Week 10 - Pediatric Orthopedic Conditions: OT Management

Question 1

for peds, an OT should split a complex eval. into ___ ___.

Answer 1

multiple sessions

Question 2

name 5 ways in which an OT can prevent and/or minimize anxiety during a peds eval.

Answer 2

• 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

Question 3

name 2 types of self-report evals. for peds.

Answer 3

• semi-structured interviewing: parent and/or child

- pt.-reported outcome measures (proxy report)

Question 4

name 2 types of pain evals. for peds.

Answer 4

• observation - FLACC scale (2 months - 7 years)

- Wong-Baker FACES Pain Rating Scale (3+)

Question 5

name 2 types ROM and strength evals. for peds.

Answer 5

• observe during play, transitional movements, interactions with objects
• over 3, can usually participate with goniometry and MMT

Question 6

name 4 aspects of peds. interventions.

Answer 6

• 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

Question 7

which physical agent modalities should be avoided for peds?

Answer 7

avoid ultrasound over growth plates

Question 8

• 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

Answer 8

adolescent idiopathic scoliosis

Question 9

what is the assessment for adolescent idiopathic scoliosis?

Answer 9

Adams forward bend test

Question 10

name 3 types of management for adolescent idiopathic scoliosis.

Answer 10

• observation
• bracing
• operative

Question 11

what is the gold standard surgical technique for adolescent idiopathic scoliosis?

Answer 11

spinal fusion

Question 12

what is the gold standard non-surgical technique for adolescent idiopathic scoliosis?

Answer 12

Schroth method

Question 13

• twisted neck
• unilateral SCM contraction which leads to ipsilateral lateral flexion and contralateral rotation
• limitations in ROM
• more common in males

Answer 13

congenital muscular torticollis

Question 14

name 3 secondary problems of congenital muscular torticollis.

Answer 14

• positional plagiocephaly
• facial asymmetry
• perceptual and balance issues if chronic

Question 15

congenital muscular torticollis treated ____ most often.

Answer 15

nonoperatively

Question 16

congenital muscular torticollis treated ____ most often.

Answer 16

nonoperatively

Question 17

why do pts. with congenital muscular torticollis go to OT?

Answer 17

• ROM deficits
• functional limitations
• developmental delays

Question 18

• “clicky” hips, abnormal gait, asymmetrical LE skin folds, extreme external rotation so feet seem to point backwards
• affects developmental milestones
• ranging subluxation to dislocation

Answer 18

developmental hip dysplasia

Question 19

name 2 ways in which developmental hip dysplasia is managed.

Answer 19

• bracing/casting: pavlik harness, hip spica cast, hip flexion and abduction
• operative

Question 20

name 4 methods of OT treatment for developmental hip dysplasia.

Answer 20

• seating
• positioning for breastfeeding, sleep, etc.
• ADL education (diapering, dressing, bathing)
• with cast/brace removal, address transitional movements and weight bearing during functional activities.

Question 21

• joint pain, redness, swelling, morning stiffness
• joint deformities and instability
• fatigue

Answer 21

juvenile idiopathic arthritis

Question 22

the onset of juvenile idiopathic arthritis is before what age?

Answer 22

16

Question 23

juvenile idiopathic arthritis must persist for at least how many weeks?

Answer 23

at least 6 weeks

Question 24

transverse arrest: amelia through aphalangia

longitudinal arrest: radial, ulnar, tibial, fibular, central, intersegmental deficiency

Answer 24

failure of formation

Question 25

soft tissue or skeletal: arthrogryposis, syndactyly, campodactyly, thumb in palm, syntosis

Answer 25

failure of differentiation

Question 26

whole limb through polydactyly

Answer 26

duplication

Question 27

whole limb through macrodactyly

Answer 27

overgrowth

Question 28

whole limb through brachydactyly

Answer 28

undergrowth

Question 29

amniotic band syndrome (ABS)

Answer 29

constriction band syndrome

Question 30

• 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

Answer 30

achondroplasia

Question 31

primary bone cancer

Answer 31

osteosarcoma or ewing sarcoma

Question 32

primary bone cancer is most commonly diagnosed in which groups?

Answer 32

preteens/teens

Question 33

primary bone cancer is most commonly diagnosed in which groups?

Answer 33

preteens/teens

Question 34

primary bone cancer is more common where?

Answer 34

LE

Question 35

name 4 peds-specific fracture conditions.

Answer 35

• growth plate (salter-harris classification)
• torus/”buckle” and greenstick fractures
• timeframes for healing
• consider potential for child abuse

Question 36

flattened portion of skill, can develop due to positioning but can be corrected with cranial orthoses

Answer 36

positional plagiocephaly

Question 37

hip is loose

Answer 37

subluxation

Question 38

hip joint is separated

Answer 38

dislocation

Question 39

orthoses for children should align with which 2 stages?

Answer 39

their developmental stage and their cognitive stage