Peds treatment considerations

d

evidence-based practice should consider

a. evidence

b. experience

c. patient preference

d. all of the above

development

maturation of physical & neuronal structures + environment + practice

cognitive

lack of _____________ maturity limits information processing, attention span, and verbal learning

more

children need more/less feedback than adults

c

research supports:

a. blocked practice

b. random practice

c. mixed research

goal

motor control - ___________-oriented approach:

→each system is contributing and interacting based on the demands of the task within the environment

→movement patterns vary

→patient encouraged to find multiple strategies to accomplish a goal

→self-initiated movement

→uses principles of motor learning

practice

more ___________ = improved performance

cerebral palsy (CP)

kids with this diagnosis need concrete instructions and careful feedback/knowledge of performance

information processing

___________ ____________ perspective:

stimulus → input → stimulus identification (perception) → response selection (decision) → response programming (action) → output → movement

-every stage affected by memory and attention

d

in the information processing perspective, which is/are influenced by memory and attention?

a. stimulus identification

b. response selection

c. response programming

d. all of the above

dynamic systems

___________ _____________ perspective:

→problem solving

→finding a coordination strategy to execute a motor task

→interacting systems

→self-organizing

movement

movement/action is a coordinated pattern of motion (part of a task)

action

movement/action is a whole task

coordination

organization of body segments into a behavioral unit

control

__________ parameters: at what threshold do you need to change what you're doing?

stability

resistance to change in movement patterns

constraint

characteristic of person/task/environment that limits movement options

activity

________-focused intervention:

→goal oriented practice of functional activities

→structured practice and repetition with consideration of the constraints of the task, person, and environment

→PT = change agent

goals

1. develop activity-related ___________

2. plan activity-focused interventions

3. integrate impairment-focused interventions

t

t/f always assume the child is cognitively age appropriate until you know otherwise

a

the PCATT model uses this approach

a. family centered

b. child centered

c. school based

d. technique based

e. theory based

b

desperate medical situations use this approach

a. family centered

b. child centered

c. school based

d. technique based

e. theory based

closed

for babies, use open/closed chain strengthening (use normal development as a guide)

-use facilitation

many

infants need many/few breaks

cerebral palsy (CP)

strengthening for children with __________ ____________:

→handling

→alignment

→sustained holding - postural control

→cardiovascular while minimizing wear and tear

→biofeedback

→work in the mid ranges

→eccentric control

→non-ballistic movements

→along with elongating shortened muscles, strengthen and shorten the over elongated muscles

→use handling and observation to determine which muscles they are using

→create positions/tasks that minimize the ability to compensate (slanted benches/stance boards, movable surface, tape/splints)

mid

for CP, strengthen in the end/mid ranges

non-ballistic

for CP, strengthen with ballistic/non-ballistic movements

c

for CP:

a. elongate shortened muscles

b. shorten elongated muscles

c. both

d. neither

eccentric

for CP, focus on concentric/eccentric control

head pod

the _______ _________ can be attached to many devices for traction/unweighting of the head for GMFCS V & severe hypotonia

movable

stable/movable surfaces

→challenge person to activate multiple muscles in various combinations

→multitasking exercise

→stimulates sensory system

→core stabilization

→create a different movement strategy

biofeedback

______________ gives children the feedback they are lacking (works very well for children of various cognitive levels)

→strengthening - they work harder

strong

there is strong/conflicting/insufficient evidence for serial casting for muscle elongation

f

t/f there is evidence that stretching and positioning alone are effective for muscle elongation

infant massage

__________ __________ is a method of teaching parents to massage their infants

-muscle elongation

-body awareness

-decreased constipation

-calming

-bonding

central pattern generators (CPGs)

the theory behind partial weight bearing treadmill training is based on __________ __________ ____________

→allows repetition, increased speed, and gradual balance control challenges

→Lite Gait and Walkable can also be used for standing and sitting

younger

e-stim should have a lower rate for younger/older children

symmetrical

starting point for e-stim for children

→rate for infant/young child 2-10 pps, 30-50 pps for older

→assess tolerance

→on/off 10-15

→symmetrical/asymmetrical waveform

→duration 350

→amplitude to desired contraction level or tolerance

spina bifida

electric stimulation is a must for this diagnosis - more is better

hippotherapy

____________ and aquatics are good for

-strengthening

-postural control

-motivating

-different sensory experience

constraint

__________ induced movement therapy

-hemiplegia and brachial plexus injuries

-cast placed on "typical" arm

-forces child to use involved side

-alignment & strength critical (NMES, Botox, splints)

-physical & social/emotional prep

home

________ program ideas

→work with the family to determine what and how much they can do

→help child be as independent as possible

→work within their cognitive ability

→multitasking exercises/stretches

→cardiovascular