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29 Cards in this Set
- Front
- Back
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Cerebral palsy
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a motor function disorder caused by a permanent nonprogressive brain defeat or lesion, characterized by a disruption in the volitional control of the posture and movement, produces atypical muscle tone and unusual ways of moving
co-activation: agonist and antagonist working at the same time reciprocal innervations impaired when one part of muscles work while other doesn’t |
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Primary Impairments:
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CNS damage occurs prenatally, perinatally, or within the first 2 years of age
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Secondary Impairments:
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-abnormal muscle tone
-muscle imbalance -contractures -weakness -poor body alignment - impaired initiation of movement -repetition of atypical movement patterns -impaired co-activation |
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Progression of atypical Movement Patterns;
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-decreased ability to control co-activation of agonist/antagonist
-impaired reciprocal innervations of agonist and antagonist muscles -development of compensations and atypical movement patterns |
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Prenatal Risk factors/causes: 70-80%
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-genetic disorders
-maternal health factors - teratogenic agents |
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Perinatal risk factors/causes:
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-prenatal conditions
-premature detachment of placenta - medical problems -multiple births - anoxia: lack of oxygen -hypoxia: reduced amt of oxygen |
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Postnatal risk factors/causes;
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-degenerative disorders
-infections -alcohol/ drug intoxication during breastfeeding -anoxic ischemic encephalopathy (damage to cells in CNS d/t inadequate oxygen) |
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Postural Mechanism:
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-normal muscle tone
-normal postural tone - integration of primitive reflex movement -righting, equilibrium, and protective extension, reactions -intentional, voluntary movement against the forces of gravity (movement purposeful with intention) -ability to combine movement patterns in the performance of functional activities |
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Righting, equilibrium and protective reactions
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when equilibrium doesn’t maintain or regain posture then protective reaction takes place)
-static posture -dynamic posture -balance reactions -protective reactions - righting reactions: ability to sense head isn’t aligned with trunk |
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Muscle tone:
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-muscles resting stiffness
-the degree of tension of muscle fibers when muscle is at rest |
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Abnormal Muscle tone:
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-Hypotonia: decreased muscle tone, floppy
-hypertonia: increased muscle tone, stiff -fluctuating muscle tone: between hypo/hypertonia |
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Common problems of Motor development:
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abnormal muscle tone
-persistance of primitive reflexes -atypical righting, equilibrium, and protective reactions -poor sensory processing -joint hypermobility -muscle weakness/ poor muscles co-contractions -decreased exploration go environment -delays in development of motor skills and adaptive functioning |
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Classification/ Distribution:
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-involvement of Extremity:
-monoplegia (one limb) -hemiplegia( one side) -diplegia(UE wkness, LE severe wkness) -paraplegia(LE body wkness) -quadriplegia(all 4 limbs) -tetraplegia (all 4 limbs +head/neck) |
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-Type of movement disorders:
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-spastic
-dyskinetic -ataxia -Mixed |
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Spastic CP:
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- quad/hemiplegia
-hypertonia and spasticity - initiation of movement leads to increases in abnormal tone |
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Dyskinetic Cp:
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-Athetosis: fluctuation of muscle tone low-high to normal (involuntary righting movements, increase and decrease tone)
-Choreoathestosis: constant fluctuation from high-low and jerky (jerky involuntary movement) -Dystonia: sustained twisted postures triggered by movement ( twisting postures, absent at rest, present at movement) |
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Ataxic CP:
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-Clumsy, with decreased balance and coordination
-decreased equilibrium reactions and lack of proximal stability |
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Mixed CP:
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-comb of high and low tone
Functional Implications and Associated problems: -muscle/bone -contractures -bone deformities -joint dislocations/misalignment -pain -risk for skin breakdown -decreased bone density -pathological fxs -cognition -hearing -speech and language, communication -decreased speech production -poor articulations -decreased speech intelligibity -dysarthria: hard time speaking clearly -decreased receptive and expressive language skills -sensory visual , and hearing impairments and tactile, proprioceptive deficits |
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-UEs or hands
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depend on type and distribution of abnormal tone
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Vision
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- stabismus (crossed eyes)
-exotropia (eye drifts temporal) one or both eyes turn OUTWARD -esotropia (eyes drifts nasally) one or both eyes turn INWARD -hypertropia (drifts up) -hypotropia (drifts down) -nystagmus (constant eye movement both eyes) |
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-physical and behavioral problems
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-seizures
-compromised cardiac/ respiratory fx -decreased endurance - learned helpness -social isolation -undesirable social behaviors |
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OT interventions:
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-engaging in occupations
-handling and positioning -training in AT and AE |
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medical-based interventions:
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-pharmacologic Txs
-orthopedic surgery -immobilization during healing phase |
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Therapeutic Modalities:
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-heat
-cryotherapy -e stim -robotics -kinesio taping (to increase ROM) -splinting.casting |
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Coactivation
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Secondary to reciprocal innervations that means that two or more muscles are sent a message from the nervous system to become active or to contract/relax simultaneously
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Co-contraction
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Contraction of both the agonist and the antagonist to provide stability at a joint
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Athetosis
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A type of cerebral palsy characterized by involuntary writhing movements, particularly of the hands and feet; loss of ability to coordinate movement due to the fluctuation of muscle tone form abnormally low to abnormally high muscle writhing movements
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Dystonia
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Neurologic movement disorder, in which sustained muscle contractions result in twisting and/or repetitive movements and abnormal postures
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Reciprocal innervation
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The distribution of nerve supply to antagonistic muscles, which allows one muscle to be excited and contract while the other muscle is inhibited, thus relaxing the muscle(s); excitation of the agonist with inhibition of the antagonist thus allowing movement at a joint
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