Tecklin CP

Question 1

Germinal matrix hemorrhages (GMH)

Answer 1

Bleeding into the tissue around the ventricles

Question 2

Periventricular intraventricular hemorrhages (PVH)

Answer 2

Bleeding into both ventricles and the tissue around the ventricles

Question 3

Bleed grades

Answer 3

I through IV

IV is the most severe

Question 4

CP general presentation

Answer 4

Mix of both lesions and lack of proper development

Dilated ventricles
Holes in brain
Malformation of brain with inappropriate development of sulci and gyri

Question 5

Assessment of Postural Control in CP

Answer 5

You can get a lot of info from observing transitional ability

Observation of child using feedback information
Can the child repeat movements and tasks?

Question 6

Spasticity presentation in CP

Answer 6

Can present with less range when taken QUICKLY through the range

R1 slowly through range
R2 quickly through range

Question 7

Hemiplegic gait

Answer 7

UE - lack of arm swing, flexion posturing

LE - circumduction, hip hiking, knee hyperext, foot drop/PF, equinovarus

Question 8

Diplegic gait

Answer 8

Equinovarus

Planovalgus - calcaneovalgus

Crouch - knee and hip flexion

Jump knee - up on toes with hips and knees flexed

Stiff knee - stiff while walking

Recurvatum

Idiopathic toe walking - also in DMD, contractures, tone, kids on the spectrum

Question 9

Quadriplegic gait

Answer 9

Mostly level IV and Level V kids

Question 10

Athetotic gait

Answer 10

Use of ATNR to walk

Question 11

Ataxic gait

Answer 11

Drunkenness
Wide base
Irregular pattern

Question 12

NDT

Answer 12

Problem-solving approach

Able to affect function with treatment interventions and handling

GOAL - finding the most independent functional outcome

Movement and sensory system are LINKED

• **We want to try and give the child the sensory input about how movement could or should be
• **Goal is that if they have that experience, they will choose to move in those types of patterns

Question 13

Sensory Integration and Sensory Processing Disorder

Answer 13

Based on the work of A. Jean Ayres

Focuses on sensory aspects

Impact on motivation, attention, movement, and socioemotional well-being

Primary treatment approach for learning disabilities and autism

Provides a variety of controlled sensory input to encourage responses in motor behaviors, social interactions, or cognitive skills

Question 14

Modified Constraint Induced Movement Therapy

Answer 14

Edward Taub

Highlights the importance of cortical reorganization and neuroplasticity

Three principles

1. Constraint of unaffected limb with a cast
2. Massed practice of affected limb
3. Intensive shaping techniques

Question 15

Treadmill training/Robotic gait training

Answer 15

Slow walking on a treadmill

Based on a task-specific motor learning principles

Can be used with electrical stimulation

Can be used with overhead harness for partial body weight supported ambulation

Robotic gait training - with extensive bracing and controlling of parameter

Question 16

Therapeutic electrical stimulation

Answer 16

Low-level, subcontraction electrical stimulus applied at home during sleep

Increases the blood flow during a time of heightened trophic hormone secretion

To increase muscle bulk

Question 17

Conductive education

Answer 17

Addresses all aspects of development (motor, cognitive, communication, psychosocial, and ADL)

Classroom setting

Overall goal to improve the child’s “orthofunction”
Capacity to respond to biologic and social demands

Specifically for children with motor disorders

Equipment used is all wooden
Idea is that it’s uncomfortable to sit still on the surface
Promotes movement

Question 18

NDT principles

Answer 18

Use of facilitation of effect “tone”

Use of reflex inhibiting postures

Use of key points of control

Question 19

Strengthening in CP

Answer 19

More effective with children with better isolated movement or selective voluntary control

60% of 1RM for a PR program

All forms of strength training can be used

For those with less selective voluntary control use of functional activities, with focus on moving against gravity

Question 20

Habit or bimanual training

Answer 20

After child goes through period of constraint to see how they will use limbs bimanually

Question 21

Hippotherapy

Answer 21

Horses

Position transition
NDT
Balance
Weight shift

All done while using the horse

The way that the horse moves as he walks is how we walk/pelvic shift

Helps decrease spasticity
Helps open up the leg

Question 22

Lokomat

Answer 22

Virtual reality sort of situation

Question 23

AFO

Answer 23

DF

Question 24

HAFO

Answer 24

Hinged

Question 25

DAFO

Answer 25

Dynamic

Question 26

KAFO

Answer 26

Long leg brace

Question 27

Scoliosis bracing

Answer 27

TLSO or body jacket

Question 28

Night splints

Answer 28

Work well after kids have botox injections

Sometimes we just want them out

*Controversy…do they actually use their PFs if they’re in a brace?

Question 29

Neoprene garments

Answer 29

Thera Togs

Scuba diving suit material

Problem - they’re hot

Question 30

Supramalleolar orthosis (SMO)

Answer 30

Gives med-lat stability while allowing free PF and DF

Question 31

Therapeutic goals in CP

Answer 31

Maximizing function

Minimizing impairment effects

Limiting the development of secondary impairments

Minimizing environmental deprivation

Provide support, guidance, and education to the child, family, and community

Question 32

Infancy concerns in CP

Answer 32

Disrupted nurturing
Dealing with the diagnosis
Apprehension
Positioning and care
Facilitating movement

Question 33

Primary treatment for infants with CP

Answer 33

Handing and positioning

Question 34

MEDEK

Answer 34

Out of South America

Great deal of distal hand holds

Give a kid distal hand holds so they can figure out how to orient themselves in space

Question 35

Intraventricular hemorrhages (IVH)

Answer 35

Bleeding into the ventricles