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Kin 187 > Neuromuscular condition 1: Cerebral Palsy > Flashcards

Neuromuscular condition 1: Cerebral Palsy Flashcards

1
Q

What is cerebral palsy

A

Group of common childhood onset neurological motor disorder due to permanent disturbances in the developing fetal or infant brain

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2
Q

Cerebral palsy is ______, but _______

A

Permanent but NON progressive

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3
Q

What is the cause of cerebral palsy

A

Abnormal development or damage to brain during fetal development or early infant life

Damages include:
White matter
Basal ganglia lesions
Cortical and subcortical lesions
Brain malformations
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4
Q

What are the different types of cerebral palsy

A

Spastic cerebral palsy

Ataxic cerebral palsy

Athetoid/dyskinetic cerebral palsy

Mixed cerebral palsy

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5
Q

Spastic cerebral palsy is

Occurs due to:

Causes:

A

Most common (around 70%)

Occurs due to damage in upper motor neuron lesion, motor cortex

Causes muscle tightness/stiffness

Hypertonic

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6
Q

Ataxic cerebral palsy

Occurs due to:

Causes:

A

Occurs due to damage to cerebellar structures

Causes problems in coordination, poor balance

Hypotonic

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7
Q

Athetoid/dyskinetic cerebral palsy

Occurs due to:

Causes:

A

Occurs due to damage to basal ganglia

Causes problems in control of muscle ton, involuntary, uncontrolled movements

Both hyper and hypotonic

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8
Q

What are the characteristics of cerebral palsy

A

Abnormal development of movement and posture

Difficulties with thinking, learning, feeling, communication and behavior

Spasticity, spasms, involuntary movements

Musculoskeletal impairment: abnormal muscle tone, reflexes, coordination

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9
Q

The gross motor functioning classification system for cerebral palsy has

A

5 levels

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10
Q

Level 1 of gross motor functioning classification system for cerebral palsy

A

Walk and runs without support

Coordination, speed and balance reduced

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11
Q

Level 2 of gross motor functioning classification system for cerebral palsy

A

Walks without support

May use support in some situations

Difficulty running

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12
Q

Level 3 of gross motor functioning classification system for cerebral palsy

A

Walks with support

Often uses wheeled mobility for commuting

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13
Q

Level 4 of gross motor functioning classification system for cerebral palsy

A

Uses powered mobility or pushed mobility for most mobility needs

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14
Q

Level 5 of gross motor functioning classification system for cerebral palsy

A

Transported in wheelchair for all mobile situations

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15
Q

What are the clinical problems for cerebral palsy

A

Motor impairment

Causes:
Bone deformity
Contracture
Muscle atrophy
Osteoporosis

Obesity
Hypertension
Dyslipidemia

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16
Q

What does the bone deformity, Contracture, Muscle atrophy and Osteoporosis as a result from motor impairment lead to

A

Falls and fractures

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17
Q

What does the obesity, hypertension and dyslipidemia as a result from motor impairment lead to

A

Cardiovascular/metabolic diseases/cancer

18
Q

What happens earlier in cerebral palsy compared to general population

A

Aging effect

Muscle weakness and atrophy

19
Q

In cerebral palsy patients what is there a high rate of

A

High rate of incidence of falls

Due to:
Low muscular strength
Low functional mobility
Deficits in postural stability

20
Q

Chain of Clinical problems associated with Osteoporosis

A

Low bone mineral density

Fragility fracture

Immobilisation

Lower bone mineral density
Muscle weakness

Functional and physical limitation

21
Q

What are the medications that treat and manage cerebral palsy

A

Improve ADLs

Anticonvulsant medication

Antispastic medicine

22
Q

What are the surgeries that treat and manage cerebral palsy

A

Selectjve dorsal rhizotomy surgery - reduction in spasticity

Orthopedic surgery - posture and balance improvement

23
Q

What are the mobility related equipment that treat and manage cerebral palsy

A

Ankle foot orthoses

Canes, crutches or walkers

Manual/powered wheelchairs

24
Q

What is the exercise response to cerebral palsy

A

Very limited information based on research

An increase in energy expenditure for a given external work rate

A reduction in peak aerobic capacity

25
Q

Bipedal locomotion is disrupted which causes what

A

Reduction in walking efficiency

26
Q

The energy required to walk _______ and the aerobic economy of walking is ________

A

Increased

Decreased

27
Q

What is the recommendation for exercise testing for cerebral palsy

A

Basic CDD4 recommendations for class level 1

People with class level 2 - 4 may need individualised adaptive measures

Functional mobility testing is preferred with class 5

28
Q

What are the goals of exercise programs for cerebral palsy

A

Maintain mobility

Increase physical activity

Counteract a sedentary lifestyle

Reduce the physical and time burdens on cargivers

Improve quality of life

29
Q

Exercise programming for cerebral palsy consists of

A

Basic CDD4 as start

FITT not set

Adaptations dependent on age and class level

Most work toward a 150 minutes per week

Flexibility exercise should be performed daily

Consider upper limb strength with adaptions where applicable

30
Q

Benefits of exercise for people with cerebral palsy

A

Not much research done

Stretching is most common
Aerobic provides some physiological benefits
Resistance strength exercise can be helpful

Improves sense of wellness
Increased capacity to perform daily activities
Lessen severity of symptoms

31
Q

Resistance training in cerebral palsy can help

A

Skeletal health

Muscular health

Functional mobility

32
Q

Hypotension is one of the secondary systemic injury in spinal cord injury

A

True

33
Q

After acute spinal cord injury, neurons and cells go through cellular alterations, such as neutrophils and anti-inflammatory cytokine releases

A

False

34
Q

After spinal cord injury, patients typically go through cycle of deconditioning with low physical activity leading to high risk factors and chronic diseases, and get worse. =

A

True

35
Q

Decreased cardiovascular performance may be found in individuals with complete spinal cord injury above T6 because they have no cardiac sympathetic innervation which can limit peak heart rate to ~130 bpm

A

True

36
Q

Spastic cerebral palsy is the most common type of cerebral palsy affecting 70% of population with cerebral palsy

A

True

37
Q

Musculoskeletal impairment is a typical characteristic of cerebral palsy

A

True

38
Q

According to Gross Motor Function Classification System (GMFCS), level IV and V indicate the individuals with cerebral palsy use methods of mobility that require physical assistance or powered mobility

A

True

39
Q

For patients with cerebral palsy, GMFCS level I-III can go through exercise testing using 6 min walk test

A

True

40
Q

One of the characteristics of ataxic cerebral palsy is ____

A

Problems in coordination

41
Q

_______ is a secondary clinical problem with individuals with cerebral palsy

A

Oesteporosis

Diabetes mellitus

Cardiovascular disease

Obesity

Kin 187 (21 decks)

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