Week 10 - Pediatric Orthopedic Conditions: OT Management Flashcards
for peds, an OT should split a complex eval. into ___ ___.
multiple sessions
name 5 ways in which an OT can prevent and/or minimize anxiety during a peds eval.
- play with child before eval.
- role play with doll, sibling, or parent
- leave child seated on parent’s lap
- have parent provide instructions
- save anything painful or scary for last
name 2 types of self-report evals. for peds.
- semi-structured interviewing: parent and/or child
- pt.-reported outcome measures (proxy report)
name 2 types of pain evals. for peds.
- observation - FLACC scale (2 months - 7 years)
- Wong-Baker FACES Pain Rating Scale (3+)
name 2 types ROM and strength evals. for peds.
- observe during play, transitional movements, interactions with objects
- over 3, can usually participate with goniometry and MMT
name 4 aspects of peds. interventions.
- fun in-clinic and home programs: simple but novel, play and games, non-traditional (hippotherapy, aquatic therapy)
- short sessions
- family involvement
- developmentally appropriate activities and teaching/learning - motor, cognitive, psychosocial
which physical agent modalities should be avoided for peds?
avoid ultrasound over growth plates
- spine looks like S or C when viewed from rear
- spinal changes in frontal, transverse, and/or sagittal planes
- may be associated with lordosis or kyphosis
adolescent idiopathic scoliosis
what is the assessment for adolescent idiopathic scoliosis?
Adams forward bend test
name 3 types of management for adolescent idiopathic scoliosis.
- observation
- bracing
- operative
what is the gold standard surgical technique for adolescent idiopathic scoliosis?
spinal fusion
what is the gold standard non-surgical technique for adolescent idiopathic scoliosis?
Schroth method
- twisted neck
- unilateral SCM contraction which leads to ipsilateral lateral flexion and contralateral rotation
- limitations in ROM
- more common in males
congenital muscular torticollis
name 3 secondary problems of congenital muscular torticollis.
- positional plagiocephaly
- facial asymmetry
- perceptual and balance issues if chronic
congenital muscular torticollis treated ____ most often.
nonoperatively
congenital muscular torticollis treated ____ most often.
nonoperatively
why do pts. with congenital muscular torticollis go to OT?
- ROM deficits
- functional limitations
- developmental delays
- “clicky” hips, abnormal gait, asymmetrical LE skin folds, extreme external rotation so feet seem to point backwards
- affects developmental milestones
- ranging subluxation to dislocation
developmental hip dysplasia
name 2 ways in which developmental hip dysplasia is managed.
- bracing/casting: pavlik harness, hip spica cast, hip flexion and abduction
- operative
name 4 methods of OT treatment for developmental hip dysplasia.
- seating
- positioning for breastfeeding, sleep, etc.
- ADL education (diapering, dressing, bathing)
- with cast/brace removal, address transitional movements and weight bearing during functional activities.
- joint pain, redness, swelling, morning stiffness
- joint deformities and instability
- fatigue
juvenile idiopathic arthritis
the onset of juvenile idiopathic arthritis is before what age?
16
juvenile idiopathic arthritis must persist for at least how many weeks?
at least 6 weeks
transverse arrest: amelia through aphalangia
longitudinal arrest: radial, ulnar, tibial, fibular, central, intersegmental deficiency
failure of formation
soft tissue or skeletal: arthrogryposis, syndactyly, campodactyly, thumb in palm, syntosis
failure of differentiation
whole limb through polydactyly
duplication
whole limb through macrodactyly
overgrowth
whole limb through brachydactyly
undergrowth
amniotic band syndrome (ABS)
constriction band syndrome
- average trunk, short arms, legs, and fingers, macrocephaly, limited elbow ROM, spinal problems
- positioning to support head, neck, back
- diet and low-impact exercise/recreation
- assistive devices to access body and environment
- social integration and emotional issues
achondroplasia
primary bone cancer
osteosarcoma or ewing sarcoma
primary bone cancer is most commonly diagnosed in which groups?
preteens/teens
primary bone cancer is most commonly diagnosed in which groups?
preteens/teens
primary bone cancer is more common where?
LE
name 4 peds-specific fracture conditions.
- growth plate (salter-harris classification)
- torus/”buckle” and greenstick fractures
- timeframes for healing
- consider potential for child abuse
flattened portion of skill, can develop due to positioning but can be corrected with cranial orthoses
positional plagiocephaly
hip is loose
subluxation
hip joint is separated
dislocation
orthoses for children should align with which 2 stages?
their developmental stage and their cognitive stage
