Week 4.3 Arthrogryposis Multiplex Congenita (AMC)

Question 1

is AMC progressive or non progressive

Answer 1

non-progressive

Question 2

what kind of syndrome is AMC

Answer 2

neuromuscular

Question 3

AMC is a ____ syndrome

Answer 3

congenital

Question 4

describe in a few words what is associated with AMC

Answer 4

joint contractures, muscle weakness and fibrosis

Question 5

AMC is associate with what two kinds of disorders

Answer 5

neuropathic and myopathic

Question 6

AMC has shown degeneration of the … which leads to

Answer 6

degeneration of the anterior horn cell, leads to muscle weakness, periarticular soft tissue fibrosis, decreased fetal movement.

Question 7

what causes AMC

Answer 7

we do not know, could be hyperthermia, virus, vascular compromise, uterine fibroid tumors.

Question 8

what is the oder of prevalence of joint contractures of AMC

Answer 8

foot, hip, wrist, knee, elbow shoulder

Question 9

there are two presentations of AMC, what are they

Answer 9

1. hip flexion, knee extension (legs by ears)
   clubfeet
   shoulder IR, elbow and wrist flexion
2. hip flexion and abduction and ER (frog)
   clubfeet
   shoulder IR, elbow extension and PRO and wrist flexion

Question 10

what are some associated characteristics of AMC

Answer 10

scoliosis, hemangioma, congenita heart disease, respiratory problems, abdominal hernias, intelligence and speech are usually normal

Question 11

what is the medical management of AMC

Answer 11

early ortho, like splints, ROM, positioning, manage the dislocated hips, and Ponseti method, serial casting

Question 12

what is the Ponseti method

Answer 12

minimally invasive clubfoot surgery

Question 13

how does the ortho management change throughout childhood

Answer 13

muscular and capsular releases, osteotomies, serial casting, bracing, splints

Question 14

when does PT begin

Answer 14

ASAP after birth

Question 15

what do we need to take at baseline

Answer 15

ROM and strength

Question 16

how do we take strength in a baby

Answer 16

really, look at what the muscle can do, with and against gravity

Question 17

what are other things PT includes in interventions

Answer 17

splints, bracing 
positioning 
family education 
promoting functional and developmental mobility skills 
mobility aids and devices 
individual plans

Question 18

how do we help children with AMC get mobility

Answer 18

we let them explore because they will find a way to move and get around

Question 19

what are the goals of PT for AMC

Answer 19

• help them problem solve, and focus on their ability
• balance stability with mobility (bracing with mobility)
• assess environment and barriers
• promote independent ADLs and mobility
• energy conservation
• promote social interactions

Question 20

what kind of outcome measures will we use

Answer 20

things like gait speed, 6MWT, and TUG, but these will look at baseline numbers, since there are no norms for children

Question 21

who is involved in our team

Answer 21

child, family, medical and therapy team, teachers, friends, animals and others