Tecklin CP Flashcards
Germinal matrix hemorrhages (GMH)
Bleeding into the tissue around the ventricles
Periventricular intraventricular hemorrhages (PVH)
Bleeding into both ventricles and the tissue around the ventricles
Bleed grades
I through IV
IV is the most severe
CP general presentation
Mix of both lesions and lack of proper development
Dilated ventricles
Holes in brain
Malformation of brain with inappropriate development of sulci and gyri
Assessment of Postural Control in CP
You can get a lot of info from observing transitional ability
Observation of child using feedback information
Can the child repeat movements and tasks?
Spasticity presentation in CP
Can present with less range when taken QUICKLY through the range
R1 slowly through range
R2 quickly through range
Hemiplegic gait
UE - lack of arm swing, flexion posturing
LE - circumduction, hip hiking, knee hyperext, foot drop/PF, equinovarus
Diplegic gait
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
Quadriplegic gait
Mostly level IV and Level V kids
Athetotic gait
Use of ATNR to walk
Ataxic gait
Drunkenness
Wide base
Irregular pattern
NDT
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
Sensory Integration and Sensory Processing Disorder
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
Modified Constraint Induced Movement Therapy
Edward Taub
Highlights the importance of cortical reorganization and neuroplasticity
Three principles
- Constraint of unaffected limb with a cast
- Massed practice of affected limb
- Intensive shaping techniques
Treadmill training/Robotic gait training
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
Therapeutic electrical stimulation
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
Conductive education
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
NDT principles
Use of facilitation of effect “tone”
Use of reflex inhibiting postures
Use of key points of control
Strengthening in CP
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
Habit or bimanual training
After child goes through period of constraint to see how they will use limbs bimanually
Hippotherapy
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
Lokomat
Virtual reality sort of situation
AFO
DF
HAFO
Hinged
DAFO
Dynamic
KAFO
Long leg brace
Scoliosis bracing
TLSO or body jacket
Night splints
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?
Neoprene garments
Thera Togs
Scuba diving suit material
Problem - they’re hot
Supramalleolar orthosis (SMO)
Gives med-lat stability while allowing free PF and DF
Therapeutic goals in CP
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
Infancy concerns in CP
Disrupted nurturing Dealing with the diagnosis Apprehension Positioning and care Facilitating movement
Primary treatment for infants with CP
Handing and positioning
MEDEK
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
Intraventricular hemorrhages (IVH)
Bleeding into the ventricles
