Boss Babies
What are the principles of muscle development?
Muscles must be lengthened before being strengthened.
How is cerebral palsy defined? (buzz words will be accepted.)
A group of permanent disorders of the development of movement and posture, causing activity limitation, that are attributed to non-progressive disturbances that occurred in the developing fetal or infant brain.
What cute little orthotic would be indicated for mild to moderate hypotonia?
Supramalleolar orthotic
What is congenital muscular torticollis?
Unilateral shortening or fibrosis of the SCM
What is spina bifida?
Defective development of any part of the spinal cord.
3 months
Posture and movement dysfunction
List two indications for a hinged AFO
DF at inital contact is limited or absent, heel toe pattern lacking
Shoes provide limited plantarflexion power
In hemis, when dynamic equinis deformity and excessive knee hyperextension are present or walking speed and stride length is too short
STS takes too long
More DF needed for stair climbing
10-12 months, postural preference, muscle tightness <15 degrees of cervical rotation.
Late moderate, grade 5
This type of spina bifida has an open and visible spinal cord defect by the presence of an external sac on the infant's back and is associated with spinal paralysis.
Myelomeningocele
What are the characteristics of the age of symmetry in 4 month old infants?
Symmetry of extremities
Midline orientation of head
Increase in extension of thoracic
Loss of the physiologic flexion in extremities
What structure is involved, and how would you classify dyskinetic CP?
Basal ganglia
Involuntary and uncontrolled, recurring movements
Describes the function of an anterior floor reaction orthosis (ground reaction orthosis).
Applies an anterior floor reaction force to reduce knee flexion and prohibits pronation and ankle DF. DF is usually set at 5 degrees.
What is the total recommended per day amount of supervised tummy time?
What is a rule of thumb for a 1-2-year-old spina bifida child?
OVER BRACE to protect the joints
Describe the posture and movement of a nine month old baby cruising without trunk rotation
Posture: LE abducted and externally rotated and wide base of support
Movement: Cruises sideways
Which two classifications of cerebral palsy by topological distribution would have insufficient force in the core?
Spastic quadriplegia and diplegia
Spina bifida L3/L4: Unable to control knee extension (KAFO) L1-L3 HKAFO
SCI
Muscular dystrophy/spinal muscular atrophy
Osteogenesis imperfecta
What objective findings would you see in a baby with muscular congenital muscular torticollis?
Unilateral tightness of the SCM during cervical rotation and/or lateral flexion w/o a nodule of the muscle.
(+) AROM
(+) SCM tightness
(+) PROM
(-) palpable mass
What is the best prognostic factor for a spinal bifida human?
Ambulatory status
At what months would you see the age of transitions? And what is the KEY to transitions?
7-8 months
Balance/strength of trunk flexors and extensors leading to trunk rotation to allow for reaching out of the base of support.
Score this newborn using the APGAR:
Pink in appearance
Pulse 99bpm
Cries and pulls away
Arms, legs flexed
Strong cry
8
Pulse: >100 bpm is 2
Active movement: is 2
List three contraindications for an anterior floor reaction orthosis
Strong equinus
Genu recurvatum
Hamstring contracture
What are three etiologies of congenital muscular torticollis?
Prenatal
Perinatal
Postnatal
What shoulder movement should you avoid when working with an infant with a brachial plexus injury in the hospital?
Avoid shoulder abduction and external rotation