Cerebral Palsy

Question 1

What is CP?

Answer 1

group of permanent disorders that affect development of posture and movement

Question 2

CP leads to —— limitations that are the result of

Answer 2

activity limitations that come from non progressive brain disturbances on brain

Question 3

BEFORE 5 months use these tools to diagnose CP

Answer 3

GMA > Hine > MRI
most to least sensitive

Question 4

AFTER 6 months use these diagnostic tools

Answer 4

Hine and MRI ( 90%)
developmental assessment
don’t use GMA after 6 months

Question 5

3 tool used for diagnosis of CP

Answer 5

GMA, HINE, MRI

Question 6

What is Dyskinesia

Answer 6

uncontrolled and involuntary movements
includes athetosis, rigidity and tremor

Question 7

What is Athetosis ? 4 long characterisitcs

Answer 7

1. abnormal timing, direction and spatial characteristics
2. impaired postural stability
3. abnormal coordination in reversal of movement and latency of onset of movement
4. oral-motor dysfunction

Question 8

Athetosis impact on MSK system?

Answer 8

1. joints may be hypermobile
2. significant asymmetry
3. frequent TMJ issues

Question 9

Which tool best has the best combination of sensitivity and specificity for predicting CP in the EARLY months

Answer 9

Prechtl’s Assessment of General Movements

Question 10

These 2 tools diagnose the CP as infants age

Answer 10

AIMS and NSMDA

Question 11

What is the one of the most common MSK abnormalities children with CP present?

Answer 11

hypertonicity or spasticity 75%

Question 12

ataxia MSK implications

Answer 12

1. rely on ligaments for balance
2. rely on vision for balance
3. Postural insecurity

Question 13

Hypotonia- which is favored fl or ext. ?

Answer 13

extension

Question 14

Hypotonia MSK implications

Answer 14

1. stability gained through end range
2. contractures
3. rib cage at risk to become flat ( decreased resting tone + gravity)

Question 15

muscles at risk for contracture

Answer 15

shoulder adductors, elbow, wrist and finger flexors,
hip flexors and adductors, knee flexors, ankle plantarflexors

Question 16

Key predictors of reduced life expectancy- 2 things

Answer 16

1. lack of mobility
2. difficulty feeding

Question 17

By what age will 90% of children with CP reach motor potential for LEVEL 5

Answer 17

3 years old

Question 18

By what age will 90% of motor potential reached
LEVEL 1

Answer 18

5 years old

Question 19

Poor prognosis for ambulation- 2 things

Answer 19

rigidity,
persistent tonic neck reflexes

Question 20

• 3 reasons for subluxation in hip

Answer 20

1. lack of changes in the neonatal hip( too great an angle of inclination, shallow acetabulum)
2. lack of LE weight bearing in multiple positions
3. muscle imbalance (hip adductors more active than abductors, contracture of hip flexor)

Question 21

** children at risk for hip dysplasia need to do this

Answer 21

1. stand in abduction (15-30 degrees) and neutral hip flexion
2. Maintain excellent biomechanical alignment especially of head and spine

Question 22

GMFCS 2
dosage
when to use stander
type of stander

Answer 22

when:
9-12 months until onset of indep ambulation
7-8 or when ROM decreases
dosage:
3Xweek for 45 min
Type:
Upright, sit-to-stand or self propelled

Question 23

GMFCS 3
when to use stander
dosage
type

Answer 23

when to use: 9-12 through age 5,
7-8 if ROM decreases,
15 if crouch gait appears
dosage: 5 x / week , 60 to 90 mins
type: prone, sit-to-stand or self propelled

Question 24

GMFCS 4 and 5
when to use stander
dosage
type

Answer 24

when: 9-12 throughout adulthood
dosage: 5Xweek for 60-90 min/day
Type: prone or supine