Lecture 3 (CP Treatment)

What is the FSA?

• What is it used for?

• Functional Strength Assessment

  • Estimated Muscle Group Strength

What is the ECAB?

• What is it used for?

• Early Clinical Assessment of Balance

  • Static Head & Trunk Control

  • Sitting & Standing Control

What is the most significant factor in cerebral palsy mortality?

• Respiratory Disease

In severe CP, when might hip dislocation be seen?

• 2-3 yrs

In severe CP, when might scoliosis be seen?

• 5-6 yrs

In severe CP, when might windswept hips be seen?

• 10 yrs

How many severe CP adults have 1 sleeping position?

• 50%

What CP meds are best for spasticity reduction?

• Of these, which one is considered first line?

• Of these, which one is considered off-label?

• Baclofen

• Diazepam

• Dantrolene

• Tizanidine

• Botox

How long does a botox injection typically last for CP spasticity?

• What part of the body do these injections show best results?

• 6 mos - 2 yrs

  • Best: LEs

What could abrupt discontinuation of most CP meds result in?

• Withdrawal Syndrome

  • Rebound Spasticity

  • Seizures

What is the benefit of serial casting in CP?

• How long are nighttime splints used?

• Short-Term Reduction Of Mild Contractures

  • Nighttime Splints - Minimum 6 Hours

What do CP surgeries most commonly target?

• Alteration Of LE Function

  • Considers: Pain Relief & WB

What is the goal standard tx plan for increasing ROM in CP?

• Of these, which is most beneficial for hip joint remodeling?

1. Postural Management

2. Standing Programs

3. Hip Surveillance

4. Mvmt w/ WB

Those with severe CP (GMFCS IV-V) should start a 24 hour postural management process. How does position change in different stages of life?

• Program Should Include:

  • Lying - Immediately

  • Sitting - 6 Months Old

  • Standing - 12 Months Old

Those with severe CP (GMFCS IV-V) should have a standing program using standers. How long should they be standing for different benefits?

• 5 days/week, for:

  • 30-45 Min - Spasticity Decrease

  • 60 Min - Hip Stability Increase

  • 60-90 Min - Bone Density Increase

What is a BWSTT?

• Who can it be for?

• What are protocols?

• Body Weight Supported Treadmill Training

  • For: DS, CP, & SCI Patients

  • Protocol For Use:

    • 2-5 days/week

    • 5-30 minutes/day

    • At 0.05 - 3 mph

What is “For All” Therapy?

• What is the benefit?

• A Focus On Task-Based, Functional Activities

  • Benefit: Self-Generated Active Movement

What is CIM Therapy?

• What is the benefit?

• Constraint-Induced (Of Non-Involved) Movement Therapy

  • Benefit: Enhances Impacted UE Function (In Hemiplegia)

What is the “power 3” for CP treatment types?

• Goal-Directed Training

• Aquatic Therapy

• Hippotherapy

How much of max effort should typical CP exercise entail?

• <30% 1RM (For Maintenance)