Term
| what are some delayed motor milestones that are warning signs in infants |
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Definition
| not rolling by 6 months. Fisting after 5 months. Not sitting with support by 8 months. Not walking by 15-18 months. Discrepancies between intellectual and motor development |
|
|
Term
| what abnormalities of muscle tone are warning signs in infants |
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Definition
| head lag beyond 6 months. Poor trunk control/balance. Extension thrusting. Dystonia. Early rolling or standing. Toe walking or scissoring. Abnormal gait patterns |
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|
Term
| at what point are you worried if clonus persists |
|
Definition
|
|
Term
| when would you be concerned about hand preference |
|
Definition
| declaring handedness prior to 18 months. Differences in functional abilities of L vs R |
|
|
Term
| what are behavioral warning signs in children |
|
Definition
| irritability. Easily startled with exaggerated Moro. Jittery. Sleeping difficulties. |
|
|
Term
| what physical properties are warning signs in infants |
|
Definition
| decreased rate of head growth. Poor suck. Delayed feeding milestones. Poor weight gain/failure to thrive. |
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|
Term
|
Definition
| cerebral palsy is the general term for a variety of non-progressive disorders that affect a child's ability to move and maintain posture and balance |
|
|
Term
| can there be any progression with CP? |
|
Definition
| the secondary effects of CP do change over time so status/functional abilities might change but it is still considered a non-progressive disorder |
|
|
Term
| is CP a developmental disability? |
|
Definition
|
|
Term
|
Definition
| injury to immature brain in utero or during/shortly after birth. Periventricular leukomalacia |
|
|
Term
| what is periventricular leukomalacia |
|
Definition
| death in areas of the ventricles |
|
|
Term
| is birth weight related to CP? |
|
Definition
| yes. As birth weight decreases, incidence of CP increases |
|
|
Term
| what are some causes of periventricular leukomalacia |
|
Definition
| maternal exposure to toxins; infections, meningitis; interventricular hemorrhage |
|
|
Term
| what are the 5 classifications of CP |
|
Definition
| spastic, dyskinetic (athetoid and dystonic), ataxic, mixed, hypotonic |
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|
Term
| what is the most common type of CP |
|
Definition
|
|
Term
|
Definition
| move in a limited ROM around mid-range. Often present with low postural tone. |
|
|
Term
| what part of the brain was affected in spastic CP |
|
Definition
|
|
Term
| what are the two types of dyskinetic CP |
|
Definition
|
|
Term
| what part of the brain was affected in dyskinetic CP |
|
Definition
|
|
Term
|
Definition
| atypical patterns of posture. Involuntary, uncontrolled movement patterns in affected body parts |
|
|
Term
| describe athetoid dyskinetic CP |
|
Definition
| slow, continuous writhing movements. This makes posture and balance challenging |
|
|
Term
| describe dystonic dyskinetic CP |
|
Definition
| involuntary muscle contractions: sustained or intermittent with repetitive movements and abnormal postures. |
|
|
Term
| how common is dyskinetic CP |
|
Definition
|
|
Term
| what part of the brain is affected in ataxic CP |
|
Definition
|
|
Term
|
Definition
| underlying hypotonic state. Poor co-contraction around joints. Difficult time sustaining positions. Poor control. Unstable |
|
|
Term
|
Definition
| combines spastic and dyskinetic qualities. |
|
|
Term
| what part of the brain is affected in mixed CP |
|
Definition
| motor cortex as well as basal ganglia |
|
|
Term
|
Definition
| low muscle tone. Challenges moving against gravity. |
|
|
Term
| what part of the brain is affected in hypotonic CP |
|
Definition
|
|
Term
| what determines the type of movement pattern presented by a child with CP |
|
Definition
| the part of the brain that has the insult |
|
|
Term
|
Definition
| one extremity involved. Rare |
|
|
Term
|
Definition
| arm and leg affected on same side of body. Arm is usually more invovled with more problems distally. |
|
|
Term
|
Definition
| legs are primarily involved. Usually spastic. Often shortened/tight Achilles leads to toe walking |
|
|
Term
|
Definition
| 3 involved extremities (usually both legs and one arm) |
|
|
Term
| what general areas should be examined in a child with neurological dysfunction |
|
Definition
| history, systems review, function, musculoskeletal exam, neuro exam, gait |
|
|
Term
| what do you want to know in history for CP kid? |
|
Definition
| family situatoin, birth history, birth weight, surgeries, tone management, adaptive equipment, splints/braces, educational/daycare setting, previous therapy |
|
|
Term
| what do you look for in systems review of a child with CP |
|
Definition
| GI function, cardiovascular/pulmonary, integumentary, cognition/attention/motivation, communication, musculoskeletal, neuromuscular |
|
|
Term
| what to consider with GI function of kid with CP |
|
Definition
| postural alignment impacts coordination of suck, swallow, breathing |
|
|
Term
| what to consider with cardiovascular/pulmonary function of kid with CP |
|
Definition
| tone impacting posture impacting respiration |
|
|
Term
| what to consider with integumentary of kid with CP |
|
Definition
| skin integrity from braces/adaptive equipment. Surgical scars |
|
|
Term
| why to consider cognition, motivation, attention in kid with CP |
|
Definition
|
|
Term
| what to consider with communcation in kid with cp |
|
Definition
| receptive vs expressive abilities |
|
|
Term
| what to consider with musculoskeletal review in kid with CP |
|
Definition
|
|
Term
| what to look at in neuromuscular review in kid with CP |
|
Definition
|
|
Term
|
Definition
| ability to move independent parts of your body separate from otehrs |
|
|
Term
| what to look for in functional assessment |
|
Definition
| symmetry in weightbearing, weightshifting, ROM, tone, weakness |
|
|
Term
| what is the gold standard test for testing kids with CP |
|
Definition
|
|
Term
| what test can be used in the NICU for a child 34 weeks gestation to 4 months |
|
Definition
| Test of Infant Motor Performance |
|
|
Term
| what are 2 tests to use with infants with suspected motor delay? |
|
Definition
| test of infant motor performance, AIMS |
|
|
Term
| what are some ways to test ROM in kids |
|
Definition
| ask them to sit longsitting (hamstrings), lie prone (hip flexor), descend stairs (limited DF, tight PF) |
|
|
Term
| what to look for in neuromuscular exam |
|
Definition
| spasticity. Postural reactions (righting reactions, equilibrium reactions.) persistence of primitive reflexes. Neuromotor development and sensory integration. Side to side asymmetries. |
|
|
Term
| describe gait of someone with spastic diplegia |
|
Definition
| crouch gait. Excessive hip and knee flexion. Often hip flexor contractures. Excessive trunk motion. |
|
|
Term
| describe gait of someone with hemiplegia |
|
Definition
| flexed, fisted UE. Active DF is hard so they will drag their toes. Lead gait with stronger side. |
|
|
Term
| describe gait of someone with athetosis |
|
Definition
| gait not smooth or coordinated. Pattern is very variable. Have voluntary control but often overpowered by writhing. |
|
|
Term
| describe gait of someone with ataxia |
|
Definition
| wide BOS, forward trunk, hip and plantarflexion |
|
|
Term
| what is especially important to remember for children with neurological dysfunction |
|
Definition
| differences in growth and development. Find what functional activities MOTIVAte them And Practice |
|
|
Term
| what are some common impairments in CP |
|
Definition
| insufficient force generation, spasticity, abnormal extensibility, poor selective control of muscle activity, poor anticipatory regulation of muscle activity, exaggerated or hyperactive reflexes, decreased ability to learn unique movements |
|
|
Term
| what are some assistive devices that provide support to kids |
|
Definition
| benches, lofstrands, reverse walker, wheechair, braces, orthotics |
|
|
Term
| what are some interventions to use with infants/toddlers |
|
Definition
| facilitate caregiving, promote optimal sensorimotor experiences and skills, educate the family |
|
|
Term
| what are some treatment considerations for kids with CP during preschool period |
|
Definition
| reduce impairments and prevent secondary sequelae: increase force production, manage spasticity, maintain extensibility, maintain good alignment, improve function and participation (UE use, mobility, recreation) |
|
|
Term
| what are treatment consderations for kids with CP during school age and adolescence |
|
Definition
| reduce primary impairment. Prevent secondary impairment. Improve mobility and endurance. Facilitate school and community participation. |
|
|
Term
| what are treatment considerations for a child with CP as she transitions to adulthood |
|
Definition
| reduce primary impairment and prevent secondary impairment. Promote life skills and recreation. Help with transitional planning. |
|
|
Term
| what can you do to help a child with hemiplegia who has difficulty crawling |
|
Definition
| utilize mobility via rolling. Work on weightbearing, weightshifting. OPEN palm in weightbearing. |
|
|
Term
| what to do for child with diplegia who has forward lean and is up on toes due to tight triceps surae |
|
Definition
|
|
Term
| how to help a kid with quadriplegia |
|
Definition
| assstiance or adaptive equipment needed for sitting and mobility |
|
|
Term
| what other conditions are confused with CP? |
|
Definition
| torticollis, brachial plexus injury |
|
|
Term
| how to determine CP intervnetion |
|
Definition
| determine highest functional skill and work from there. Target intervention on what their next step is and what is holding them back. |
|
|
Term
| what are some ideas for stretching kids with CP |
|
Definition
| trunk rotation games. Stretch while watching TV. Have them take ownership and control as many stretches as they can. Prolonged positioning with orthoses, standers. |
|
|
Term
| what is an ex Rx for passive stretching |
|
Definition
| 3-5 repetitions, hold 20-60 seconds, 1-3x/day |
|
|
Term
| Ex Rx for prolonged positioning |
|
Definition
| >6 hrs/day using splinting or equipment |
|
|
Term
| what device can be used to stretch tight hamstrings |
|
Definition
|
|
Term
| what device can be used to stretch tight PF |
|
Definition
| DF orthoses to hold ankle at 90 |
|
|
Term
| what are some strengthening ideas for kids with CP |
|
Definition
| task oriented/functional strength training: step ups, using a ball, playing games. |
|
|
Term
| how to work on strengthening for postural control in kids with CP |
|
Definition
| balance play with reaching to shift weight to the limits of stability. repetitions of balance perturbations in various positions. Target the trunk. Trunk elongation and rotational movements. Core/trunk strengthening activities. Babies on therap balls. |
|
|
Term
| what are benefits of aerobic exercises |
|
Definition
| improves CV endurance. Reduces cost of movement. Preserves bone mass |
|
|
Term
| what are ways to do aerobic exercise in kids with CP |
|
Definition
| walking: using assistive device. Aquatic therapy |
|
|
Term
| what is the best predictor of walking |
|
Definition
| independent sitting by 24 months |
|
|
Term
| what is the age by which most kids with CP walk if they will ever walk |
|
Definition
|
|
Term
| what is a selective dorsal rhizotomy? |
|
Definition
| selectively snip nerve rootlets in cauda equina to reduce levels of spasticity. |
|
|
Term
|
Definition
| medicine used for spasticity management |
|
|
Term
| describe botox injections |
|
Definition
| local target for overactive muscles |
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