Q2: Pathology (Review of Clark Lectures) Flashcards
Primary gait deviations
caused by a direct factor
Secondary gait deviations
caused in order to compensate for a primary deviation
Gait deviations from Steppage Gait
Primary - Foot Drop (Paralytic Equinas)
Secondary - Excessive knee and hip flexion
Gait deviations from Plantarflexor Paralysis
Primary - Uncontrolled tibial progression
Secondary - shortened contralateral step
CP - Etiology (congenital)
85-90% are due to congenital problems (mostly idiopathic)
placenta detachment
uterine rupture
disrupted oxygen supply
CP - Etiology (acquired)
infection: meningitis or encephalitis
TBI: MVA or abuse
reduced blood flow to brain
CP - (T/F) Cerebral Palsy is progressive and gets worse with time
False
CP - Four Types
spastic
ataxic
athetoid
mixed
CP - Spastic
most common
70-80% of diagnosed cases
hypertonia
spasticity
joint stiffness
damage to the cerebral cortex
CP - Ataxic
occurs in 10% of diagnosed cases
difficulty with balance
poor muscle coordination
cognitive functioning impairment
hypotonia
damage to cerebellum
CP - Athetoid
dyskinetic
5% of cerebral palsy diagnoses
hypo and hypertonia combination
postural impairments
motor functioning difficulties
poor/uncontrolled movements
damage to basal ganglia
CP - Mixed
combination of 2 or more CP types
damage occurs in multiple areas of brain
CP - Measurement of Motor Function Scale
Gross Motor Function Classification
CP - Measurement of Communication Impairment System
Communication function classification system
CP: LL Ox Intervention
Foot orthoses
SMOs
AFOs
FRAFOs
Positional AFOs
Decontracture orthoses
CP: UE Ox Intervention
hand, wrist, and elbow static positioning orthoses can help to decrease contractures
CP - Common Gait Pattern(s)
Spastic Diplegic and Spastic Hemiplegic
Spina Bifida - Etiology
Congenital neural tube defect
Overall incidence is declining
Spina Bifida - Risk Factors
heredity
environmental
teratogenic
folic acid
Spina Bifida - Occulta
mild presentation; results in only boney defect with spinal cord, meninges and spinal fluid intact
Spina Bifida - Meningocele
protrusion of meninges; involves the bifid vertebra, with only CSF filled sac protruding
least common
Spina Bifida - Myelomeningocele
protrusion of meninges and spinal cord; most severe surviving form
Spina Bifida - Myelocele
Meninges open, spinal cord exposed; low survival rate
Spina Bifida - most common vertebral location
Lumbosacral (90%)
Spinal Bifida - Clinical Presentation
not symmetrical, muscle imbalance, contractures, scoliosis; paralysis
Spina Bifida - Ox Intervention
Primarily for standing and ambulating; joint stability and deformity prevention
Spina Bifida - Common Gait Pattern
increased pelvic oscillation, trunk/pelvis leaned posteriorly, shortened steps
MS - Etiology
chronic, inflammatory demyelinating disease of brain and spinal cord; Idiopathic
MS - Clinical Presentation
decreased balance
difficulty with swallowing and speech
visual impairments
pain
fatigue
muscle weakness
cognitive issues and fatigue
MS - Ox Intervention
FOs
SMOs
AFOs
KOs
KAFOs
MS - Common Gait Pattern
Ataxic; clumsy, unsteady, possible tremors
CVA - Etiology
AKA Stroke; rapid loss of brain function, blockage of blood to brain
CVA - Clinical Presentation
Neurological function impairment; issues with speaking, eating, emotion control, eating control, vision, spasticity, etc.
CVA - LL Ox Intervention
Assist in ambulation; increase proprioception and reduce spasticity
CVA - UE Ox Intervention
Assist in shoulder stability; reduction/prevention of wrist and elbow contractures
CVA - Common Gait Patterns
Hemiparetic
TBI - Etiology
Commonly 15-24 year olds (risk taking), secondarily toddlers and geriatrics
Causes: MVA, Falls, GSW, Sports/Athletics
TBI - Clinical Presentation
Initially flaccid, followed by increased spasticity and rigidity; two posturing types (decorticate and decerebrate)
TBI - Classification Scale
Glasgow Coma Scale (GCS)
TBI - Orthotic Intervention
Contracture prevention, reduction, & correction; stability in static standing
