84
Q

Cycle of Assessment

The cycle of assessment begins when

A

a family, caregiver, or care provider notes a concern and seeks pediatric PT

85
Q

Children are NOT Little Adults!

Adults, the focus is on rehabilitation;

Stark differences exist between treating children and treating adults

A

children the
focus is on habilitation

86
Q

Children are NOT Little Adults!

With children, we are dealing with a growing system

Stark differences exist between treating children and treating adults

A

so we focus not only on how the child presents today, but how we predict the child might look in 6 months, a year, and even 5 years from now

87
Q

Children are NOT Little Adults!

We never work with children in isolation

Stark differences exist between treating children and treating adults

A

we work with children within the context of their family and social unit

88
Q

Children are NOT Little Adults!

We work with children (location)

Stark differences exist between treating children and treating adults

A

at home, in the childcare center, in school, on the playground, in the community and as they transition to adulthood, at their job site

89
Q

Children are NOT Little Adults!

With children social roles continually change

Stark differences exist between treating children and treating adults

A

so we often engage with children and their families across their entire lifespan

90
Q

Play and Movement

Play begins with movement and

A

active movement begins
with play

91
Q

Play and Movement

Play is critical to a child’s

A

overall development

92
Q

Play and Movement

Typically developing children move through stages of
play development

A

hat parallel and reinforce their cognitive, psychosocial, speech and language, fine motor, and gross motor development

93
Q

Play and Movement

Through play, children learn

A

to gain greater control over their bodies, develop self-regulation, and interact effectively with others

94
Q

Play and Movement

Through play, children develop

A

physical literacy

95
Q

Play and Movement

physical literacy

A

Motor competence, confidence and motivation to engage in physical activity. Underpins lifelong habit of movement and ahealth related fitness and wellness.

96
Q

Moro Reflex (Startle Reflex):

A
  • Stimulus: Sudden head movement or a loud noise.
  • Response: Arms extend outward, fingers spread, and then arms return to the body.
  • Appears: At birth.
  • Disappears: By 4-6 months.
97
Q

Rooting Reflex:

A
  • Stimulus: Stroking the infant’s cheek.
  • Response: Turns head toward the stimulus and opens mouth.
  • Appears: At birth.
  • Disappears: By 3-4 months
98
Q

Sucking Reflex

A
  • Stimulus: Placing a finger or nipple in the infant’s mouth.
  • Response: Rhythmic sucking.
  • Appears: At birth.
  • Disappears: By 4 months
99
Q

Palmar Grasp Reflex:

A
  • Stimulus: Pressure on the infant’s palm.
  • Response: Fingers close around the object.
  • Appears: At birth.
  • Disappears: By 4-6 months
100
Q

Plantar Grasp Reflex:

A
  • Stimulus: Pressure on the ball of the foot.
  • Response: Toes curl down.
  • Appears: At birth.
  • Disappears: By 9-12 months.
101
Q

Asymmetrical Tonic Neck Reflex (ATNR):

A
  • Stimulus: Turning the infant’s head to one side.
  • Response: Arm on the face side extends, and arm on the opposite side flexes.
  • Appears: At birth.
  • Disappears: By 4-6 months.
102
Q

Babinski Reflex:

A
  • Stimulus: Stroking the sole of the foot.
  • Response: Toes fan out and the big toe extends.
  • Appears: At birth.
  • Disappears: By 12-24 months.
103
Q

Galant Reflex:

A
  • Stimulus: Stroking the side of the infant’s spine.
  • Response: Infant curves the trunk toward the stimulated side.
  • Appears: At birth.
  • Disappears: By 3-6 months.
104
Q

Landau Reflex

A
  • Stimulus: Supporting the infant prone in the air.
  • Response: The head lifts, and the back arches in a “superman” position.
  • Appears: 3-4 months.
  • Disappears: By 12-24 months.
105
Q

Parachute Reflex:

A
  • Stimulus: Holding the infant upright and quickly tilting them forward or downward.
  • Response: Extends arms outward as if to protect from falling.
  • Appears: 6-8 months.
  • Persists: Throughout life.
106
Q

Reflex Significance

A
  • Persistence: If a primitive reflex persists beyond its normal timeframe, it may indicate a neurological problem (e.g., cerebral palsy, brain injury).
  • Absence: The absence of expected reflexes can suggest developmental delays or neurologic impairments.
107
Q

Sitting in a W position

A

sitting posture where a child’s buttocks rest on the floor, their knees are bent, and their legs are splayed out to the sides, forming the shape of a “W”

Internal rotation of the hips can place excessive stress on the hip joints, ligaments, and surrounding muscles.

Reduced opportunities to strengthen core and hip muscles can impact balance and motor skill development.

Address in PT if it’s the child’s primary sitting position.

108
Q

Evidence Based Practice

Currently, there is no single gold standard

A

approach to treating children

109
Q

Evidence Based Practice

Clinical practice guidelines

A

are emerging

110
Q

Evidence Based Practice

A focused area of study showing promising
results in the pediatric population

A

is the
application of motor learning principles

111
Q

Pediatric motor learning principles that work

Constraint induced movement therapy

A

treatment that involves a splint or cast on the uninvolved side to encourage forceed use of the impaired UE

112
Q

Pediatric motor learning principles that work

HABIT - hand-arm bimanual intensive therapy

A

children with CP or hemiplegia. involves activities purposely designed to encourage and demand use and coordination of both upper extremities.

113
Q

Challenges involved in obtaining high-quality evidence to support a gold standard approach to treatment include

A

 small sample sizes
 heterogeneity of clinical presentation
 lack of consistent dosing
 varying research designs
 lack of random sampling
 inadequate funding
 use of multimodal approaches
 inconsistent definitions
 insufficient measurement tools
 children are continually maturing over time

114
Q

Motor learning principles

Salience

A

Meaningful activites:
* Using play
* Involving child in goal setting
* Explaining why activities are important
* Egnaging the child in task-specific activities rather than rote unskilled movement exercise
* Focusing on the use of play and movement that can be embeded into the daily routine.

115
Q

Motor learning principles

Specificity

A

use the natural environment and the child’s daily routine, including play.

Actual equipment or materials child will need.

Engage parents or school.

116
Q

motor learning principles

Instructional Strategies

A
  • Concrete and simple verbage
  • foster imitation with demonstration
  • Observe near-peers
  • give specific feedback and let it fade
117
Q

motor learning principles

Frequency and Practice

A

Children walk 14,000 steps per day and fall 100 times per day for months to perfect the skill of walking.

Without parents to help, impossible to get enough practice

Embed in daily routine.

Blocked and distributed practice
Random practice

118
Q

Mobility Devices

Some children may not have the sensorimotor or cognitive ability to move on their own and
engage in their environment

A

Our role is to engage the family in obtaining
appropriate equipment or other assistive devices to enable the child to interact effectively

119
Q

Mobility Devices

Splints, taping, and bracing can help

A

prevent tightness
and asymmetries and potentially increase mobility

120
Q

Mobility Devices

Positioning devices such as, sidelyers, standers,
adapted chairs

A

enable children to view the world from
different perspectives and engage with peers on eye level.

121
Q

Mobility Devices

Mobility devices such as rolling walkers, adapted tricycles, motorized wheelchairs, and powered cars

A

can provide a sense of movement through space and a way to independently engage with peers and their environment

122
Q

Powered mobility

A

can improve a child’s cognitive, perceptual, and social-emotional development, as well as speech and language
skills, play skills, upper extremity use, and
overall level of engagement and independence.

123
Q

Powered mobility training

A

can begin as young as
7 months of age

124
Q

Role of PTs/PTAs Beyond Direct Intervention

Advocacy:

A

from the individual level with insurance companies, schools, and physicians to the societal level with government policies impacting children with disabilities.

125
Q

Role of PTs/PTAs Beyond Direct Intervention

Community Resources and Supports:

A

identify and evaluate community resources and supports and connect families to those resources and supports.

126
Q

Role of PTs/PTAs Beyond Direct Intervention

Transition planning

A

 from early intervention, to preschool, to school, to work or to some community placement

 from hospital to home or to another healthcare facility to provide for the child’s complex medical needs

127
Q

Role of PTs/PTAs Beyond Direct Intervention

Education and Empowerment:

A

 encourage self-determination by educating, engaging, and empowering children to take charge of their own health and well-being throughout life

Intro to PT (15 decks)

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