Pediatric Physical Therapy Review

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IER Book page 246- O'Sullivan & Siegelman Some flashcards were made into questions to facilitate learning. May contain most of the content in IER book for pediatric physical therapy

First trimester

What trimester in the fetal sensory-motor development (1st,2nd or 3rd trimester)?
Muscle spindles
- Muscle starts to differentiate, and tissue becomes specialized

Second trimester

What trimester in the fetal sensory-motor development (1st,2nd or 3rd trimester)?
Muscle spindles
- Motor end plate forms, and clonus response to stretch

Third trimester

What trimester in the fetal sensory-motor development (1st,2nd or 3rd trimester)?
Muscle spindles
- Some muscles are mature and functional, other still maturing

First trimester

What trimester in the fetal sensory-motor development (1st,2nd or 3rd trimester)?
Touch and Tactile System
- First sensory system to develop
- response to tactile stimulus

Second trimester

What trimester in the fetal sensory-motor development (1st,2nd or 3rd trimester)?
Touch and Tactile System
- receptors differentiate

Third trimester

What trimester in the fetal sensory-motor development (1st,2nd or 3rd trimester)?
Touch and Tactile System
- touch functional
- Actual temperature discrimination at the end of the third trimester
- Most mature sensory system at birth

First trimester

What trimester in the fetal sensory-motor development (1st,2nd or 3rd trimester)?
Vestibular System
- Functioning at the end of the first trimester (not completely developed)

First trimester

What trimester in the fetal sensory-motor development (1st,2nd or 3rd trimester)?
Vision
- eyelids fused
- optic nerve and cup being formed

Second trimester

What trimester in the fetal sensory-motor development (1st,2nd or 3rd trimester)?
Vision
- startle to light
- visual processing occurs

Third trimester

What trimester in the fetal sensory-motor development (1st,2nd or 3rd trimester)?
Vision
- Fixation occurs
- Able to focus (fixed focal length)

Second trimester

What trimester in the fetal sensory-motor development (1st,2nd or 3rd trimester)?
Auditory
- will turn to auditory sounds

Third trimester

What trimester in the fetal sensory-motor development (1st,2nd or 3rd trimester)?
Auditory
- debris in middle ear, loss of hearing

Third trimester

What trimester in the fetal sensory-motor development (1st,2nd or 3rd trimester)?
Olfactory
- nasal plugs disappear, some olfactory perception

First trimester

What trimester in the fetal sensory-motor development (1st,2nd or 3rd trimester)?
Taste
- taste buds develop

Thrid trimester

What trimester in the fetal sensory-motor development (1st,2nd or 3rd trimester)?
Taste
- can respond to different tastes (sweet, sour,bitter, salt)

First trimester

What trimester in the fetal sensory-motor development (1st,2nd or 3rd trimester)?
Movement
- sucking, hiccuping
- fetal breathing
- quick generalized limb movement
- positional changes
- 7 1/2 weeks; bend neck and trunk away from perioral stroke

Second trimester

What trimester in the fetal sensory-motor development (1st,2nd or 3rd trimester)?
Movement
- quickening, sleep states
- Grasp reflex
- reciprocal and symmetrical limb movements

Third trimester

What trimester in the fetal sensory-motor development (1st,2nd or 3rd trimester)?
Movement
- 28 weeks primitive motor reflexes
- rooting, sucking, swallow
- palmar grasp, plantar grasp
- MORO
- crossed extension

1 month

Developmental Sequence Summary at what month(s)?
- decreased flexion
- momentary head elevation with minimal forearm support
- tracks a moving object
- head usually to side
- reciprocal and symmetrical kicking
- positive support and primary walking reflexes in supported standing
- hand fisted with indwelling thumb most of the time
- neonatal reaching
- alert, brightening expression

2 months

Developmental Sequence Summary at what month(s)?
- head elevation to 45° in prone
- prone on elbows with elbows behind shoulders
- head bobs in supported sitting
- does not accept weight on lower extremities (astasia-abasia)
- responds to friendly handling

3 months

Developmental Sequence Summary at what month(s)?
- prone on elbows, weight bearing on forearms
- elbows in line with shoulders, head elevated to 90°
- head in midline in supine, hand on chest
- increased back extension with scapular adduction in supported sitting
- takes some weight with toes curled in supported standing
- coos, chuckles

4 months

Developmental Sequence Summary at what month(s)?
- rolls prone to side, supine to side
- sits with support
- no head lag in pull to sit
- optical and labyrinthine head-righting present
- bilateral reaching with forearm pronated when trunk supported
- ulnar palmar grasp
- laughs out loud

5 months

Developmental Sequence Summary at what month(s)?
- rolls from prone to supine
- weight shifting from one forearm to the other in prone
- head control in supported sitting

6 months

Developmental Sequence Summary at what month(s)?
- prone on hands with elbows extended, weight shifting from hand to hand
- rolls supine to prone
- independent sitting
- pulls to stand, bounces

7 months

Developmental Sequence Summary at what month(s)?
- can maintain quadruped
- pivots on belly. Infant in prove moves body in a circle
- pivot prone (prone extension) position
- assumes sitting from quadruped
- trunk rotation in sitting
- recognizes tone of voice
- may show fear of strangers

8-9 months

Developmental Sequence Summary at what month(s)?
- belly crawls
- quadruped creeping
- moves quadruped to sitting
- side sitting
- pulls to stand through kneeling
- cruises sideways, can stand alone
- reaches with: closest arm, radial digital grasp, radial palmar, 3 jaw chuck grasp, and inferior pincer grasp with thumb and fore finger
- can trasnfer objects from one hand to the other

10-15 months

Developmental Sequence Summary at what month(s)?
- begins to walk unassisted
- begins self-feeding
- reaches with supination, neat pincer grasp, can release, build a tower of 2 cubes
- searches for hidden toys
- suspicious of strangers
- play patty-cake and peek a boo
- imitates

20 months

Developmental Sequence Summary at what month(s)?
- ascends stairs step to pattern (2 feet on each step)
- running more coordinated
- jump off of bottom step
- plays make believe

2 years

Developmental Sequence Summary at what month(s)?
- runs well
- can go up stairs foot over foot (reciprocal stair climbing)
- active, restless, trantrums

3 years

Developmental Sequence Summary at what month(s)?
- rides tricycle
- stands on one foot briefly
- jumps with two feet
- understands sharing

3 years

Developmental Sequence Summary at what month(s)?
- hops on one foot
- kicks ball

4 years

Developmental Sequence Summary at what month(s)?
- hops on one foot several times
- stands on tiptoes
- throws ball overhand
- relates to friends

5 years

Developmental Sequence Summary at what month(s)?
- skips
- kicks ball well
- dresses self

Test of Infant Motor Performance (TIMP)

This is a test that is developed for PRETERM infants as part of an examination. It includes infants of 32 weeks post conceptual age to 3 1/2 months post term.
It evaluates spontaneous and elicited movements to evaluate postural alignment and selective control for functional movement
This test is called?

38-42 weeks

How many weeks are considered to be a normal gestational period?

APGAR

This test developed for full term newborn, infant and child as part of the pediatric examination. It is a screening test administered to newborns at 1 minute, 5 minutes, and 10 minutes after birth. It includes five items such as:
- Heart rate, respiration, reflex irritability, muscle tone and color. Each item is scored 0,1 or 2.
A score of ≥ 7 is considered to be good.
This test is called?

≥ 7

What score is considered to be good in the APGAR test?

Downward

Which protective extension begins at 4 Months?

Sideward sitting

Which protective extension begins at 6 months?

Forward sitting

Which protective extension begins at 7 Months?

Backward sitting

Which protective extension begins at 9 Months?

4-6 months, and persist throughout life

Body righting reaction acting on the head (BOH). At what age does it begins?

6-8 months, and persists

Body righting reaction acting on the body (BOB). At what age does it begins?

6-8 months

Symmetrical Tonic Neck Reflex (STNR), at what age is integrated?

4-18 months

Landau's Reaction, at what age does it begins and integrates?

5 months

Tilting reactions are slow shifting of BOS or slow displacement of body in space that will result in lateral flexion of spine toward elevated side, and sometimes trunk rotation toward the elevated side this reactions persists throughout life. Tilting reactions reactions in prone, at what age does it begins?

7 months

Tilting reactions are slow shifting of BOS or slow displacement of body in space that will result in lateral flexion of spine toward elevated side, and sometimes trunk rotation toward the elevated side this reactions persists throughout life.Tilting reactions in supine, at what age does it begins?

8 months

Tilting reactions are slow shifting of BOS or slow displacement of body in space that will result in lateral flexion of spine toward elevated side, and sometimes trunk rotation toward the elevated side this reactions persists throughout life.Tilting reactions sitting, at what age does it begins?

12 months

Tilting reactions are slow shifting of BOS or slow displacement of body in space that will result in lateral flexion of spine toward elevated side, and sometimes trunk rotation toward the elevated side this reactions persists throughout life.Tilting reactions Quadruped, at what age does it begins?

0-2 months

The following list are neonatal reflexes that are tested as part of pediatric examination, when are these reflexes emerge and integrated?
- Babinski, flexor withdrawal, Cross extension
- Galant or trunk incurvation
- Primary walking and primary standing reaction

0-3 months

The following list are neonatal reflexes that are tested as part of pediatric examination, when are these reflexes emerge and integrated?
- Rooting

0-4 months

The following list are neonatal reflexes that are tested as part of pediatric examination, when are these reflexes emerge and integrated?
- Moro reflex
- Palmar grasp

0-6 months

The following list are neonatal reflexes that are tested as part of pediatric examination, when are these reflexes emerge and integrated?
- NOB (Neck righting On Body)
- Sucking reflex
- Startle reflex
- Tonic Labyrinthine reflex
- Asymmetrical Tonic Neck Reflex (ATNR)
- Placing reactions

Tilting reactions

Defined as slow shifting of BOS or slow displacement of body in space that will result in lateral flexion of spine toward elevated side, and sometimes trunk rotation toward the elevated side this reactions persists throughout life.

ATNR

What neonatal reflex, if persists, may result in scoliosis or hip dislocation, and may interfere with grasping, and hand to mouth activities?

Rooting,sucking

Which two neonatal reflexes are considered to be important feeding reflexes?

Tonic labyrinthine reflex

Which neonatal reflex if persists and it is strong may block or interfere with rolling from supine due to increased extensor tone?

Tonic Labyrinthine Reflex (TLR)

Identify the following reflex
- Prone position results in maximal flexor tone
- Supine position results in maximal extensor tone
if persists and is strong, may block rolling from supine due to increased extensor tone

Plantar grasp

Which neonatal reflex MUST be integrated before walking can occur?

Protective extension

Defined as quick displacement of trunk in a downward direction while held or while sitting in a forward, sideward, or backward direction will result in extension of legs in downward and extension of arms in the sitting position to catch weight. These reactions persists throughout life.

STNR

Which neonatal reflex if persists, may interfere with development of stable quadruped position and creeping?

Denver Developmental Screening Test II

Which pediatric test screens for developmental delay, and tests for: social, fine, gross motor, and language skills from birth to 6 years of age?

Primary standing reaction

Which neonatal reflex if persists will interfere with walking by causing extension of all joints of the LE and not allowing disassociation of flexion and extension?

Alberta Infant Motor Scale (AIMS)

Which screening test is an observational scale for assessing gross motor milestones in infants from birth through independent walking?

Peabody Developmental Motor Scale

Which standardized motor test assesses gross and fine motor development from birth to 42 months, and includes spontaneous, elicited, reflexes and automatic reactions?

Gross Motor Function Test (GMFT)

Identify the following test.
This test was developed to measure change in gross motor function over time in children with Cerebral Palsy. All itmes on this test could be accomplished by a 5 year old with typical motor development.
This test focus voluntary movements in 5 developmental dimensions:
1. - prone and supine
2.- sitting
3.- crawling and kneeling
4.- standing
5.- walking and jumping

Sensory Integration and Praxis Test (SIPT)

This test is a sensorimotor assessment for children between ages of 4 - 9 yrs having mild to moderate learning impairment
It measures the sensory integration processes that underlie learning and behavior. By showing how children organize and respond to sensory input,this test helps pinpoint specific organic problems associated with learning disabilities, emotional disorders, and minimal brain dysfunction. Includes
- balance, proprioceptive and tactile sensation, and control

Bayley Scales of Infant Development

A norm-referenced motor and mental scales for children form birth to 42 months of age. It is a standard series of measurements used primarily to assess the motor (fine and gross), language (receptive and expressive), and cognitive development of infants and toddlers, ages 0-3

Pediatric functional assessments

What are the main function of these two following pediatric tests?
- Pediatric Evaluation of Disability Inventory (PEDI)
- Functional Independence Measure for children (WeeFIM)

Pedriatric Evaluation of Disability Inventory (PEDI)

Identify the following pedriatric test?
It is an interview or questionnaire scale of activities of daily living (ADLs), with or without modification completed by the giver, an instrument for evaluating function in children with disabilities between 6 months to 7.5 years. It measures both functional performance and capability in three domains:
1.- self-care
2.- mobility
3.- social function.

Functional Independence Measure for children (WeeFIM)

Identify the following test
It assesses functional performance in self-care, mobility,locomotion,and communication and social cognition
It also assesses the need for assistance and the
severity of disability in children. IT is the pediatric version of the Functional Independence Measure (FIM), a functional assessmentoutcome measure for adults.

Newborn Individualized Developmental Care and Assessment of Progress (NIDCAP)

Identify the following test
A systematic behavioral observation of preterm of full-term infant in nursery or home during environmental input, care-taking and treatments. note what stresses, consoles infant

Atelectasis

Defined as lack of gas exchange within alveolar due to alveolar collapse

Respiratory Distress Syndrome

This condition is due to atelectasis (collapse of lungs) caused by insufficient surfactant in premature lungs, which may lead to acute respiratory failure and death

Supported side-lying while doing visual (use black, white, and red objects 9 inches away), and auditory tracking and reaching, midline position of head

An appropriate PT intervention/activities to teach parents are play activities and positioning to facilitate shoulder protraction, adduction such as:

Avoid activities which may increase extensor tone such as use of infant jumpers and walkers

An appropriate PT intervention/activities to teach parents to avoid is/are?

Encourage reaching for toys, parent's face

An appropriate PT intervention/activities to teach parents for an infant over 32 weeks' conceptional age is:

Monoplegia

A classification of Cerebral Palsy that involves impairment of one limb is called:

Diplegia

A classification of Cerebral Palsy that involves impairment of two LOWER limbs is called:

Hemiplegia

A classification of Cerebral Palsy that involves impairment of Upper and Lower limbs of one side of the body is called:

Quadriplegia

A classification of Cerebral Palsy that involves ALL four limbs is called:

Spasticity

If a patient with cerebral palsy has increased tone, lesion of motor cortex or projections from motor cortex. This type of impairment will be called:

Athetosis

If a patient with cerebral palsy has fluctuating muscle tone (can be rigid, can be flaccid), lesion of basal ganglia. This type of impairment will be called:

Ataxia

If a patient with cerebral palsy has instability of movement, lesion of cerebellum. This type of impairment will be called:

Spastic diplegia

If a Patient with cerebral palsy has increased tone, and the lesion is in the motor cortex and it involves both lower extremities, this condition is called:

Level 1

Based on the Gross Motor Function Classification, what level would it be if patient is able to walk without restrictions, and limitations is in more adavance gross motor skills?

Level 2

Based on the Gross Motor Function Classification, what level would it be if patient is able to walk WITHOUT assistive devices, limitations: walking outdoors, and in the community?

Level 3

Based on the Gross Motor Function Classification, what level would it be if patient is able to walk WITH assistive mobility devices; Limitations: walking outdoors and in the community?

Level 4

Based on the Gross Motor Function Classification, what level would it be if patient demonstrate self-mobility with limitations: Children are transported or use power mobility outdoors and in the community?

Level 5

Based on the Gross Motor Function Classification, what level would it be if self mobility is severely limited, even with the use of assistive technology?

Spastic cerebral palsy

What kind of impairment of cerebral palsy would the following description indicates?
- Increased muscle tone in antigravity muscles
- Abnormal postures and movements with mass patterns of flexion/extension
- Imbalance of tone across joints may cause contractures and deformities, especially of: LE : hip flexors, adductors, internal rotators, knee flexors, ankle plantarflexors
- Imbalance of tone across joints may cause contractures and deformities, especially of: UE: scapular retractors, Glenohumeral extensors, and adductors, elbow flexors, forearm pronators
- visual, auditory, cognitive and oral motor deficits

Athetoid cerebral palsy

What kind of impairment of cerebral palsy would the following description indicates?
- generalized decrease in muscle tone, floppy baby syndrome
- poor functional stability especially in proximal joints
- ataxia and incoordination when child assumes upright positions with decreased BOS and muscle tone fluctuations
- poor visual tracking, speech delayed and oral motor problems
- Tonic reflexes such as: ATNR, STNR, Tonic labyrinthine reflex (TLR) may persist, blocking functional postures and movements

Ataxia cerebral palsy

What kind of impairment of cerebral palsy would the following description indicates?
- Low postural tone with poor balance
- Stance and gait are WIDE based
- Intention tremor of hands
- Ataxia follows initial hypotonia
- poor visual tracking, nystagmus
- Speech articulation problems
- May occur with spastic or athetoid Cerebral palsy

Tilt wheelchair seat posteriorly

A pediatric patient diagnosed with cerebral palsy, has been given a wheelchair for ambulation. Upon examination, the patient shows increased extensor tone and decreased hip flexion. What wheelchair modification will be appropriate to address this issue?

Decrease extensor tone and maintain hip flexion

What effect has a wheelchair seat tilted posteriorly on a patient with cerebral palsy with severe extensor tone?

Sidelying

Tonic Labyrinthine Reflex (TLR) (0 - 6 Months) is defined as: prone position = maximal flexor tone, and supine position = maximal extensor tone. what position will most likely decrease the effect of TLR?

Posterior rollator walkers

Rollator walkers are often used as part of orthoses in the treatment of CP. What type of rollator walker would be appropriate to help a child maintain upright position and arm position to decrease extensor tone?

Side effects: sedation, weakness, drowsiness, dry mouth

Oral medications such as: presynaptic inhibition of acetylcholine release, benzodiazepines, diazepam (valium), Baclofen (lioresal) are used in the managment of spasticity in patients diagnose with cerebral palsy, what are the side effects of these medications?

Cerebral palsy

Selective dorsal rhizotomy (SDR) is a surgical transection of electromyography (EMG)- selected dorsal sensory rootlets with the goals of facilitating or maintain ambulation or improving ease of care. This procedure will be most likely performed in patients with:

An intensive strengthening program

A patient with cerebral palsy has undergone Selective Dorsal Rhizotomy (SDR) with the goal of maintaining ambulation. After surgery, when ambulation is the goal, an appropriate entry in the physical therapy plan of care includes:

Achilles tendon, hamstrings, iliopsoas, hip adductors

In the orthopedic management of CP lengthening procedures of muscles/tendons are performed to correct deformity or weak muscle(s) to prevent hip subluxation/dislocation. Which muscles/tendons are most often lengthened?

hip adductor transferred to hip abductor

In the orthopedic management of CP muscle transfers are performed to move/change the direction of force to increase function and decrease spascity. Which muscle transfer is most often done?

Spina bifida occulta

Defined as no spinal cord involvement, may be indicated by a tuff of hair, dimple or sinus

Spina bifida cystica

Defined as when the neural tube defect is visible or open lesion. This is called?

Meningocele

Defined as: type of spina bifida cystica, where cyst includes cerebrospinal fluid; cord intact

Myelomeningocele

Defined as a type of spina bifida cystica, where cyst includes cerebrospinal fluid and herniated cord tissue

talipes equinovarus (club foot)

What foot deformity is most likely seen in Spina bifida with neural tube defects at the level of L4-L5?

Myelodysplagia/Spina bifida

Defined as a neural tube defect resulting in vertebral and/or spinal cord malformation

Reciprocating gait orthosis (RGO)

Patients with myelodysplegia at high lumbar levels exhibit paralysis or weakness of hip flexors. what type of orthotic is the only one that makes ambulation possible?

Bowel and bladder dysfunction

Patients with myelodisplasia spina bifida with lesion at level L4-L5 results in what kind of GI dysfunctions?

C5-6

Brachial plexus injury called Erb's Palsy which cord segments involves?

C8-T1

Brachial plexus injury called Klumpke's Palsy which cord segments involves?

C5-T1

Brachial plexus injury called Erb-Klumpke (whole arm paralysis) Palsy which cord segments involves?

Erb's palsy

This characteristic in arm postion is seen in which brachial plexus injury?
- UE is in adduction, internal rotation of shoulder with extension of elbow, pronation of forearm and flexion of the wrist

Decreased shoulder girdle function with 1:1 humeroscapular movement

What functional limitations are observe in patients with Erb's palsy (C5-6) brachial plexus injury?

Decreased wrist and hand function

What functional limitation are observed in patients with Klumpke's palsy brachial plexus injury?

Klumpke's palsy

Upon examination it is observed the following
- lower arm paralysis, involving intrinsic muscles of hand, flexors and extensors of wrist and hand. which brachial plexus is this finding most consistent with?

Erb-Klumpke palsy

Upon examination it is observed the following
- Paralysis of the whole arm
Which brachial plexus injury is this finding most consistent with?

Instrinsic muscles of hand, flexors and extensors of wrist and fingers

With an Klumpke's palsy brachial plexus injury which upper arm paralysis may involve which muscles?

Erb's palsy

Upon examination it is observed the following
- paralysis of upper arm with possible involvement of: rhomboids, levator scapulae, serratus anteior, deltoid, supra/infra spinatus, biceps brachii, brachioradialis, brachialis, supinator, and long extensors of wrist, fingers and thumb
Which brachial plexus injury is this finding most consistent with?

Rhomboids, levator scapulae, serratus anterior, deltoid, supraspinatus,infraspinatus, biceps brachii, brachioradialis, brachialis, supinator, and long extensors of wrist, fingers, and thumb

With an Erb's palsy brachial plexus injury which upper arm paralysis may involve which muscles?

Moro's reflex, bicep's reflex, radial reflex, but grasp is intact

Physical therapy examination of pediatric population with brachial plexus injury what reflexes are likely not to be present?

Down syndrome

Which pediatric population this PT intervention is best described for?
- Avoid hyperextension of elbows, and knees during weight bearing activities
- Prognosis may be correlated with tone. lower tone = the more significant the motor delay
- impairment: Atlantoaxial subluxation/dislocation could possibly be due to laxity of transverse odontoid ligament

Infant Coma Scale

Evaluation of children/infant with TBI uses behavioral scales such as glasgow coma scale and Rancho los amigos scale to assess the child's orientation to time and place and the ability to respond to various stimuli. Which scale is used for non verbal infants?

Duchenne's Muscular Dystrophy

Which pedriatic population the follwing description is best described?
- An X-link recessive inherited by boys, and carried by recessive gene of mother. Lack dystrophin. this gene is missing which results in increased permeability of sarcolema and destruction of muscle cells.
- Collagen, adipose laid down in muscle leading to pseudohypertrophic calf muscles

Positive Gower's sign

Occurs in patients with diagnose with Duchenne's Muscular Dystrophy, and because of weak quadriceps and gluteal muscles, child must use upper extremities to "walk up legs" to rise from prone to standing. This is called:

heel cords, tensor facia latae and lumbar lordosis and kyphoscoliosis

Patients with Duchenne's Muscular Dystrophy develop contractions and deformities due to muscle imbalances. What areas are common for contractures and deformities

Duchenne's Muscular Dystrophy

Which pediatric population this PT intervention is best described for?
- Maintain mobility as long as possible by encouraging recreational and functional activities to maintain strength and cardiopulmonary function
- Maintain joint ROM through the use of active and passive ROM exercises, positioning devices such as prone standers or standing frames
- Gastrocnemius and tensor fascia lata shorten first
- ESTIM for younger children has bee able to increase contractile ability
- Do not exercise at maximal level (no strength training), may injure muscle tissue (overwork injury)

Respiratory insufficiency

The most likely cause of death of individuals diagnosed with Duchenne's Muscular Dystrophy is?

Supine stander

A child needs a stander to help with weight bearing experience and maintaining his hips, knees, ankles and trunk in optimal position, in addition to facilitate formation of acetabulum and aiding in bowel and bladder function. What kind of stander will be prescribed if more posterior support is needed?

Side-lyers

What kind of pedriatric adaptive equipment will help decrease the effects of Tonic Labyrinthine Reflex (0-6 months), and put the hands in visual field?

Steroids (prednisone)

A child has been diagnosed with Duchenne's Muscular Dystrophy. He has been prescribed antibiotics to fight pulmonary infections. What other medication is likely to be prescribed during the lifetime of this child to help increase life expectancy by decreasing pulmonary dysfunction?

Gastrocnemius

A child has been diagnosed with Duchenne's Muscular Dystrophy, is in need for orthopedic surgery to lengthen one of his muscles. which muscle is likely to be lengthened?

Ankle set at 5-10 degrees

AFOs are used to provide support to foot, ankle, knee to provide a stable base of support and reduce effects of spasticity and hypoextensibility of muscles. At what angle is the AFO set at the ankle to decrease genu recurvatum?

Tone reducing AFO

Which orthotic may present with the following benefits?
- Decreases the effects of spasticity, including sissoring by maintained stretch
- Stretches and maintains length of heel cord to prevent or lessen contracture
- provides good mechanical BOS for standing and ambulation

KAFO

Which orthotic may present with the following benefits?
- Used for standing or ambulation
- Knee may be solid at 0 - 5 ° flexion or hinged
- Used by children with spina bifida or muscular dystrophy

HKAFO

Which orthotic may present with the following benefits?
- Used for standing and ambulation
- Swing through gait
- Used by children with spina bifida or spinal cord injuries

RGO

Which orthotic may present with the following benefits?
- HKAFO with molded body jacket
- Cable system allows forward step with lateral weight shift
- Used by children with Thoracic level spinal bifida or spinal cord injuries

Pavlik harness

Which orthotic may present with the following benefits?
- Used for infants with congenital hip dysplagia (congenital or acquired deformation or misalignment of the hip joint)
- Hips are held in flexion and abduction to maintain femoral head in acetabulum

Pediatric Evaluation of Disability Inventory (PEDI) and/ or WeeFIM

Assessment of functional abilities during physical examination of patients with spina bifida is done by which two functional assessment tests?

Increased irritability,increased muscle tone, seizures, vomiting, bulging fontanels, headache, and redness along shunt tract

Signs and symptoms of shunt malfunction include:

Child requires fair (3/5) sitting balance and UE control

A child is going to be prescribed a scooter/three wheeler for mobility aid. What will be the minimum requirement in terms of balance and UE control in order to maneuver this mobility aid safely?

Forward walker or anterior rollator walker

Which mobility aid (walker) provides the following benefits?
- Encourages forward trunk leaning
- Provides maximum anterior stability

Posterior walker or postural control walker

Which mobility aid (walker) provides the following benefits?
- Encourage trunk extension
- Encourages shoulder depression, elbow extension, neutral wrist which may decrease scissoring in lower extremities

Babinsky reflex

Stroke the lateral aspect of the plantar surface of foot and get extension and faning of toes. What is this reflex called?

0-12 months

The Babinski reflex when does it become evident and when it should have been integrated?

Flexor withdrawal

It is a sharp, quick pressure stimulus to the sole of the foot or palm of hand, and get withdrawal of stimulated extremity. What is this reflex called?

0-2 months

When the flexor withdrawal reflex becomes evident and when it becomes integrated?

Cross extension

It is a sharp, quick pressure stimulus to the sole of the foot results in withdrawal of stimulated lower extremity and extension of the opposite leg. What is this reflex called?

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