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Pediatric Physical Therapy Flashcards

1
Q

ICF Framework and F-Words

A

Fitness
Functioning
Friends
Family
Fun
Future

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2
Q

Fitness

A

body structure and function

Refers to the importance of physical health and well-being, including regular exercise and healthy living

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3
Q

Functioning

A

activity

Emphasizes the importance of focusing on what individuals can do and their participation in everyday activities

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4
Q

Friends

A

Participation

Stresses the significance of social relationships and friendships in a child’s development and quality of life

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5
Q

Family

A

Environmental Factors

Highlights the central role of family in the development and well-being of children, stressing the need for family-centered approaches.

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6
Q

Fun

A

personal factors

Underlines the need for enjoyable activities and experiences, which are crucial for overall well-being and quality of life

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7
Q

Future

A

Encourages planning for the future, including setting goals and preparing for transitions in life

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8
Q

Common Participation Tests and Measures

A

Children’s Assessment of Participation (CAPE)

School Function Assessment (SFA)

Child Engagement in Daily Life (CEDL)

Participation and Environment Measure – Children and Youth (PEM-CY)

Young Children’s Participation and Environment Measure (YC-PEM)

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9
Q

Common Activity Tests and Measures

A

Gross Motor Function Measure (GMFM-88)

Pediatric Evaluation of Disability Inventory (PEDI and PEDI-CAT)

Gait/Postural Control Measures (eg, 6MWT, TUG, TUDS)

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10
Q

Common Body Function and Structure Tests and Measures

A

UMN Tests (eg, DTRs, Babinski, Hoffman, modified Tardieu)

Pain (eg, Faces, r-FLACC)

Vital signs

Gait/Postural Control Measures

ROM and joint mobility

Selective Control Assessment of the Lower Extremity (SCALE)

Functional Strength Tests

Sensory Processing and Modulating

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11
Q

neuromuscular system = positive upper motor neuron signs ->

A

multisystem impairments

sensory
ROM
strength/endurance
cognition
motor control/planning

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12
Q

Faces Legs Activity Cry Consolability Revised Scale (R-FLACC)

A

0-10 scale

For non-verbal or pre-verbal patients

Parent or therapist report

For ages between 2 months to 18 years

0 = nothing of concern
2 = signs of distress - concern

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13
Q

Modified Tardieu Scale (MTS)

A

assess muscle spasticity by evaluating the response of muscles to passive stretch at different velocities

Used more frequently than modified ash worth 

* scores are very similar - but this gives ROM at R1 and R2

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14
Q

Modified Tardieu Scale (MTS)
Angle of Muscle Reaction:

A

R2: passive ROM following a slow velocity stretch ( V1)

R1: the angle of catch following a fast velocity stretch (either V2 or V3)
Joint angle: R2- R1

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15
Q

Modified Tardieu Scale (MTS)
Score:

A

0 = no resistance

1 = slight resistance, no clear catch

2 = clear catch followed by release

3 = fatiguable clonus (<10 sec)

4 = unfatiguable clonus (>10 sec)

5 = joint immovable

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16
Q

Modified Tardieu Scale (MTS)
Velocity of Stretch:

A

(once chosen, remain consistent)

V1: As slowly as possible (slower than drop due to gravity) -used to measure passive ROM

V2: Speed of the limb segment falling under gravity- used to rate spasticity

V3: As fast as possible (faster than drop due to gravity) - used to rate spasticity

V2 is no longer used

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17
Q

If it is small (catch was quickly in the
 range and they didn’t have much ROM
after) =

A

small tardieu angle
* likely contracture = medical intervention

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18
Q

Large tardieu angle =

A

likely not a contracture
* more flexibility in what you are able 
to do

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19
Q

Selective Control Assessment of the Lower Extremity (SCALE)

A

5 reciprocal lower extremity movements

10-15 min to complete

Therapist administered

For ages ≥ 4 years (need to follow simple motor commands)

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20
Q

Spinal Alignment Range of Motion Measure (SAROMM)

A

26 items
45-60 min to complete
Therapist administered
For ages between 2-18 years

Developed for CP pop. But can be used with others

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21
Q

Spinal Alignment Range of Motion Measure (SAROMM)
scoring:

A

0 = normal alignment and range
1 = normal alignment and range with passive correction
2 = mild fixation
3 = moderate fixation
4 = severe fixation

Low score = better
High = more fixation of the joints

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22
Q

Muscle Strength

A

MMT or handheld dynamometry (“make” test recommended)
Functional Strength more common like the Verschuren Functional Strength Tests

23
Q

Verschuren Functional Strength Tests:

A

lateral step-up test

sit-to-stand test

1/2 kneel-to-stand test

24
Q

lateral step-up test

A

20 cm step

Within 15 deg to full knee extension

30 seconds

25
sit-to-stand test
Bench high enough for 90 deg knee flexion Within 15 deg to full knee extension 30 seconds
26
½ Kneel-to-Stand Test
Start in ½ kneel with buttocks clear of the floor or legs Within 15 deg to full hip and knee extension No external support
27
Development of Postural Control: Cephalocaudal progression of control
Follows a discontinuous, steplike progression of motor milestones
28
Development of Postural Control: Cephalocaudal progression of control Birth:
Lack of head control due to lack of strength and organized muscle activity
29
Development of Postural Control: Cephalocaudal progression of control 3 months:
Emerging anticipatory and reactive postural response in neck muscles, but highly inconsistent
30
Development of Postural Control: Cephalocaudal progression of control 6-8 months:
Steady-state control for independent sitting
31
Development of Postural Control: Cephalocaudal progression of control 10 months:
Postural responses present in standing
32
Development of Postural Control: Cephalocaudal progression of control 15 months of age:
Postural responses in walking
33
Development of Postural Control: Cephalocaudal progression of control By 3 years:
Shift from predominance of visual control to more somatosensory and vestibular control of balance
34
Development of Postural Control: Cephalocaudal progression of control By 10-12 years:
Postural control is essentially mature
35
Tests of Postural Control in Pediatrics
kids-balance evaluation systems test early clinical assessment of balance pediatric balance scale
36
Kids-BESTest Domains:
biomechanical constraints stability in gait sensory orientation reactive transitions & anticipatory stability limits & verticality
37
Kids-BESTest = Kids Balance Evaluation Systems Test
For ambulant children with/without CP between 7-18 years old 27 tasks (36 items), 30 minutes to administer/score Validity mixed Reliability good for full test Ceiling effect: Sensory Orientation domain
38
Kids-BESTest Responsiveness:
Smallest detectable change (w/o CP) = 3 points (same examiner), 4 points (different examiners)
39
How does the Kids-BESTest differ from the BESTest?
Same tasks Instructions are clarified and some modifications have been made * equipment = 2 stack boxed 9inch for adult - shin height for kids BESTest= quantitative tool that identifies the systems that cause poor balance in adults Kids-BESTest is = first assessment to evaluate all systems that contribute to postural control in children with cerebral palsy (CP) Kids-BESTest modifies the tasks within these categories to be more age-appropriate and engaging for children, making it relevant for the pediatric population Kids-BESTest: The tasks are adapted to reflect typical childhood activities. For instance, it includes tasks like jumping, skipping, and other movements that are more dynamic and relevant for kids. It also simplifies certain tasks to accommodate cognitive and motor development differences in children BESTest: The tasks in the adult version focus on more mature motor control, including tasks like standing on one leg or postural transitions that are more challenging for adults with balance issues
40
Pediatric Balance Scale
14 items, 15 min administration Reliability excellent Validity mixed Responsiveness in children with CP MDC – 1.59 points total MCID – 5.83 points total Norms and cut off scores for children developing typically ages 2 years 4 months to 13 years 7 months Ceiling effect – 7 years old
41
Pediatric Balance Scale compared to Berg Balance
Pediatric Balance Scale is a modified version of the Berg Balance Scale that is used to assess functional balance skills in school-aged children items in a more functional sequence for the child *Helps it go quicker too BS: Designed specifically for children, particularly those aged 5 to 15 years. It accounts for developmental differences in motor control and balance. BBS: Designed for adults, especially older adults or individuals with balance impairments (e.g., post-stroke, elderly at risk of falls). Both scales contain 14 functional tasks like standing, sitting, transferring, and turning, with slight modifications in PBS to make them age-appropriate for children PBS has more lenient cut-off scores to reflect the typical abilities of children, while the BBS has stricter thresholds for assessing fall risk in adults
42
Early Clinical Assessment of Balance (ECAB)
For children with between 1.5 and 12 years old 13 items, 15-30 minutes to administer/score Validity high Reliability excellent Ceiling effect: 3-5 years of age for children with higher function
43
Early Clinical Assessment of Balance (ECAB) Responsiveness:
MCID: 7.39 (GMFCS I/II) 5.32 (GMFCS III) 6.88 (GMFCS IV/V)
44
Segmental Assessment of Trunk Control (SATCo)
For children and adults with and without CP (3 months+) Static, Active, and Reactive Control across 7 segmental areas Validity high Reliability good Ceiling effect: about 8-9 months for children developing typically
45
Segmental Assessment of Trunk Control (SATCo) Responsiveness:
Demonstrated changes in static, active, and reactive trunk control over time from 4 to 9 months of age MCID = not yet established
46
The F-words is based on:
the ICF framework, bringing a positive, strength-based approach to pediatric PT examinations
47
Use information from the ____ to determine most useful tests and measures.
child’s medical history, systems review, and movement analysis
48
Postural control develops in a ____ pattern
cephalocaudal
49
Four postural control tests commonly used in pediatric PT:
Kids-BESTest Pediatric Balance Scale Early Clinical Assessment of Balance Segmental Assessment of Trunk Control
50
Kids-BESTest age range & domains:
7-18yrs all domains
51
Pediatric Balance Scale age range & domains:
2.5-13.5yrs all but reactive
52
Early Clinical Assessment of Balance age range & domains:
1.5-12yrs all but space/sensory orientation
53
Segmental Assessment of Trunk Control age range & domains:
3+ months only steady state and postural responses (APA and RPA)

Neuro 2 (9 decks)

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