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Cerebral Palsy

as it relates to PTA

CP - disease? no, movement disorder
CP - progressive? non progressive
causes mostly unknown, infectious meningitis, trauma, CMV, Rh factor, poor prenatal care, asphyxia (cord issues), low birth rate (33%, 50% diplegic), cerebral hemorrhage
CP involvement in periventricular area, central bleed is what type (42% )? diglegic
CP involvement in the parietal lobe, hemispheric bleed results in what type 36% of time? hemiplegic
CP, frontal lobe involvement, global ischemia results in what type 7% of the time? Quadriplegic
spasticity is? resistance to stretch
what percentage of CP patients have mental retardation? 40-60%
what age do children usually walk? 12 - 18 mo
CP classified by? location of involvement, type, severity
what type of CP is most common? 80% spastic
hypotonic CP lack resting tone
athetoid CP fluctuating tone
classes by location? hemiplegia, quadriplegia, diplegia
what level on the GMFM scale is a child at who can walk w/o restriction; limitations in more advanced gross motor skills? level I
what level is a child who can walk w/o AD; limitations in walking outdoors & in the community, rough terraine, jumping level II
what level can a child walk w/AD; limitations in walking outdoors & in the community level III
at level III, how much energy does it take to get around? 2x more than usual
what level is a child self-mobility w/limitations; children are transported or use power mobility outdoors & in the community level IV
what level is a child self-mobility, severely limited even w/the use of AD? level V
what types of medical tx available for CP? PT, OT, speech TX, orthopedic surgery, baclofen pump, botox, AD
what is PT goal for diplegia & hemiplegia? reduce primary impairments & prevent secondary impairments
what are some tx's for diplegic & hemiplegic CP? inc force generation - overload strengthening, physioball, functional skills; stretching; address spasticity, inc mm length especially important in 2 jt mm, botox, bacolfen
what are LE & pelvic mm's that need STRENGTHENING? (di & hemi) ABDOMINAL MM'S - ARE KEY!!!, TA, EO, IO hip extensors & abductors (gracilis), quads, anterior tib & gastroc/soleus
exercises for LE & pelvic mm stg planks, put on ball to work on obliques, stg hip...gracilis, need good core strength!
what LE & Pelvic mm's that need LENGTHENING? hamstrings, gracilis, gastroc & possibly soleus, iliopsoas
what to consider when developing a plan for CP patient? where are they compared to normal development? GMFM, what skills does that show they lack?
what to work on w/CP? standing, standing w/rotation, balance exercise, gait training, put on ball to force rotation, strengthen core mm's
PT basics for CP - level IV & V work on trunk & head control, prevent contractures, equipment needs, TRANSFER TRAINING, power mobility is the ultimate goal not limited by physical skill, primarily by behavior & cognition), Pt/family education ....if they can't sit, they can't walk!
what is an exercise for head & trunk control? see how long they can hold head up when laying over physio ball
Created by: djbari



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