Outcome Measures/Labs Flashcards
GMFCS- what is it for? What are the levels?
Cerebral palsy classification system
Level 1- walks without limitations
Level 2 -walks with limitations
Level 3- walks with handheld device
Level 4- self mobility with limitations, power wheelchair may be used
Level 5 - power wheelchair/dependent/mobility severely limited
GMFM
Gross motor function measure
- Observational
- Can do the 88 or 66 question version
- Measures gross motor function over time
- Ages 4 months to 16 years
- Takes 45-60 minutes to administer (88) or 20-30 minutes (66)
- Promotes reaching and developmental milestones
Assessment of Trunk Control
-what is it for?
quick and easy postural assessment
-
Static, Active, Reactive trunk control
- Child strapped to bench
- Ideal to administer with 2 people
-
Ages 6-8 months
- Trunk control develops here
- Helps assess fall risk, and amount of support as well as postural control
- Takes 15-20 minutes to administer
Child and Adolescent Scale
-survey for developmental status
- Administered by parent/admin
- Survey of broad activities
- Home, neighborhood, school, and community
- Age of at least 5
- Helps ID participation and activity limitations
- Takes 10 minutes to complete
- Will help you to determine developmental status and what to focus your interventions on
HAT
Hypertonia Assessment Tool
- Classifies hypertonia progression over time
- Consists of 7 items that help determine type of hypertonia present
- Ages 4-19 years
- Takes 20 minutes (5 minutes per limb)
- Less effective if dystonia + spasticity present
- Not commonly used but very helpful
SCALE
selective control assessment of the LE
- Tests for normal, impaired, unable movements in LE
- There is no age range – child must be able to follow simple commands
- Takes 15 minutes to administer
- Assists with ROM and synergy goal planning
MCHAT
questionnaire for parents to fill out/looks at autism
- Ages 16-30 months
- Helps determine risk for Autism
- Helps ID behavioral issues associated with ASD
- Helps to inform a subj interview
- Could help with intervention planning
- Takes less than 2 minutes to admin
SAROMM
Spinal alignment and ROM measure for children with CP
- Looks at spinal alignment, ROM and muscle extensibility
- Scored 0-4 (least to most impaired)
- No stated age range but must be able to follow directions
- Determines areas of decreased ROM or strength in trunk and LE
- Takes 15-30 minutes to administer
- Helps inform intervention planning
crouched gait
- Loss of PF and knee extension coupling due to inaccurate surgical lengthening of soleus
- Lever arm dysfunction due to femoral and tibial torsion deformities (includes pes valgus)
- Compensation strategies not effective bc gravity has shifted posterior to the knee thus causing the “crouched gait”
Latrogenic crouch
related to crouched gait → weakness of the muscle due to surgical tendo achilles lengthening (TAL) to correct a contracted triceps surae
firm placement and use of hands
- allows deep sensory input
- focus is inhibition
- PT has abundant control
- guides rather than controls
- focus on facilitation
- child needs to have ample control
light placement and use of hand
- requires active control on the part of the child
- focus is on facilitation
Intermittent placement and use of hands:
- good way to combine inhibition, firm sensory input, and the patient can be active above/below your key points of control
slow movement with a firm touch
- small ranges of movement can be used to inhibit abnormal postural responses
Fast movement with a firm touch
- facilitates automatic reactions
fast movement with light touch
facilitates holding of a posture against gravity
stopping the movement
- better for children with fluctuating tone and disorganized movement
- rhythmic movement
may be better for children with spasticity
arrhythmic movement
pressure on a joint can be facilitatory or inhibitory as can distraction
compression
- hand placement close to trunk and large joints
proximal key points
hand placement further away from trunk and large joints
distal key points
used when there is a real or apparent weakness of specific muscles groups or generalized hypotonia
tapping
LE Assessment Handout
- Staheli’s Prone Hip Extension Test – used to assess hip flexion contracture for a child with spasticity (most valid method for CP child)
- Leg length
- Assess Femur torsional status
- Assess knee flexion contracture → popliteal angle
- Assess for Tibia and Fibula Torsion
- Thigh foot angle
head/neck lateral flexion facilitates?
hip abd
Arm ER, supination, and extended elbow facilitates
facilatates trunk extension
IR rotation of the arms facilitates
trunk flexion
arm horizontal abd with ER faciltates
ER of hips, inhibits spasticity of pects
arms elevated overhead with ER
facilitates trunk extension (might be too much)
arms diagonally backward with ER
faciltates trunk extension, hands open, may use with ambulatory child to build extensor tone
abduction of thumbs
facilitates finger opening
flexion of hips and knees
favors abd and ER of hips
ankle DF
ER of LES in standing
facilitates hip abd, ankle DF
DF of toes 2-5
inhibits LE extensor spasticity
facilitates DF
