lecture 8: cerebral palsy Flashcards by Tanya Thibault

is intellectial Is Intellectual Disability more common among individuals
with CP?

yes (1/2 have mild disability)

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cerebral means

brain

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palsy mean

decrease muscle control

“paralysis of the brain”

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true or false CP is non progressive

true

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CP is non progressive but not BLANK u

unchaning (sympttoms can change)

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CP is a disorder of what and due to what

movement and/or posture due to an insult or abrnormality of the developping brain

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true or calse: CP can only affect movement and posture

false, it can also affect speech and sensed like hearing and vision

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CP has to be an abnormality of the developping or developped brain

developping

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is CP contagious

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is CP hereditary

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is CP life threathing

Is NOT life-threatening
(life expectancy is
similar to able-bodied
individuals)

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tetraplegic also means

quadriplegic

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what is the incidence of CP

2 to 2.5 cases per 1000 birth

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has CP incidence declined over the last 60 years despite medical advances

because of increase survival rate of pretem babies

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CP is more common in males or females

males

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males born preturn are more vulnerable to what

Males born very preterm also appear to be more
vulnerable to white matter injury and intraventricular hemorrhage than
females.

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what is the affect of sex hormones in CP

sex hormones such as estrogens
provide protection against hypoxic-ischemic injury, and the neonatal
brain is also influenced by these hormones. This

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what percentage of brain lesions are before or during birth

90%

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what percentage of brain lesions occur after birth

10%

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what are the causes of CP before or during birth (5)

Maternal infections (aids, rubella, herpes)

Chemical toxins (alcohol, tobacco, drugs)
Injuries affecting fetal development

• Damage to the brain or oxygen
deprivation during deliveries

• Genetic disorder, chromosomal
abnormality, faulty blood supply

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what is the number one cause of CP

Damage to the brain or oxygen deprivation during deliveries

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what are the causes of CP after birth

Brain infections (meningitis)
• Cranial traumas (accidents,
shaken baby syndrome)
• Oxygen deprivation
(near drowning)

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what are some other causes of CP that are not classified before or durinr of after birth

age of the mother

premature and low birth weight babies

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why do less than 20 year old mothers have more CP babies

because of chemical toxins and drugs (lifestyle factors)

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why do more than 34 year old mothers have more CP babies

genetic disorders (physiological factors)

what age is an early sign of cerebral palsy

before 3 years of age

what are the 4 early signs of CP

Before 3 years of age Motor skills not developing normally – Coordination + balance Abnormal muscle tone: – hypotonia (1st), hypertonia (2nd) l Favour one side of body

how do we clasffiy CP

by # of limb affectoed | by movment diorders

what are the 5 types of CP classifeid by limb affected

``` quadriplegia diplegia hemiplegia triplegia monoplegia ```

quad=

4 extremities

in diplegia, are lower or upper extremeity more frequence

lower

what is hemiplegia

the entire left or right side affected

what is triplegia

3 extremeities, usually both legs and 1 arm

what is mono plegia

1 extremeity

what are the 3 types of CP classified by movement disorder

spasticic CP athethoid CP axatic CP

what is the most common tyoe of CP

spastic CP

what is the genetal degination of spastic CP

"tug of war" or co cotnraction

what is the general definition of athetoid CP

mixed muscle tone, constant motion

what is the general defintion of axatic CP

look unstready and shaky

Spastic CP affects what part of the brain

motor cortex and premotor cortex

athetosis CP affects what part of the brain

basal ganglia

axatoic CP is affected by what part of the brain

cerebellum

spasticity has abnormal what

muscle tigtness and stiffness

what percentage of people with CP have spasticity

65%

what is spacfific caused by

damage to the motor cortex and cortical tracts | (if thre is basal ganglia and cerebrellum involved it can exacerbate spasticity

spasttic muscles interfere with what

voluntary movements

what are the interventtions for spasiticity CP

surgical lengthening of tendon (toe walking and knee flexion) -dorsal rhizotomy

ADD CARD ON SPASTIC CP

what is the most severe form of motor disorders related to CP

Athetosis

what is athetosis

``` Constant, unpredictable, and purposeless movement caused by fluctuating muscle tone (hypertonia-hypotonia) ```

athetosis is due to damage in what part of the brain

basal ganglia

how is the percentage of people with CP who have athetosis

25%

those with athetosis have problems with doing what

Problems with: facial expression, eating, speaking, head control, fingers + wrist control

true or false: people with athetosis are usually paraplegic

false, quadraplegic

what is ataxia

Disturbance of balance and coordination characterized by hypotonia + ↓ postural tone

ataxia results from disorders in what part of the brain

cerebellum and vestibular system

what percentage of people with CP have ataxia

10%

what is the text for ataxia

hold a finger or a toy in front of a child and ask them to touch it on the first try and the child with ataxia cannot do it

scissor gait is associated with what form of CP

spastic

hemiplegic gait is associated with what type of CP

spastic

cerebellar gait is assocaited with what type of CP

ataxix

explain sciessors gate

legs are flexed and inwardly roated (with toe walking)

explain hemiplegic gait

hip circumduction and toe walking

exokain ataxix or cerebellar gate

eyes down and wide base of support with arms away from body (absence or opposition of arms and legs)

which gate is similar to immature walk of childhood

cerebellar gait

for the same workdload as able bodied people, those with CP have higher or lower HR, BP and lactate concentration

higher

for the same workdload as able bodied people, those with CP have an increased or decreased mechanical efficiency

decreased and therefore need an icnreased energy

why do those with CP have higher bp, higher hr and lower mechanical effienciency than able bodied peopel

spasticity and athetosis | poor exercise habits

why do those with CP use a support harness during exercise

1) balance | 2) BW support

what is the effect of exerise on those with CP

``` improvement of -sense of wellness – body image – capacity to perform ADLs – ↓ spasticity + athetosis (mild to moderate changes) – Resistance training = controversial ```

why is resistance traiing controversial for those who have CP

some people say that RT may make spacsisty worse but that is not true

According to the latest studies, resistance training increases spasticity (and in turn ↓ range of motion) by ____% in participants with CP.

what was the study for children with CP

Effect of 12 weeks of progressive resistance training on walking ability:

what was the summury of the study for kids with cp on walking ability

3 times a week for 60 minutes; 26 subjects per group aged 6 to 13 y/old - Training group: leg press machine and 3 exercises (sit-to-stand, lateral step-up, half knee-rise); - Control group: conventional PT program

in the study there was improvement in muscle tstrength vs the control group in what muscles

knee extensors hip abductors and total strength

after the study, was it concluded that RT increase walking ability

there was no improvement in walking ability in both groups

there was no improvement in walking ability as demonstrated by what outcomes

comfortable walking speed cadans step length fast walking speed

after the 12 week training program was there any change in muscle spasiticity

No change in muscle spasticity (muscle tone) and range of motion in both groups

what are some possible explanations for why there was no improvements in walking after the study

lack of specificity (lack of specific exercises)