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Pediatric Physical Therapy

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Cerebral Palsy. Spina Bifida. Torticollis/Plagiocephaly. Developmental ... Cerebral Palsy. Team Hoyt: www.teamhoyt.com. Incidence: 2 ... Cerebral Palsy (cont) ... – PowerPoint PPT presentation

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Title: Pediatric Physical Therapy


1
Pediatric Physical Therapy
  • Curt Phillips, MPT

2
Objectives
  • Identify common pediatric conditions
  • Describe states of tone and one pediatric
    condition associated with each type of tone
  • Describe how pediatric physical therapy differs
    from adult physical therapy
  • Understand that disability does not define a
    person

3
Unique Challenges of Pediatric Physical Therapy
  • Tone issues
  • Childrens ability to understand how physical
    therapy benefits them
  • Family/Caregiver compliance and interaction with
    the family
  • Grieving process

4
Muscle Tone
  • What is tone?
  • What is high tone?
  • What is low tone?
  • What is fluctuating tone?
  • How do you test for increased tone?

5
Grieving Process
  • THE STAGES OF GRIEF
  • Denial and Isolation
  • Anger
  • Bargaining
  • Depression
  • Acceptance
  • Why is it important to understand the grieving
    process?

6
Common Pediatric Disorders/Syndromes
  • Down Syndrome
  • Cerebral Palsy
  • Spina Bifida
  • Torticollis/Plagiocephaly
  • Developmental Delay

7
Down Syndrome
  • Special Olympics www.specialolympics.org
  • Incidence 1 / 800-1000 live births
  • AKA Trisomy 21
  • Associated with LOW TONE (hint)
  • Developmental rate approximately twice as long
  • Affects cognition

8
Down Syndrome (Cont)
  • Physical therapy treatment
  • Parent education for positioning
  • Core stability
  • Compression of joints
  • Patience stubborn little guys/gals

9
Cerebral Palsy
  • Team Hoyt www.teamhoyt.com
  • Incidence 2 / 1000 live births
  • Junk term for any pre-birth or during birth brain
    trauma similar to stroke in adults
  • Associated primarily with HIGH TONE, but can be
    associated with low tone or fluctuating tone
  • Widely varied developmental rate

10
Cerebral Palsy (cont)
  • Can affect cognition
  • Widely varied demeanor possibly due to pain or
    lack thereof
  • Physical therapy treatment
  • Parent education
  • Stretching of tight muscles (hamstrings, hip
    flexors, hip adductors, heel cords)
  • Core strengthening
  • Functional positioning

11
Spina Bifida
  • Sledge hockey team / paralympics
  • Incidence 1-2 / 1000 births
  • Spinal cord not fully developed
  • No tone in affected neural pathways incomplete
    lesions

Spinal lesion
12
Spina Bifida (cont)
  • Can affect cognition in math and other concrete
    subjects
  • Difficult adjustment for youth
  • Physical therapy treatment
  • Parent education
  • Assistive technology
  • Core strength
  • Usually will use assistive device for life

13
Torticollis/Plagiocephaly
  • Incidence Not listed, but appears to be on the
    rise.
  • TorticollisIncreased tension in the SCM
    (sternocleidomastoid) muscle in the neck
  • Causes a tilt to one side and a rotation to the
    other
  • Not sure of cause could be birth trauma or
    congenital

14
Torticollis/Plagiocephaly (cont)
  • Usually resolves with physical therapy at a young
    age
  • Plagiocephaly Mis-shapen head
  • Physical therapy treatment
  • Parent education
  • Stretching
  • Positioning
  • Possible TOT collar or helmet

15
Developmental Delay
  • Incidence Because of the lack of true
    definition, difficult to assess
  • Catch all term for dont know what causes the
    delay
  • Causes could be tone, neuromuscular coordination
    issues, weakness, tightness, or balance

16
Assistive Technology
  • What is assistive technology?
  • AT lab here on campus/classes in AT
  • Common assistive devices
  • Braces
  • Walkers
  • Crutches
  • Seating/Positioning devices
  • Scooters

17
Take Home Messages
  • Parent Education is the key
  • Core strengthening is primary goal
  • Be sensitive to parental grieving
  • Treat the child/symptoms, not the disease
  • Every child is unique and should be treated so
    even if have same diagnosis
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