Outcome Measures/Labs

Question 1

GMFCS- what is it for? What are the levels?

Answer 1

Cerebral palsy classification system

Level 1- walks without limitations
Level 2 -walks with limitations
Level 3- walks with handheld device
Level 4- self mobility with limitations, power wheelchair may be used
Level 5 - power wheelchair/dependent/mobility severely limited

Question 2

GMFM

Answer 2

Gross motor function measure

• Observational
  
  • Can do the 88 or 66 question version
• Measures gross motor function over time
• Ages 4 months to 16 years
• Takes 45-60 minutes to administer (88) or 20-30 minutes (66)
• Promotes reaching and developmental milestones

Question 3

Assessment of Trunk Control

-what is it for?

Answer 3

quick and easy postural assessment

• Static, Active, Reactive trunk control
  
  • Child strapped to bench
• Ideal to administer with 2 people
• Ages 6-8 months
  
  • Trunk control develops here
• Helps assess fall risk, and amount of support as well as postural control
• Takes 15-20 minutes to administer

Question 4

Child and Adolescent Scale

Answer 4

-survey for developmental status

• Administered by parent/admin
• Survey of broad activities
  
  • Home, neighborhood, school, and community
• Age of at least 5
• Helps ID participation and activity limitations
• Takes 10 minutes to complete
• Will help you to determine developmental status and what to focus your interventions on

Question 5

HAT

Answer 5

Hypertonia Assessment Tool

• Classifies hypertonia progression over time
• Consists of 7 items that help determine type of hypertonia present
• Ages 4-19 years
• Takes 20 minutes (5 minutes per limb)
• Less effective if dystonia + spasticity present
• Not commonly used but very helpful

Question 6

SCALE

Answer 6

selective control assessment of the LE

• Tests for normal, impaired, unable movements in LE
• There is no age range – child must be able to follow simple commands
• Takes 15 minutes to administer
• Assists with ROM and synergy goal planning

Question 7

MCHAT

Answer 7

questionnaire for parents to fill out/looks at autism

• Ages 16-30 months
• Helps determine risk for Autism
  
  • Helps ID behavioral issues associated with ASD
  • Helps to inform a subj interview
  • Could help with intervention planning
• Takes less than 2 minutes to admin

Question 8

SAROMM

Answer 8

Spinal alignment and ROM measure for children with CP

• Looks at spinal alignment, ROM and muscle extensibility
• Scored 0-4 (least to most impaired)
• No stated age range but must be able to follow directions
• Determines areas of decreased ROM or strength in trunk and LE
• Takes 15-30 minutes to administer
• Helps inform intervention planning

Question 9

crouched gait

Answer 9

• Loss of PF and knee extension coupling due to inaccurate surgical lengthening of soleus
• Lever arm dysfunction due to femoral and tibial torsion deformities (includes pes valgus)
• Compensation strategies not effective bc gravity has shifted posterior to the knee thus causing the “crouched gait”

Question 10

Latrogenic crouch

Answer 10

related to crouched gait → weakness of the muscle due to surgical tendo achilles lengthening (TAL) to correct a contracted triceps surae

Question 11

firm placement and use of hands

Answer 11

1. allows deep sensory input
2. focus is inhibition
3. PT has abundant control

Question 12

1. guides rather than controls
2. focus on facilitation
3. child needs to have ample control

Answer 12

light placement and use of hand

Question 13

1. requires active control on the part of the child
2. focus is on facilitation

Answer 13

Intermittent placement and use of hands:

Question 14

1. good way to combine inhibition, firm sensory input, and the patient can be active above/below your key points of control

Answer 14

slow movement with a firm touch

Question 15

1. small ranges of movement can be used to inhibit abnormal postural responses

Answer 15

Fast movement with a firm touch

Question 16

1. facilitates automatic reactions

Answer 16

fast movement with light touch

Question 17

facilitates holding of a posture against gravity

Answer 17

stopping the movement

Question 18

1. better for children with fluctuating tone and disorganized movement

Answer 18

1. rhythmic movement

Question 19

may be better for children with spasticity

Answer 19

arrhythmic movement

Question 20

pressure on a joint can be facilitatory or inhibitory as can distraction

Answer 20

compression

Question 21

1. hand placement close to trunk and large joints

Answer 21

proximal key points

Question 22

hand placement further away from trunk and large joints

Answer 22

distal key points

Question 23

used when there is a real or apparent weakness of specific muscles groups or generalized hypotonia

Answer 23

tapping

Question 24

LE Assessment Handout

Answer 24

1. Staheli’s Prone Hip Extension Test – used to assess hip flexion contracture for a child with spasticity (most valid method for CP child)
2. Leg length
3. Assess Femur torsional status
4. Assess knee flexion contracture → popliteal angle
5. Assess for Tibia and Fibula Torsion
6. Thigh foot angle

Question 25

head/neck lateral flexion facilitates?

Answer 25

hip abd

Question 26

Arm ER, supination, and extended elbow facilitates

Answer 26

facilatates trunk extension

Question 27

IR rotation of the arms facilitates

Answer 27

trunk flexion

Question 28

arm horizontal abd with ER faciltates

Answer 28

ER of hips, inhibits spasticity of pects

Question 29

arms elevated overhead with ER

Answer 29

facilitates trunk extension (might be too much)

Question 30

arms diagonally backward with ER

Answer 30

faciltates trunk extension, hands open, may use with ambulatory child to build extensor tone

Question 31

abduction of thumbs

Answer 31

facilitates finger opening

Question 32

flexion of hips and knees

Answer 32

favors abd and ER of hips ankle DF

Question 33

ER of LES in standing

Answer 33

facilitates hip abd, ankle DF

Question 34

DF of toes 2-5

Answer 34

inhibits LE extensor spasticity facilitates DF