CP treatment, goals, ADs

unofficial CPG

task specific training

strength training

treadmill training

mobility training

tape and elastic garments

what demographic benefits most from task specific training

younger children

cons of task specific training

transferability between tasks can be limitied

how ling should strength training last

40-50 min sessions

key component of strength training for CP

increase time of rest interval

how beneficial is strength training

can increase muscle mass up to 27%

purpose of body weight supported treadmill training

improves walking velocity and gross motor function

purpose of non-supported treadmill training

increases endurance and strength

What is included in mobility training

AD training

walking

stairs

quad crawling

purpose of tape/elastic garments

facilitate postural control to improve dynamic activities

process in the creation of goals

1. what changes need to made to the environment

2. decide what needs to occur in order to achieve goal

3. total amount of time to practice

4. identify strength needed specific to goal

5. address all components of the ICF

6. QoL

What should be our goal w/ evey patient

education

encouraging mvmt in any way

goals specific to GMFCS 1-2

progression through developmental sequence

goals specific to GMFCS 3

head control

goals specific to GMFCS 4 and 5

postural equipment needed for eating, sitting, sleeping, standing

treatment ideas for infants

importance of everyday handling

movements across all planes

encourage full lengthening of muscles

mix of handling/facilitation and self directed movement

what is preschool age

3-5y

goals in preschool

• manage the primary impairments and prevent secondary

• maintain/regain mobility through active mvmt

• WB

• comfortable supports in dif postures

When might activity and participation limitations be more obvious to patients

preschool

options for preschool mobility

adaptive trike

power mobility

manual WC

strollers

goals of school age/adolecents

• secondary impairments

• teaching others how to help them

• efficient mobility

• education plans

• child’s goals

• encourage PA

at what age do children w/ CP reach CM capacity

5 y

PT goals for transitioning to adult

maintain function

prevent deterioration

achieve optimal independent living

treatment for hypotonia

WB

deep pressure through joints

treatments for hemiplegia

• AFOs, stretching

• bilateral use

• crossing midline

• WB

treatment for Diaplegia

ROM through stretch, casting, AFOs

trunk control/posture

hip/LE strengthening

motor control of LEs

treatment for quadriplegia

slow rhythmical rotation

stretch/ROM maintenance

trunk and head control

WB

standing protocol

strengthen through mvmt

treatment for ataxia

balance and protective rxns

proximal stability

proprioception input (weighted vest, ankle weights)

learn how to fall

treatment for athetoid

hold posture

control/direct mvmt

WB

benefits of stander

• LE strength/ROM

• endurance and CV health

• bone density and prevent fxs

• hip stability

• pressure sores

• circulation

• breathing

• constipation

• urinary function

• hand use

• self esteem and social interaction