lecture 8: cerebral palsy Flashcards
is intellectial Is Intellectual Disability more common among individuals
with CP?
yes (1/2 have mild disability)
cerebral means
brain
palsy mean
decrease muscle control
“paralysis of the brain”
true or false CP is non progressive
true
CP is non progressive but not BLANK u
unchaning (sympttoms can change)
CP is a disorder of what and due to what
movement and/or posture due to an insult or abrnormality of the developping brain
true or calse: CP can only affect movement and posture
false, it can also affect speech and sensed like hearing and vision
CP has to be an abnormality of the developping or developped brain
developping
is CP contagious
no
is CP hereditary
no
is CP life threathing
Is NOT life-threatening
(life expectancy is
similar to able-bodied
individuals)
tetraplegic also means
quadriplegic
what is the incidence of CP
2 to 2.5 cases per 1000 birth
has CP incidence declined over the last 60 years despite medical advances
because of increase survival rate of pretem babies
CP is more common in males or females
males
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.
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
what percentage of brain lesions are before or during birth
90%
what percentage of brain lesions occur after birth
10%
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
what is the number one cause of CP
Damage to the brain or oxygen deprivation during deliveries
what are the causes of CP after birth
Brain infections (meningitis) • Cranial traumas (accidents, shaken baby syndrome) • Oxygen deprivation (near drowning)
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
why do less than 20 year old mothers have more CP babies
because of chemical toxins and drugs (lifestyle factors)
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.
0%
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)
