L11: CP Section 5: Interventions

Question 1

PT Interventions: Infant & Toddler (0-3yo)

Answer 1

• Parent education→ pos/handling for functional voluntary mvmt
• Facilitate postural stability and control→ sensorimotor dev.
• Promote emerging age→ approp motor skills
• use specialized equipment when impairments prevent typ emergence of skill
• Family-centered care→ trust/maintain hope

Question 2

PT Interventions: Preschool (3-5yo)

Answer 2

• INC Strength
  
  • transitional mvmts, functional training w/ adaptive equip if needed
• Functional IND
  
  • gross/fine motor, communication, social
• Mng Spasticity** (growth spurt here)
  
  • preserve ROM, promote active elongation

Question 3

PT Interventions: Preschool (3-5yo)

Cont’d…

Answer 3

• Skeletal align + encourage WB in pos’s
  
  • Pd of growth
  • w/ and w/out equip/orthotics
  • normal sk. modeling and jt formation
• IND mobility
  
  • GMFCS lvl + projected abilities
    
    • upright mobility
    • wheeled mobility
    • Power mobility* (early as 2yo w/ intact cog.)

*attn + interaction w/ peers

Question 4

PT Interventions: School Aged (5-12yo)

Answer 4

• *Extent of functional limitations becomes evident
• Goals/Tx: extension of preschool
• MAXIMIZE IND*
  
  • mobility
  • self-care
  • home vs school/community (keeping up w/ peers)
• Prevent 2* impairments→ monitor growth spurt

NOTE: age of incd ortho sx’s

Question 5

PT Interventions: Adolescent (13-18yo)

Answer 5

• Self img concerns
  
  • aware of limts
  • impact on others
• Emphasize:
  
  • involve child in goals
  • involve PT/OT
  • self-responsibility
• Goals:
  
  • reduce/prevent 2* impairments
  • maint. force gen.
  • mobility/endurance
  • wellness

*transition to adult care, relationships, IND living, employment, well-being

Question 6

Intervention Ideas: Poor Motor Control/Impaired Strength

Answer 6

• Strengthening→ no adverse effects or incd spasticity
  
  • resistance training
  • E-stim
  • aquatic
  • strengthening thru functional training/therapeutic play
    
    • transitions, squats, stairs, climbing, walking
  • hippotx- equine
  • swinging-posture
• Postural supports/muscle facilitators
  
  • theratogs, spio vests, orthotics, benik vest, k-taping

Question 7

Intervention Ideas: Impaired Muscle Extensibility

Answer 7

• Low Load Passive stretching long Duration
  
  • best for >6hrs→ spasticity
• Proactive intervents:
  
  • sleep pos’ing, serial casting, orthotics, day-time pos’ing
  • Active stretching: child initiates and maint’s stretch
    
    • yoga, twister, long sitting

Question 8

Long sitting example

also pic of serial casting

Answer 8

NADA Chair

*NOTE: set serial casting bw R1/R2

Question 9

Pos’ing Aids for Improving/Maintaining Extensibility

Answer 9

• Resting Splints
  
  • Resting AFO
  • Dynamic AFO
• can include pull straps→ inc DF
• knee immobs/zimmers
• hip ABD brace

Question 10

Intervention Ideas: Balance & Coordination

Answer 10

• Balance→ Obstacle courses
• Hand-Eye Coord
• GROSS motor play
• Playground
• Core control→ Theraball*** (CONKLIN LOVES THERABALL!!!!!!)
• PNF

Question 11

Intervention Ideas: Endurance & Fitness

Answer 11

• Bennies of phys act: improved CV, MSK, pscho. status
• Goals:
  
  • improve CV fitness
  • delay OP
  • improve strength+function
  • social interaction+self-image
• Group programs: health bennies
  
  • aerobic capacity, GMFM scores, participation, child/fam satisfaction

Question 12

Intervention Ideas: Endurance & Fitness

ACSM Recommends for kids:

Answer 12

• Aerobic ex. 20-40mins, 3-5x/week
• 15min walks or WC pushes 2x/week
• Strength + flexibility training

Question 13

Intervention Ideas: Gait Deviations/Functional Mobility

Answer 13

• Mitigate gait devs:
  
  • Strengthening
  • Flexibility
  • Orthotics+bracing

Question 14

Interventions: Gait Deviations; Orthotics

Answer 14

• Goals of orthotics:
  
  • Biomech. alignment (limtd atyp. jt mvmt)
  • Prevent/limit 2* impairs
  • tone reduction*
  • • function/postural control
  • • efficiency

*Warning: evidence limtd, consideration of limiting active mvmt

Question 15

Interventions: Gait Deviations; Orthotic Intervents

Mild Impairment

Answer 15

• Footplate
• UCBL- University of California Biomechanics Lab
• SMO- Supramalleolar Orthotic

Question 16

Interventions: Gait Deviations; Orthotic Intervents

Moderate Impairment

Answer 16

• SAFO-Solid Ankle Foot Orthotic
• Hinged AFO
• Floor Reaction Braces
• Anti-crouch braces
• KAFO’s

Question 17

Interventions: Gait Deviations; Orthotic Intervents

Mod→Severe impairment

Answer 17

• HKAFO’s
• RGO’s- Reciprocating Gait Orthotics

Question 18

Interventions: Functional Mobility/Gait

Answer 18

see pics