Cerebral Palsy

Question 1

Cerebral Palsy Statistics

Answer 1

2.1 out of 1000 live births

most common childhood disability (1-323 identified in the US)

Question 2

What is Cerebral Palsy

Answer 2

Group of common childhood-onset neurological motor disorders due to permanent disturbances in the developing fetal or infant brain
Permanent but non-progressive

Question 3

Cause of CP

Answer 3

abnormal development or damage to brain during fetal development or early infant life
white matter, basal ganglia lesions, cortical and subcortical lesions, and brain malformations

Question 4

Spastic CP

Answer 4

most common (70%)

• damage in upper motor neurton lesion, motor cortex
• muscle tightness/stiff
• hypertonic

Question 5

Ataxic CP

Answer 5

classified by

• damage to cerebellar structures
• problems in coordination/poor balance
• hypotonic

Question 6

Athetoid/dyskinetic CP

Answer 6

classified by

• damage to basal ganglia
• inability to control muscle tone, involuntary, uncontrolled movements
• both hypertonic and hypotonic

Question 7

Characteristics of CP

Answer 7

• abnormal development of movement and posture
• difficulty with thinking, learning, feeling, communication and behavior
• spasticity, spasms, involuntary movements
• musculoskeletal impairment: abnormal muscle tone, reflexes, coordination

Question 8

GMFCS 1

Answer 8

walks and runs without support by coordination, speed and balance are reduced

Question 9

GMFCS 2

Answer 9

Walks without support but may use support in some situations, difficulty running

Question 10

GMFCS 3

Answer 10

Walks with support

Often uses wheeled mobility in the community

Question 11

GMFCS 4

Answer 11

Uses powered mobility or is pushed in a manual chair for most mobility needs

Question 12

GMFCS 5

Answer 12

Transported in a wheelchair for all mobility situations

Question 13

Motor Impairment leads to

Answer 13

bone deformity, contracture, muscle atrophy, osteoporosis
and
obesity, hypertension and dyslipidemia

Question 14

bone deformity, contracture, muscle atrophy, osteoporosis lead to

Answer 14

falls/fractures

Question 15

obesity, hypertension and dyslipidemia lead to

Answer 15

cardiovascular/metabolic diseases/cancer

Question 16

Muscular Atrophy

Answer 16

Aging effect on musculature earlier than general population
Leads to a high rate of incidence of falls
because of low muscular strength and function, low functional mobility, and deficits in postural stability

Question 17

Osteoporosis

Answer 17

Low bone mineral density> fragility fracture> immobilization > lower bone mineral density muscle weakness > functional and physical limitation

Question 18

osteoporosis in CP

Answer 18

Greater severity in osteoporosis, fracture vs. fragility fracture, physical limitation and mortality

Question 19

Medications for CP that improve ADL’s

Answer 19

Anticonvulsant medication
Antispastic Medicine
Selective dorsal rhizotomy surgery
Orthopedic Surgery

Question 20

Orthopedic Surgery

Answer 20

improves posture and balance

Question 21

Selective dorsal rhizotomy surgery

Answer 21

Reduction in spasticity

Question 22

Antispastic Medicine

Answer 22

Antipasmodic

ex. botulinum toxin (botox)

Question 23

Anticonvulsant Medication

Answer 23

antiseizure, antiepileptic

Question 24

Therapy

Answer 24

• physical/movement therapy

- occupational therapy

Question 25

Mobility-Related Equipment

Answer 25

Ankle Foot Orthoses Canes, crutches or walkers Manual or powered wheelchair

Question 26

Exercise Response

Answer 26

Not a lot of information based on research There is an increase in energy expenditure for a given external work rate -bipedal locomotion synchronization is disrupted, causing reduction in walking efficiency -the energy required to walk is increased and the aerobic economy of walking is decreased Reduction in peak aerobic capacity

Question 27

Testing for GMFCS level V

Answer 27

functional mobility testing is preferred

Question 28

People in GMFCS 2-4

Answer 28

might need individual adaptive measures

Question 29

GMFCS 1

Answer 29

Basic CDD4 recommendations may be appropriate

Question 30

Goals of exercise program

Answer 30

maintain mobility increase PA counteract a sedentary lifestyle that predisposes to cardiovascular and metabolic diseases reduce the physical and time burdens on caregivers improve quality of life

Question 31

Exercise programming

Answer 31

stat with CDD4 FITT not set Adaptations for aerobic activities are necessary (level 2-4) goal of 150 min a week Flexibility Exercises daily upper-limb strengthening with adaptations: contraindicated in level V children or adults

Question 32

Aerobic Benefits of Exercise

Answer 32

some physiological outcomes

Question 33

General Benefits of Exercise

Answer 33

- improved sense of wellness, body image - increased capacity to perform activities of daily living - lessen the severity of some symptoms (spasticity and athetosis)

Question 34

Resistance benefits of exercise

Answer 34

- bone mineral density - strength and endurance - balance