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113 Cards in this Set
- Front
- Back
spinal cord malformation; neural tube defect
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spina bifida
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non progressive CNS damage before age 3. lack of postural control. Brain damage decreases the brains ability to monitor and control nerve and voluntary muscle activity
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cerebral palsy
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Lower brachial plexus injury involving C-7, C8, and T-1. Results in weakeness of the intrinsic muscles of the hand and long flexors of the wrist and fingers. The biceps reflex is present but grasp is absent. (claw hand)
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klumpke's paralysis
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autosomal, chromosome 19. Affects face, neck, hand, and foot. characterized by myotonia, a delay in muscle relaxation time, and muscle weakness.
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myotonic dystrophy
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abnormal developement of trochanter
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trochanteric dysplasia
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non progressive neuromuscular disorder estimated to occur in first trimester in utero.
Charasteristics- cylinder like extremeties, significant and multiple contractures, dislocation of joints, muscle atrophy, muscle weakness, and imbalance. |
arthrogryposis multiplex congenita
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unilateral shortening of SCM muscle. limited cervical ROM. causes lateral flexion to the same side of the contracture and chin rotation to opposite side.
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torticollis
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results from abnormal development and growth of the hip joint. Testing for this condition includes Ortolani test, barlow maneuver
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hip dysplasia
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method of decreasing spascity in mucscle of cerebral palsy patients- phenol and botulinum toxin A
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neuromuscular blocks
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pump faclofen into abdomen and intrathecal space
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intrathecal baclofen
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trisomy 21 extra chromosome. Clinical manifestations: hypotonia, flattened nasal bridge, Simian line (palmar crease) epicanthal fold, enlargement of the tongue, and developmental delay
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down syndrome
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lag progrssion as compared to full term. takes 2 years to catch up. due to prematurity
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developmental delay
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a self limiting disease of the hip initiated by avascular necrosis of the femoral head- 4 stages
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legg calve perthes disease
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x gene linked recessive by boys. Dystrophin gene missing. destruction of muscle cells collage, adipose laid in muscle, pseudohypertrophic calf muscle
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duchenne muscular dystrophy
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dislocation at birth
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congenital dislocation
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results when chromosome 5 is missing. abnormal laryngeal; development of weak and high pitched cry in infants; causes hypotonia, scoliosis, delayed development, small head size, low birth weight.
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chr-du-chat syndrome
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congenital disorder of collagen synthesis that affects all connective tissue in the body. can cause osteoporosis, excess fractures, bowing legs, spinal deformity, and muscle weakness.
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osteogensis imperfecta
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congenital talipes equinovarus, ankle plantarflexion, hindfoot varus, and forefoot adduction
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club foot
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alteration developent of blood vessels in the eye. a vasoproliferative disease of the immature retina.
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retinopathy of prematurity
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surgery for cerebral palsy; a surgical approach that focuses on the spinal reflex arch and its modulation at the level of the anterior horn cell by supraspinal and segmental influences.
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selective dorsal rhizotomy
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injections into the dominant agonist muscle at the nerve terminals to causes temporary paralysis of the muscles lasting 3-6 months. improve function of children with cerebral palsy
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botulinum A toxin
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typical development that followa a predictable sequence. there are variations in the sequence and the rate at which each child moves through the sequence varies
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motor development
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underutilized areas of the brain take over functions of damaged tissue
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vicariance
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areas of brain reprogrammed, increased sensitivity of hands to blind
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functional subsititution
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reaccqusiton of movement skills lost through injury
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recovery function
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sympathetic nervous system
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fight or flight
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performance of task visualized
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mental practice
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study dealing with neural, physical, and behavioral aspects
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motor control
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ability of brain to change or repair itself
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neuroplasticity
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sending signals adcance of movement to ready system; allows anticipatory adjustments of postural activity
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feed forward
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performing two tasks at once (catching and throwing a ball)
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dual task training
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what is the spinal level for functional ambulation with spina bifida?
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L3-L4
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what is most important to remember with down syndrome patients?
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no approximation through the head
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how low to heal fractures in infants?
in children? |
4-6 wks
6-8 wks |
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aversive response to tactile stimuli manifested by hyperactivity or distractibility. children who show this may display avoidance reactions around the hands, feet, and face. in the oral area may cause child to reject textured or flacored food in preference to smoother blander foods.
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tacticle defensiveness
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serial casting needs to be changed...
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every 5-7 days
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goals of positioning preterm infant (2)
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1. enhance flexor tone with flexed trunk and protracted scapula
2. increase midline orientation |
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how to measure leg length difference
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asis to medial malleolus
1-2 cm |
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when does mother first feel fetus move?
when do movements decrease? |
20 weeks
32 weeks |
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why do we promote balanced strength in opposing muscle groups for children?
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for postural control
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primitive reflexes appear after..
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1st month
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is w sitting good for kids?
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no
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primitive reflex that affects feeding if it doesn't integrate?
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Asymmetrical tonic neck reflex
(ATNR) |
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3 stages of motor learning
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1. cognitive
2. associative 3. autonomous |
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is it harder for adults to relearn developmental sequence than infants?
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yes
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modalities prior to stretching
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heat, ultrasound, and E-STIM
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what is a neonate period
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first 28 days after birth
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early childhood
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3-6 years
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later childhood
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after 10 years
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developmental transistion that lasts from about 10-11 intil the late teens or rarly twentites. the onset of puberty -- 13 YEARS
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adolescence
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increased tone, results from a motor cortex lesion- mild
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spastic cerebral palsy
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results from a cerebellar lesion, a balance disorder- moderate
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ataxic cerebral palsy
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flucating tone, basal ganglia lesion
severe |
athetoid/dystonic cerebral palsy
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affects one limb
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monoplegia (S CP)
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affects four limbs
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quadriplegia (At CP)
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affects two lower limbs- severe
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diplegia (Ath CP)
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affects one side
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Hemiplegia- Mixed CP
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flexion contractures are present at hips, and external ROM is slightly greater than internal rotation. knees exhibit genu varum, or bowing
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0-9 months normal gait progression
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wide base of support, hips in abduction, flexion, and slight external rotation, genu varus continues
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9-15 months normal gait progression
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genu varus straightens, may be limitation in hip extension ROM, base of support is decreasing, heel strike begins to develop and is normally consistent by 24 months
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18-24 months normal gait progression
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genu valgus, child normally has consistent heel strike and knee flexion in swing phase
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3-3.5 years gait progression
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the gait patterns should vbe fully mature, genu valgus returns to neutral
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6-7 gait progression
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the motor task is to develop an overall understanding of the skill.
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1st stage of motor learning-
cognitive stage |
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motor strageties are refined through continued practice. "how to do"
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associative stage
2nd stage of motor learning |
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motor performance that after practive is largely automatic. -runs themselves
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3rd stage of motor learning
Autonomous stage |
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facilitation techniques to increase tone (7)
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1. quick stretch
2. resistance 3. joint approximation 4. joint traction 5. light touch 6. manual contacts 7. fast vestibular stimulation |
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inhibition techniques to decrease muscle tone (7)
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1. prolonged stretch
2. inhibitory pressure 3. maintained touch 4. slow stroking 5. prolonged icing 6. neural watmth 7. slow maintained vestibular stimulation |
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compares children to other "normal" children
has 4 test sections- assisted in referral to OT and SLP |
Denver II
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provides a comprehensive sequence of gross and fine motor skills from which the therapist can determine the relative developmental skill level of a child and plan an instructional program to develop those skills; for children from birth to 83 months
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peabody developmental motor scale (PDMS)
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evaluates muscle tone, primitive reflexes, automatic reactions, and volitional movement in the first year of life; provides a assesment of risk for motor dysfunction
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movement assessment of infants (MAI)
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assesment of gross motor performance designmed for the identification and evaluation of motor development in infants from term through the age of independet walking; focus is on the development of postural control relative to four postural positions; supine, prone, sitting and standing. from children from birth to 18 months
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alberta infant motor scale (aims)
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means of evaluating a child's current developmental status at a particular age; consists of scales composed of three parts; a mental scale, a motor scale, an infant behavior record, for children 1-30 months
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bayley scales of infant development (BSID)
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a motor assessment; used to evaluate child's motor repertoire and capacity for movement; examines quality of movement as opposed to attainment of motor milestones; for children 0-42 months
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toddler and infant motor evaluation (TIME)
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measures change over time, or after therapy, in gross motor function in children with CP; designed to assess motor function, or how much of an activity a child can accomplish; all item usually can be accomplished by a 5 year old with normal motor abilities
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Gross Motor Function Measure (GMFM)
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an assessment for detecting functional limitations and disability in age appropriate independence; measures both the capability and performance of functional activities in three content domains: self-care, mobility, and social function; for children 6 months to 7.5 years
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Pediatric Evaluation of Disability Inventory (PEDI)
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test of disability for assessing functions in self-cae, sphincter control, mobility, locomotion, and communication and social cognition; for children between the ages of 6 months and 7 years
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functional independence measure for children (weeFIM)
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used to determine developmental level of infants and young children, plan intervention strategies, and assess affects of instruction; birth to 8 years; tests personal-social, adaptive, motor, communication, and cognition
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Battelle Developmental Inventory
(BDI) |
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used to assess function abd guide progran planning for students with disabilities within the educational environment; children with disabilities attebdibg grades K-6; areas testedL participation, task supports, activity performance, physical tasks and cognitive/behavioral tasks
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School Function Assessment (SFA)
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development of object manipulation (9)
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1. rotation of held objects (2)
2. shaking of held objects (4) 3. bilateral hold of two objects (4.5) 4. two handed hold of a single object (4.5) 5. hand to hand transfer (4.5-6) 6. coordinated action with a single object in which one hand holds the object while other bangs it (5-6.5) 7. coordinated action with two objects such as striking two together (6-8.5) 8. deformation of objects (bending, squeezing) (7-8.5) 9. instrumental sequential actions(open a box with one hand take contents out with other) 7.5-9.5 |
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developmental prone progression
(6) |
1. prone lying
2. prone on elblows 3. prone on extended arms 4. pivot prone 5. quadruped 6. locomotion in prone |
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active four point that requires stability around the hip joints caused by cocontraction of the hip musculature. hands are aligned under flexed shoulders and his knees are aligned under flexed hips.
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quadruped
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infant must develop: stabilzation of the pelvis, head lifting with cephalocaudally progressing antigravity extensore control, and movement of the upper extremeties out of the neonatal position.
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prone on elbows
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equipment used for positioning (3)
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1. sidelyer-(to encourage hands to midline)
2. corner chair- for back stability for sitting 3. bolster chair-(to keeps legs apart in case of tight hip adductors- scissors gait) |
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equipment used for standing(4)
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1. vertical stander
2. a-frame 3. supine stander 4. prone stander (to improve head control) all used for stability, if child has decreased LE strength |
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equipment used for LE orthotics (6)
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1. heel cup
2. SMO 3. AFO 4. KAFO 5. HKAFO 6. THKAFO |
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walker equipment (2)
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1. anterior walker
2. posterior walker- used more in pediatrics, improve upright posture |
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crutch equipment(2)
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1. axillary
2. forearm |
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ambulation assistance equipment (3)
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1. RGO --
2. Parapodium 3. Gait trainer |
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how to use standers
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1. 20-30 mins 4-5 times per day initially
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how to use standers for control of LE contractures
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45 mins 2-3 times per day
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how to use standers to facilitae bone development
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60 mins 4-5 times per week
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how to use LE orthotics
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use as needed for standing or while placed in standers
at night |
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PNF pattern D1 Flexion
-lower extremity |
Flexion-adduction-external rotation
foot dorsiflexs and inverts; leg externally rotates and pulls up and across body moving into hip adduction and flexion |
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PNF pattern D1 Extension
lower extremity |
extension-abduction-internal rotation
foot plantar flexes and everts; the leg internally rotates and pushes down and out, moving into hip abduction and extension. the knee remains straight. |
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PNF pattern D2 flexion
lower extremity |
flexion-abduction-internal rotation
foot dorsiflexes and inverts; leg internally rotates and lifts up and out, moving into hip abduction and flexion. knee remains straight. (kick out) |
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PNF pattern D2 extension
LE |
extension-adduction-external rotation
foot plantarflexes and inverts; leg externally rotates and pushes down and in moving into hip adduction and extension. |
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PNF D1 Flexion UE
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flexion-adduction-external rotation
hand closes with wrist flexion; arm ext. rotates and pulls up and across the face, moving into shoulder adduction and flexion. elbow is straight |
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PNF D1 Extension UE
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extension-abduction-internal rotation
hand opens with extension; arm internally rotates and pushes down and out, moving into shoulder abduction and extension. elbow is straight |
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PNF D2 Flexion UE
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flexion-abduction-external rotation
hand opens with extension; arm externally rotates and lifts up and out moving into shoulder abductionand flexion. elbow is straight |
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PNF D2 extension UE
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extension-adduction-internal rotation
hand closes with flexion; arm internally rotates and pulls down and across the body moving into shoulder adduction and extension. elbow is straight. |
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PNF Chop pattern
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upper trunk flexion with rotation to right or left- chop is D1 extension
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PNF lift pattern
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lead arm is D2 flexion; trunk extend and rotate to right or left. both elbows are straight.
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the use of active inhibition in conjunction with passive stretching
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facilited stretching
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deep tendon pressure with passive stretching
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inhibitory pressure
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an expansion of active assistive movement, manual contancts to provide support and stability
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therapeutic guiding
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pt moves limb to the end of pain free ROM. a strong isometic contraction of restricting muscles is resisted followed by voluntary relaxation and passive movement into the newly gained range of the agonist pattern.
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hold-relax
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used to improve mobility; pt is instructed to relax as therapist moves the pt passively thru the range establishing appropriate speed and rhythmn using verbal cues. finally movements are lightly resisted.
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rhythmic initation
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used to improve mobility; repeated isotonic contractions are performed directed to agonist muscles, initiated by a quick stretch and enhanced by resistance. (PNF Patterns)
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repeated stretch
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used to improve mobility; pt is positioned in the end position(shortened range) of a movement and is told to Hold don't let me move you. the isometric contraction is resisted followed by voluntary relaxtion and passive movement into the lengthened range. then instructed to push back into end position again.
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replication
(hold-relax-active) |
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used to improve stability; alternating isotonic contractions of first agonists and then antagonists (don't let me push u backwars, then forward) against resistance allowing only very limited movement.
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stabilizing reversals
(alternating isometrics) |
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used to improve stability; isometric contractions of anatgonist patterns, focusing on co-contraction of muscles. resistance applied to one segment while applying resistance to the other segment. a twisting motion
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rhythmic stabilization
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used to improve stability; isotonic contractions of first agonists then antagonists perfomed against resistiance. therapist resists contraction of one pattern, at the end of the desired range a command is given to guve reverse direction
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dynamic reversals (slow reversals)
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used to improve controlled mobility; resisted concentric contraction of agonist muscles moving thru the range is followed by a stabilizing contraction and then eccentric, moving slowly back to start position. (push up. now hold. now go down slowly.)
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combination of isotonics (agonist reversals)
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