Cerebral Palsy

Cerebral palsy - occurs from? when?

Cerebral palsy - Affects?

Cerebral palsy - Co-morbidities:

Cerebral palsy - Classification is based on?

Is CP progressive?

non--progressive

While the original brain lesion does not change, there may be symptom changes over time including:

CP - etiology

CP - dx

CP - early on sx

CP Diagnosis

• Not typically until?

• Type of Imaging:

What is death of the white tissue around the ventricles called?

PVL

What causes an increased risk for PVL

IVH

What is bleeding in the ventricles called?

PIVH

What is the fluid filled space near the ventricles

PVC

PVL or injury to white matter around the ventricles causes?

spastic diplegia

Classification

• Spastic CP - comes from damage to?

Classification

• Dyskinetic CP - comes from damage to?

Classification

• Ataxic CP - comes from damage to?

Spastic CP

• is it velocity dependent?

• Affected limbs?

Type - Diplegia

Affected limbs?

Common causes?

Type - Hemiplegia

Affected limbs?

Common causes?

Type - Quadriplegia

Affected limbs?

Common causes?

Type - Triplegia

Affected limbs?

Common causes?

Varying tone with involuntary uncontrolled recurring movement

Dyskinetic CP

What symptoms do you see with ataxic CP

GMFCS

• Based on self-initiated movement in 3 domains?

• Also includes the need for?

• Based on __ performance

• __ scale

GMFCS

• Age bands

Level 1

Level 2

Level 3

Level 4

Level 5

GMFCS Distinction Between Levels - level 1

• Difficulty with?

GMFCS Distinction Between Levels - level 2

• Difficulty with?

GMFCS Distinction Between Levels - level 3

GMFCS Distinction Between Levels - level 4

GMFCS Distinction Between Levels - level 5

Image

GMFCS & GMFM

• Levels 1 & 2: Do GMFM scores demonstrate a functional decline?

• Levels 3-5: GMFM scores peak at age ___ and then decline

GMFM Review

• __ referenced

• Age?

• __: barefoot

• __: aids, AD, orthoses

Crouched gait

Jump gait

• Ankle equines in ___

• Increased hip and knee flexion in __

Equinous gait

• Ankle equines with…

Apparent equinous

• Normal ankle ROM with…

Idiopathic toe walking

• Have a ___ contracture

• Minimal to no __ tightness

• Increased __ in stance

• Increased __ of foot

Modified Ashworth scale

For muscle tone — not same grade for whole body

If modified Ashworth scale is not specific enough and need to classify it further, use?

HAT

less subjective

Gross motor skills goal

Infancy goals

Postural stability - sitting ability leads to?

Ultimate goal

GAME

• includes?

• Want to do - Functionally relevant cognitively engaging __ practice

EBP

• GAME for which subtypes?

• CIMT for which subtypes?

• Why???

Interventions?

• PROM?

• What is BWSTT

• __ activities and stretching

• Serial casting and stretching?

• __ and balance therapy

• __ surveillance

GMFCS level IV and V

• Early continuous postural management for?

Preschool interventions

• Muscles need?

• Bones need?

• GMFCS levels III, IV, V

  • Goal is to?

Children respond best to what kind of instruction

Posterior walker

• pros

Powered mobility

• can you use powered mobility & gait training?

YES

Stoplight Article: 2019

look at good vs bad things, don’t memorize chart in PPT

It classifies things as red, yellow, green (like stop light) based on amount of research and if the research shows it affective

Don’t do it: hyperbaric oxygen, NDT

Green: mobility & task specific training, surgeries, medications

Botox

• Blocks nerve impulse at?

• Peak at?

• Muscle inactivated for up to?

Selective Dorsal Rhizotomy

Predictor of good outcome after SDR ?

Can’t use SDR if?

What happens after?

Selective Dorsal Rhizotomy - test nerve roots and clip the ones that contribute to spasaticity

Pharmaceuticals

Ortho management

Seizure management

Prognosis

• Motor abilities that indicate a potential for future walking?

Prognosis

• What predicts walking

Negative walking prediction

Bone health

• Pre-term infants

  • When stable - we want to?

Bone health

• Bone responds to __ loads

  • Short burst of?

  • Loading can be short or long?

  • Rests between loading doses?

  • How many months is needed for entire bone process?

Hip surveillance

• Monitoring for?

• Most important for which GMFCS levels?

• Are all levels monitored?

• Monitored how often?

• Until??