Development of the Child with Cerebral Palsy: Difference between revisions
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== Introduction == | == Introduction == | ||
The knowledge of the normal development is essential to compare the atypical development of the CP children, at all stages but even more in early stages were the | The knowledge of the normal development is essential to compare the atypical development of the CP children, at all stages but even more in early stages were the imparments are not so clear. http://www.cdc.gov/ncbddd/actearly/milestones/index.html | ||
Depending on the type of the Cerebral Palsy and Neurodevelopment Disorders, we will observe different patterns including positions and movements and different impairments. | Depending on the type of the Cerebral Palsy and Neurodevelopment Disorders, we will observe different patterns including positions and movements and different impairments. | ||
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Other impairments that CP child develop are skin and digestión problems, motivation, nutrition and growth, déficit of attention, learning difficulties…<br> | Other impairments that CP child develop are skin and digestión problems, motivation, nutrition and growth, déficit of attention, learning difficulties…<br> | ||
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== Typical Postures and Movement Strategies == | == Typical Postures and Movement Strategies == |
Revision as of 14:24, 29 August 2016
Introduction[edit | edit source]
The knowledge of the normal development is essential to compare the atypical development of the CP children, at all stages but even more in early stages were the imparments are not so clear. http://www.cdc.gov/ncbddd/actearly/milestones/index.html
Depending on the type of the Cerebral Palsy and Neurodevelopment Disorders, we will observe different patterns including positions and movements and different impairments.
The symptoms and function of each person with Cerebral Palsy varies. Cerebral Palsy is non-progressive so does not get worse over time, but the exact symptoms and function can change over a person's lifetime. From Birth to 5 years of age, a child should reach specific movement goals or developmental milestones - e.g. rolling, sitting up, standing, and walking which are often delayed or absent in the child with Cerebral Palsy.
Lets examine the development related to each type of Cerebral Palsy. Different body systems can influence the development milestones in children with Cerebral Palsy.
Musculoskeletal System:[edit | edit source]
Bony structures deformities or impairments are secondary due to:
- Impact of gravity on a body that has poor alignment and moves abnormally
- Abnormal muscle contraction during growth
- Lack of variety of movements and strategies e.g. weight-bearing postures.
Neuromuscular System;[edit | edit source]
In relation to Spasticity and Muscle Fibre, the literature supports the notion that, although spasticity is multifactorial and neural in origin, significant structural alterations in muscle also occur. An understanding of the specific changes that occur in the muscle and extracellular matrix may facilitate the development of new conservative or surgical therapies for this problem. ( see Annexe 1)
Sensory and Perceptual System;[edit | edit source]
In many children with Cerebral Palsy vision is compromised in relation to postural control and movement, proprioceptive, tactile and vestibular functioning, which creates pathologic patterns and strategies to move and orient the body in space.
Respiratory System:[edit | edit source]
Many children with Cerebral Palsy have difficulty to maintain respiration while at the same time supporting posture and movement. Infants breathe primarily with the diaphragm which sits high in the thoracic ribcage, with each inspiration, it contracts, pushing down on the abdominal contents. In the infant, the abdominal muscles are not yet working to oppose this force of the diaphragm, and the belly expands. This is called belly breathing. In addition the ribcage is elevated and the ribs horizontally positioned, making the ribcage a fairly rigid structure. This is why the ribcage remains elevated and the spine in flexion in many children with Cerebral Palsy. They have difficulty to expand the rib cage for air exchange and difficulties in exhalation of air to control the speech. The abdominal muscles fail to be used posturally to support lower trunk stability in children with Cerebral Palsy.
Associated Conditions:[edit | edit source]
Other impairments that CP child develop are skin and digestión problems, motivation, nutrition and growth, déficit of attention, learning difficulties…
Typical Postures and Movement Strategies[edit | edit source]
This information is based on clinical observation and clinical reasoning from the evaluation and assessment of the impairments, and describes the atypical features for children with spasticity, athetosis, hypotonia and ataxic cerebral palsy.
The child adopts pathologic pattern in the attempt to see or play:
- Head is sustained with asymmetrical hyper-extension, cervical spine is not elongated, not able to move in the 3 planes (frontal, sagittal, transverse) so often develops tightness in extensors and the loss of ROM in the upper cervical spine into flexion.
- No chin tuck.
- Minimal upper to mid-thoracic extension
- Shoulders in extension and Internal/Medial Rotation
- Ribcage elevated with Scapulae Elevated and Abducted
- Forced Thoracic Extension with no elongation of Cervical or Thoracic Vertebrae in 3 Planes
- Forearm remain in pronation
- Wrist in Flexion and Ulnar Deviation, Finger Flexion and Thumb in Adduction
- No binocular vision. The eyes are not independence from the movement of the head (like a normal child at 3months) so perception of the environment is difficult.
- The jaw remains open (extension) and the tongue retracted, coordination between them is severely compromised, due to these poor alignment of oral structures they will have difficulties in feeding and sound production.
- Quadriplegic kids have extremely difficult using upper extremities, such as reaching out, grasp and release.
Quadriplegia:[edit | edit source] | |
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Lower Limb Observation: |- | valign="top" | Neuromuscular System:
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Neuromuscular System:
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Musculoskeletal Feature:
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