SDR
all green light interventions had in common
practice of real-life tasks and activities, using self-generated active movements, at a high intensity, where the practice directly targets the achievement of a goal set by the child (or a parent). The mechanism of action is experience-dependent plasticity. Motivation and attention are vital modulators of neuroplasticity, and successful
task-specific practice is rewarding and enjoyable to children, producing spontaneously regular practice
CVI is defined as a significant deficit in visual
function associated with damage to retrochiasmatic visual pathways and cerebral structures in the
absence of ....
major ocular disease or ocular abnormalities
the 5 inclusion criteria for having the SDR procedure are
1 spasticity in LE interfering with function
2 strength is adequate in the LE
3 straight - adequate trunk and head control without fixed orthopedic deformities
4 slim
5 smart - no significant cognitive impairments
the 3 tools with best predictive validity for detecting cerebral palsy before 5 months’ corrected age are
1. neonatal MRI
2. Prechtl Qualitative Assessment of General Movements
3. Hammersmith Infant Neurological Examination -HINE
these interventions are what color? casting,
constraint-induced movement therapy, environmental enrichment, fitness training, goal-directed training, hippotherapy, home programs, literacy interventions, mobility training, oral sensorimotor, oral sensorimotor plus electrical stimulation, strength training, task-specific training, treadmill training, partial body weight support treadmill training, and weight-bearing.
green!
common behaviors seen with CVI include
light gazing, need for movement to stimulate vision, delays in looking at objects, atypical visual reflexes, absence of visually guided reach, and difficulty with visual novelty
when would SDR be indicated for a client with spastic quadriplegia?
significant spasticity interfering with positioning, care, and stretching,
AFTER 5m corrected age the most predictive tools for detecting CP are
1. MRI
2. HINE
original NDT, hyperbaric oxygen treatment, and sensory integration are considered what color for gross motor skills?
RED - don't do or stop interventions
red, yellow, orange
PT after SDR focuses on
strengthening
true or false: In infants younger than 2 years, prediction of motor severity should be made cautiously
true - In infants younger than 2 years, motor severity is difficult to accurately predict because almost 50% of infants younger than 2 have their GMFCS reclassified, little natural history
data exist about infants with cerebral palsy (eg, the onset of spasticity, dyskinesia, or contractures), motor skills are developing, the presence or absence of hypertonia changes and evolves, and there is rapid brain growth and use-dependent reorganization
in response to caregiving and therapy.
true or false: bottom-up, generic, and/or passive motor interventions are less effective and sometimes clearly ineffective for improving function and movement for children with cerebral palsy.
TRUE - they do not activate the motor pathways required for neuroplasticity because they are passive treatments
true or false: postural control especially head control and alignment are impacted by CVI
true
the most important indication for SDR in clients with spastic diplegia is to improve
gait and motor function patterns
infant detectable risks where investigation should occur include
Any infant with:
(a) Inability to sit independently by age 9 mo, or
(b) Hand function asymmetry, or
(c) Inability to take weight through the plantar surface (heel and forefoot) of the feet should receive
standardized investigations for CP
the state of the evidence can help guide treatments especially for contracture management
true - contracture treatment should be seen as a continuum of treatments
treatment modifications can include:
dimming the lights, working in a quiet room, moving toys to facilitate tracking or fixation, using toys that sparkle/reflect, or attract attention, assisting reach with eye gaze, working with the TVI and interdisciplinary team