Red Flags
What are 4 primary red flags to look out for in a baby that is 1-2 months old?
1. feeding problems
2. floppy body
3. no LE movement in supine
4. head is "stuck"
Name the difference between neck hyperextension block vs. head and neck asymmetry block.
hyperextension block is when baby's neck flexors are weak vs. asymmetrical block is unable to hold head in midline with ATNR preferred for function.
Explain the anatomic impact of shoulder and UE control block.
There is decreased scapular stability in prone due to weakness > scapular winging > decreased humeral dissociation
With and APT block, the hip is unable to go into ____ whereas with a PPT block, the hip is unable to go into _____.
APT block > hip is unable to achieve extension, IR, and adduction.
PPT block > hip is unable to go into flexion, ER, and abduction.
Primary PT treatment to focus on with neck hyperextension block. (hint: there's 3)
> increase neck flexor strength
1. pull to sit from prone
2. arm cradle with looking down at toy
A baby usually learns to crawl/creep in a symmetrical bunny hop pattern, however, it is considered a red flag if the kid is still doing so at _____months.
What is the primary compensation for neck hyperextension block?
shoulder/scapular elevation
What is the primary compensation for shoulder and UE control block?
scapular adduction for thoracic stability
With and APT block, it typically causes the following impairments: abdominal _____ > _________ and lumbar ______> __________.
abdominal weakness > rib flaring
lumbar tightness > hyperextension
Primary PT treatment to focus on with PPT block. (hint: there's 3)
1. increase LE dissociation
2. increase mobility at all joints TOGETHER
3. align in sagittal plane first THEN strengthen controlled movements in frontal and transverse plane
>it depends
What are 4 major red flag components once the kid is 1+ years old. (hint: 2 are motor and 2 are cognitive)
1. Toe walking
2. Little to no words
3. Social avoidance
4. Ritualistic behavior
What are the negative consequences of the compensation for neck hyperextension block? (hint: there's 5)
1. open mouth and drooling
2. limited downward gaze
3. no head righting responses
4. limited cervical and shoulder mobility
5. increased thoracic extension
What are the negative consequences of the compensation for shoulder and UE control block? (hint: there's 6)
1. decreased wt shifting in prone
2. decreased UE AROM
3. decreased UE proprioceptive input
4. lack of transition into quadruped
5. excess thoracic extension in sitting
6. limited reach and grasp
What are the impairments and its negative consequences of an APT block? (hint: there's 4)
1. no alternating hip and pelvis movement (bunny hops)
2. sustained frog-legged position (hip loses mobility)
3. decreased wt shift and balance reaction (wide BOS with game and excess ankle pronation)
4. weak abdominals (rib flaring, W sitting, and hypermobile T12-L1)
Primary PT treatment to focus on with shoulder and UE control block. (hint: there's 6)
> align trunk and pelvis FIRST
1. increase active thoracic extension
2. increase strength in proper postural alignment
3. increase UE WB and wt shifting
4. increase dynamic strength of scapulohumeral complex AROM in proper postural alignment
5. Increase UE ER, Flx, horizontal adduction (scapular abduction)
supine:
- unable to hold head in midline
- unable to bring hands to midline
prone:
- dislikes the position overall
- unable to do shoulder abduction
What are the negative consequences for head and neck asymmetry block? (hint: there's 5)
1. Atypical ocular movements
2. Oral motor impairments
3. Scoliosis
4. Atypical UE movement
5. "windswept" posture of LE
We want to assess for this block in what age range?
4-6 months because this age range is crucial for baby's ability to WB in prone.
What are the impairments and its negative consequences of an PPT block? (there's 4)
overall decrease in hip, knee, and ankle AROM
> decreased kicking and HF in supine
> army crawl without LE
> sacrum sitting with knee and trunk flexion
> excess ankle PF
Primary PT treatment to focus on with APT block. (hint: there's 5)
1. increase hip extension
2. increase abdominal strength/activity
3. align LE in neutral position
4. Wt shift to lateral borders of foot in standing
5. Orthotics as needed
My baby is ___months old. She isn't quite developing like her peers because she isn't able to prop sit or roll. Even during tummy time, she doesn't play with any of her toys or use her forearms.
> what is another test you can do to assess for red flags at cervical spine?
6 months old
> pull to sit from prone and assess for head lag
It's important to look out for cranial region block in what age range?
With these kids, we want to promote UE movement into ______, ______, and ______. (hint: think treatment)
Promote ER, flexion, and horizontal adduction reach
What age range do we want to consider pelvic blocks?
3-9 months because this is when the baby developing supine, prone, quadruped, and pre-walking skills
Primary PT treatment to focus on with head and neck asymmetry block. (hint: there's 6)
> increase symmetrical flexion strength with hands to hand, to mouth, to knee, to feet
> symmetrical head and trunk rotation to each side
> prone on elbows <> hands
In sitting:
> ocular tracking
> UE reaching
> lateral wt shifting