Spastic Quadriplegia

People who suffer with cerebral palsy may have contracted muscles or joints causing a fixed rigid limb. Care staff must be aware of the needs of people who suffer with cerebral palsy and ensure that effective communication skills are used when assisting people to move or reposition.

Olama, K.A., & Thabit, N.S. (2010) performed a randomized controlled trial to determine the efficacy of whole body vibration (WBV) and a designed physical therapy program versus suspension therapy and the same designed physical therapy intervention in balance control in children with hemiparetic CP. Criteria for inclusion for the study were children with hemiparesis cerebral palsy from both sexes ages 8 to 10 years old, able to understand commands given to them, able to stand and walk independently with frequent falling, and balance problems ( as confirmed by the Tilt Board Balance Test). The exclusion criteria consisted of presence of any medical condition such as vision and hearing loss, cardiac abnormalities, and musculoskeletal disorders. Children who met the criteria (n=30) were recruited from the outpatient clinic, College of Physical Therapy, Cairo University The randomization was done according to the Gross Motor Function Classification System (GMFCS). Treatment allocations were done by the selection of a closed envelope randomly selected. Parents and children were informed of the treatment allocation after the selection, procedures were explained to both of them and signed assent and consent were obtained.

Throughout this experience, I watched as they targeted more than just strength and flexibility, but also balance, gait, coordination, and sensory issues. Their

A person with this diagnosis will see a variety of health care providers throughout their life. Some of these may be Physical Therapists, Occupational Therapists, and Neurologists. Physical Therapists will help each patient to learn how to be as functional as possible with their condition. Many patients will have to walk with an assistive device or even wear a leg brace. Gait training is very important for patients with Spastic Diplegia. Patients that are diagnosed with Spastic Diplegia can have complete paralysis or muscle weakness in both lower extremities. This often results in asymmetries on the right or left lower extremity. Therefore, when a person with Spastic Diplegia walks they will repeat movements irregularly, and this can lead to them developing secondary disabilities. 6(p1) A person with Spastic Diplegia can expect to see a Physical Therapist on and off for their life due to the fact that physical therapy can help them in so many different ways. Some doctors are prescribing certain medications, such as muscle relaxers, to help with spastic muscles or even giving their patients Botox injections in the tight muscles. This is a form of treatment that Brenna is now undergoing. The Botox shot is injected into the tight muscles and is supposed to help these muscles be able to relax. The words “Cerebral Palsy” and “Spastic Diplegia” can be very scary when they are used to diagnose somebody

Patients will report to physical therapists with a multitude of impairments throughout the progression of the disease. The most prominent impairments will present during cerebellar testing. Patients will show signs of dysmetria, dysphasia, dysdiadochokinesia, and ataxia primarily as a result of the atrophy and damage to the cerebellum. Instability and lack of postural control will be demonstrated during the Romberg's test. Additionally, cranial nerve testing will have positive results for many cranial nerve palsies such as CN III, V, VII, IX, and XII. Patients show weakness in their trunk and extremities during the manual muscle testing. Vestibular testing will result in abnormal VOR, saccades, smooth pursuits and nystagmus. As a result of these impairments, patients experience functional limitations. Primarily, these patients are considered to be “high fall risks,” which ultimately decreases their independence due to weakness, instability and decreased postural control. These patients will feel uncomfortable in many situations and be unable to function independently in the community. This creates an increased risk for further injury. Due to the dysmetria and weakness, patients will also experience difficulty with their daily living skills, such as maintaining proper hygiene; They will have trouble bathing themselves and brushing their teeth without assistive equipment. PT interventions can help minimize and control these limitations. The implementation of balance training and assistive devices will be imperative interventions for an individual to modify and adapt to their gait

As ethical and moral physical therapists, it is essential to consider all possible sources of the impairment and figure out how to resolve, educate, and prevent future implications for patients. In order to be able to complete such a task, physical therapists must be able to look at functional status through all of its domains, biophysical, psychological, and sociocultural.2,5 In the realm of pediatrics, performing screenings, functional tests, and questionnaires offer a great diagnostic and prognostic data for children. The DDST3 enables a PT to get a sense of a child's cognition, motor functions, and behavior. Identifying possible delays or problems early on is vital in order to ensure proper development, especially since many systems have

conducted a study on 34 children from 3-12 years old who had bilateral spastic (32) or unilateral CP (2) to investigate the effectiveness of hippotherapy. The participants took part in forty-five minute hippotherapy sessions twice a week for an eight week period. These sessions were conducted by a registered occupational therapist (OT) who had been accredited by the American Hippotherapy Association, an assistant to lead the horse, and a volunteer sidewalker. Baseline tests for physical function were conducted prior to the intervention therapy. The participants were then tested for progress after the hippotherapy program had commenced. The measurement tests utilized were: GMFM 66, GMFM 88, and PEDI-FSS. A control group of 21 children with CP were tested and included in the study for comparison and

A.K. receives weekly home-based occupational therapy because of her delays in gross motor, fine motor, and self-help skills. Activities of daily living (ADL) and play are the areas of occupations that affected. Independency in ADLs is not a factor for A.K. given that she is only 2 years of age. She relies heavenly on her parents for most. ADLs that are affect include bathing, dressing, feeding, and functional mobility. A. K. needs assistance with dressing skills such as undressing and removing shoes and socks. To independently feed herself, A.K. uses adaptations. As a result, of A.K. having spastic diplegia her play skills are affected. The play skills that are affect include, moving around her environment to attain toys to play with. She also

The spasticity is considered the main problem as it will cause the affected muscle constantly in contracted state, hence limited the range of movement of the affected joint. Spasticity is defined as a velocity dependent increased resistance to passive muscle stretch, or alternatively as inappropriate involuntary muscle activity associated with upper motor neuron paralysis (GOLDSTEIN, 2001 and SANGER et al., 2003). Muscle over-activity produces muscle shortening and muscle shortening increases spindle sensitivity. Thus, Stephanie will feel extreme pain and struggle whenever the affected muscle is being lengthened unconsciously or fast. This will severely affect her functional activity like not able to move freely as a normal child. For example, Stephanie already has grade 3 spasticity of her both ankle plantar flexors while grade 2 for both hip adductors and internal rotators. These constantly tighten muscles already severely affect her from

The article “Muscular contributions to hip and knee extension during the single limb stance phase of normal gait: a Theoretical Framework for Crouch Gait” by Allison Arnold, Frank Anderson, Marcus Pandy, and Scott Delp investigates the biomechanics of normal gait in hopes to uncover ideas to help determine treatments for crouch gait. Crouch gait is a bothersome abnormality that affects the gait pattern of people who suffer from the condition of cerebral palsy. It’s characterized by excessive flexion of the hips and knees during standing and excessive use of metabolic energy to complete a single gait cycle. Currently, the treatments for this condition are limited and have unpredictable outcomes due to the unknown biomechanical causes of the excessive flexion in crouch gait. These treatments include surgical lengthening of hamstrings, ankle-foot orthoses, and intense stretching regimens, with patients experiencing results ranging from no improvement in their symptoms to dramatic improvements. The vast array of results from treatments are due to the little understanding medical professionals have of not only abnormal gait patterns (such as crouch gait) but of normal gait as well (Arnold, Anderson, Pandy, and Delp, 2005). Despite the article’s title relating to crouch gait, the purpose of the study conducted was to examine and quantify the accelerations of normal hip and knee movements that were induced by specific muscles during the single limb stance phase and to rank these

The Jebsen-Taylor hand function test and Jamar dynamometer were the two hand function tests given to participants. The Motor Assessment Scale (MAS) and the Berg Balance Scale (BBS) were also given to participants and recorded the day after making the first FMA evaluation of the video recording. A follow-up assessment was given to participants 3 months after the baseline assessment to calculate the subject’s responsiveness. Data was available for sixteen of the fifty original participants. The sixteen participants continued physical therapy following the baseline

Spasticity is described as an abnormal muscle tone that is velocity-dependent, and it is usually correlated with an upper motor neuron lesion with an association of hyperactive deep tendon reflexes (Nair & Marsden, 2014, p. 1). There are numerous neurologic diseases that exhibit

Effects of Combined Exercise Training on Functional Performance in Children with Cerebral Palsy: A Randomized Controlled Study Spring 2017 EPR 214-QL Professional Reflection Brandon England The University of Alabama at Birmingham PROCEDURAL SUMMARY My Professional Reflection summarizes the procedures and statistics used in a randomized controlled study on the Effects of Combined Exercise Training on Functional Performance in Children with Cerebral Palsy. This study was published in January 2017 in Volume 29 of Pediatric Physical Therapy, the official journal of the Section on Pediatrics of the American Physical Therapy Association and the first and only peer-reviewed journal devoted to the pediatric specialty. The purpose of this study was

Another researched treatment option for cerebral palsy is hyperbaric oxygen therapy. Hyperbaric oxygen (HBO2) therapy involves having the patient placed in a pressurized room or tube where the air pressure is three times higher than normal (Hyperbaric oxygen therapy, 2014). While the patient is in the hyperbaric chamber, he or she is exposed to 100% oxygen (Hyperbaric oxygen therapy, 2014). Hyperbaric oxygen therapy increases the amount of oxygen the blood can carry which helps promote healing and fights infection (Hyperbaric oxygen therapy, 2014). The UHM journal conducted a study to see if intensive rehabilitation combined HBO2 therapy would improve gross motor function in children with cerebral palsy (Mukherjee, 2017). This study involved one hundred and fifty children with CP. The children were divided up into four groups; one control the three others all were exposed to varying levels of HBO2 therapy (Mukherjee, 2017). The children were observed over an eight month period (Mukherjee, 2017). Every child who was assigned to a HBO2 therapy session went once daily for six days within a week. At intervals of two, four, six, and eight months after the treatment began, the children's gross motor function measure (GMFM) was evaluated (Mukherjee, 2017). The results were conclusive  revealing all the children’s GMFM scores improved. However, the children who had the rehabilitation coupled with

Because CP describes a group of neurological and physical abnormalities, people affected by the disorder may have other neurological and physical problems. CP may not be noticeable at birth. Children with CP develop predictable developmental milestones slowly because of their motor impairments, and these delays in reaching milestones are usually the first symptoms (Gale Enc). Doctors diagnose CP by checking the infant’s motor skills, looking for developmental delays, and considering the child’s medical history. Many Doctors use the Early Motor Pattern Profile (EMPP) to help in their evaluations. The EMPP indicates variations in muscle tone, reflexes, and movement and is used to identify children during the first year of life who are at risk for the development of CP. The EMPP can be done during a routine office visit. Observation and minimal handling can detect abnormal motor patterns, making it quick and inexpensive. EMPP is the beginning of evaluation and intervention (“Early” 692). CP is a neurological disorder affecting motor control. It is the most common physical disability in childhood. It is a lifelong condition that varies from person to person. It can be very mild or extremely severe. There is no known cure, and the cause is not completely understood. The four main categories of CP are spastic, athetoid, ataxic, and mixed. Spastic is stiff and difficult movement. Athetoid is involuntary and uncontrolled movement. Ataxic is a disturbed sense of balance and