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Flashcards in [MND] Cerebral Palsy Deck (19):

Epidemiology: Cerebral Palsy

2 to 2.5 / 1000 live births in NZ

Approximately 7000 people have a degree of cerebral palsy in NZ (1/3 are under 21 years old)


Pathophysiology of CP?

The initial neurological lesion the child sustains is non-progressive as it remains unchanged; however the effects of the lesion on other systems such as the musculoskeletal system can be progressive


The clinical presentation of Cerebral Palsy is dependent on

The area and extent of the CNS affected



A reduced life expectancy (90% survival rate into teens and 20s)

Immobility and severe learning difficulties are considered influencing factors


Ataxic Cerebral Palsy?

@ the cerebellum
- Affects 5-10% of the cases
- Characterised by low muscle tone and poor co-ordination of movements
- Affects the sense of balance and depth perception (resulting in poor co-ordination, unsteady, wide based gait)


The Gross Motor Function Classification System (GMFCS) is an outcome measure for..

cerebral palsy; it is a classification tool with five levels based on the child’s ability to perform gross motor skills and assistance required when mobilising in a variety of conditions (i.e. stairs, distances, altered terrain)


Cerebral Palsy can be described as

A group of disorders primarily affecting the development of movement and posture causing limitation of activity


In CP, what percent does hemiplegia account for?



Dyskinetic Cerebral Palsy is a lesion located @? What are the movements like?

The basal ganglia (10-20% of cases)
Movements are uncontrolled, purposeless, slow, writhing movements



Based on patient history and physical examination. CT and MRI can be useful when the aetiology (cause) has not been established


Constraint-Induced movement therapy can improve functional ability in the affected upper limb and aid cortical reorganisation and can be useful for



What are some causes / risk factors for CP?

Multiple Pregnancy (i.e. twins/triplets)
Low and very low birth weight (50% of cases, 30% increase in risk)
Vascular Accidents
Damaged placenta
Foetal malformation syndromes


About 10% cases of CP is 'Mixed Cerebral Palsy' which means

Several areas of the brain are involved


Spasticity in the arm, leg and trunk on one side, underdevelopment of the affected side (smaller limbs/leg shortening), equines of foot and ankle, flexion of elbow, wrist and fingers

All this sounds like what kind of CP?

Spastic Hemiplegia


In CP, symptoms are developed before or during the...

First year of birth


Orthotics can be used to ....
What are a some types of CP this might be useful for?

maintain leg length, prevent further deformity, improve joint alignment, improve biomechanics and function
(can be useful for spastic diplegia / hemiplegia / quadriplegia)


Lesion locations of CP

Premotor / motor cortex = Spastic

Cerebellum = Ataxic

Basal Ganglia = Dyskinetic


What guidelines can we use for strength training for CP?

ACSM guidelines - 3x8-12 reps; 2x a week; light to moderate load


What are the guidelines for Serial Casting and what is it effective for?

Effective in lengthening shortened muscles

Guidelines: short periods, frequent reapplication over 6 weeks