Week 5 Flashcards
Subjective Musc assessment for children
- Demographic ifnormation
- Main Problem
- For parent/carer
- For child (may be different) - Body chart
- Age-appropriate language
- Child-specific pain assessment - Behaviour of symptoms
- Parent vs child report - History
- Birth history (full/preterm, vaginal/c-section, oligohydramnios, number of previous pregnancies, birth order of this child)
- Age
- Developmental history - motor milestones (similar to siblings?), sleep, sit, play, positions
- Sudden verse gradual onset
- Sport training history
- Previous management - Medical and social history
- Family history - similar anomaly?
- Family members, household structure (shared custody)
- Year in school - Red and yellow flags
- Red flags in children
- External pressures (competitions and exams)
- Inconsistent story/doesn’t match injury
Objective assessment
- Observation (walking/standing)
- Functional assessment
- Walk, run, jump, hop, SLS, toe walk, heel walk
- On/off floor, sit to stand
- +/- motor performance assessment (are gross motor skills age appropriate if child <5 years - Target impairment based assessment
- ROM
- Rotational profile
- Strength
- Special tests
-Sensation, proprioception, neurology (reflexes, spasticity, tone)
Assessing strength and ROM in children
Strength
-Assess strengthen in babies/toddlers in anti-gravity positions - observation through play
-Functional and field tests
-MMT
- Hand-held dynamometry
-Strain gauges
- Isokinetic dynamometry
ROM
-Goniometry
-Linear measures
-Inclinometer
-Compare to other side vs norms
Measurement of sensation, proprioception, paralysis
-Sensory grading system for BPI
-Sensory performance analysis - 5 to 21 years
-Sensory profile - 5 to 10 years
-Test of sensory function in infants - 4 to 18 months
- Neuro-sensory and motor developmental assessment - 1 to 6 years
Usually from 6-7 years many adult tests can be used for proprioception and paralysis but may be modified for age
Assessment of physical activity and fitness
Physical activity:
-Criterion (direct observation, doubly labelled water, indirect calorimetry)
-Objective (HR, pedometer, accelerometer)
- Subjective (self-report, interview, proxy-report, diary)
Fitness
- Cardiorespiratory fitness (field test or lab testing)
Flexibility (sit and reach)
- Muscular endurance (flexed arm hang, squat test)
- Muscle strength (shot put throw, pull-up, sit ups)
- Muscle strength (dynamometry, MMT, functional and field tests)
-Agility, balance, coordination
- Power (10m shuttle run) and/or speed (50m sprint)
Assessment of torsional anomalies (rotational profile)
Foot progression angle
- Angular difference between axis of the foot and the line of progression while walking
- Subjective examination represents average of angles noted on multiple steps
In-toeing expressed as negative value e.g. -30 degrees and out-toeing as positive value e.g. +20 degrees
Hip rotation
-Assessing ER and IR in prone to stabilise the pelvis
-Greater than 60-75 degrees IR = femoral anteversion
Thigh-foot angle - tibial torsion
- Reflection of torsion of the tibia: angular difference b/w longitudinal axes of the thigh and foot when measured in prone with hip neutral and knee flexed to 90 degrees
- Internal tibial torsion expressed as a negative value
Assessment of angular anomalies
Knee: measure distance between femoral condyles/medial malleoli to assess for varum/valgus
Foot: X-ray and subjective measurement to assess for conditions such as metatarsus adductus
Intervention for Decreased ROM, contracture, malformation, muscle stiffness
- Positioning
-Passive movements
-Stretches
-Casting, splints
-Orthotics
Intervention for muscle weakness and wasting
-Strengthening
-Active movement
