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Case Smith Chapter 28

Terms in this set (59)

What is Cerebral Palsy?
Group of developmental disorders arising from non-progressive lesion or disorder of brain
Damage to one or more areas of brain resulting in paralysis, spasticity abnormal movement or posture
why is CP considered static?
not going to progress are get worse
true or false cp pattern of movement does not change over time
false :Pattern of motor impairment changes over time
Because CP is in the brain what areas can in affect?
cognition, sensation, communication,and perception, the development
Describe the movement pattern of CP
Limited smooth and lack of efficient motion
and Considered to have uncoordinated and inefficient movements of muscles of trunk/extremities
what isthe most prevalent cause of motor dysfunction in children
CP
what is the prevalency of cp
1 in 500 births or 3 in a 1000
is CP more common in males or females?
males by 1.5
how late can CP occur once the child is born>
2nd year
hypozemia
the cause of CP, lack of exygen
What are 4 pracitice models for children with CP?
1.motor control and motor learning concepts
2. dynamic systems theory
3. reflex-hierarchial model
4. MNRI method
Why is motor control and motor learning concepts used with children with CP
work on interaction of Interaction of child-task-environment
what is the reflex hierarchical model?
Motor development is based on CNS maturation→ reflexes are integrated as we develop
MNRI method
(masgutove neurosensorimotor reflex integration )

Motor reflex patterns play a subordinate role in the maturation of more complex motor reflex schemes→ some more simple reflexes are underlying more complex schemas when you integrate them you can improve functional movement
Integrating reflexes improves functional movement
postural mechanis.:
ability to develop repertoire of postures and change them easily during an activity integration of automatic and involuntary movement decision
what movements do those with CP rely on?
rely on primitive and automatic reflex movement patterns as primary means of mobility
muscle tension allows for what kind of movement
perform sequential movements
what age can hypotonia turn into hypertonia?
6 to 7 months
monoplegia
ne extremity-upper or lower is affected
hemiplegia
upper and lower is effected on one side
paraplegia
both lower extremities are effected
quadriplegia
all limbs
tetraplegia
all limbs including head and neck
spastic
hypertonia and muscle spasticity
dyskinetic
excessive and abnormal movement
athetoid
slow, writhing, involuntary, abrupt, irregular and jerky
choreoathetosis
constant fluctuations that are jerky and more proximal
dystonic
sustained twisted, triggered by movement and repetitive
ataxia
poor balance and coordination
mixe
uadriplegic or tetraplegics will have little tone in their neck and will have spastic extremities and hypotonic trunk or mixed with dystonia
limited proximal control, trunk and shoulder girdle effect a person with CP by
they are not moving it through full range bc they don't have the strength which then it becomes weak
synergistic patterns
moving both the flexor or extensor pattenrs
contractions, bone deformities, spinal misalignment, skin breakdown, respiratory issues, and strength and endurance are all what?
secondary impairments of cp
how can cp affect cognition?
by there being a lesion in the frontal lobe
what does the frontal lobe control?
affects cognition, attention, organization, problem solving, inhibition of inappropriate behaviors and judgement
what will the temporal lobe effect?
language and speech and also oral , facial, breathing, speech production, articulation, and intelligibility
how does CP effect quality of voice?
decreased strength and will also effect the control of respiration and the postural muscles
blindness , uncoordinated eye movements, and eye muscle weakness can occur due to what?
cp
trabismus
misaligned eye due to muscle imbalance
esotropia
drift nasally
hypotropia
drift downward
hypertropia
eyes drift upward
exotropia
eyes drip temporally
nystagmus and what does it cause?
constantly moving in repetitive uncontrolled way--> this leads to reduced acuity, reduced target accuracy,and compensatory head and posture movements
when assessing a child with cp you should look at what 6things
cognitive,perception, adls, motor, fine motor skills, psychosocial development
what is the goal of intervention with a child who has CP?
promote function and independence
how will casting and orthotics help a child with CP?
help to slowly increase range of motion of a joint, or maintain a position to maintain a movement to stay involved and independent in an activity that they are doing
how will constraint induced movement therapy help a child with cp?
constraint induced movement therapy: constrain so the child has to focus on using the impaired side
how does adaptive equipment training help a child with cp?
Help with ADLS, IADLS, play and education
and matches motor needs with sensory function, environment, and child's position during use
what should you always do in conjunction to splinging?
use active therapy
improving hand function, preventing joint contractures, improving hygiene, relieving pain, reducing self injuries,and improving performance for children with cp are all done wtih:
splinting and orthotics
how long does splinting or a cast need to be applied for to be effective?
longer than 6 hours
What is developmental disreguard?
because they were born or this occured when they are young, the diagnoses taught them to learn their affected extremity does not work as well and they stopped using it→ will work better with exposure and practice
Three Essential Features
how long should cimt be done for?
3 to 6 hours a day over consecutive days (2 to 3 weeks) ; natural setting, shaping techniques (engaged in play that is fun or use positive reinforcements): combined with less than 3 hours a day of therapy→ use of bilateral play is important to do once this therapy is done → there is a carry over!
what is electrical stimulation?
electrical stimulation in muscles to strengthen antagonist muscles this can re-educate the muscles, target pain reduction, improve coordination, increase ROM, and reduce spasticity
what is rigid taping
limiting movement and protecting the joint
Prosthetic
Assistive device for functional tasks
Therapeutic for repetitive movement pattern
Connected to computer are all what ?
robotics than can help with cp
baclofen
educe spasticity it can be oral or a pump
botox
educe tone- injected into muscle
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