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PHYSICAL MANAGEMENT
I. Management Programs vs. Instructional programs
II. Patterns of normal development Cephalo – Caudel (head to tail) Proximal – Distal (midline first) Mass to Specific Gross to Fine (large movements to small)
Flexion-bending
Extension- straightening
Supine- lying on back
Prone- lying on stomach
Abduction- away from midline
Adduction- to midline
III. Neuromuscular involvement A. Cerebral palsy - definition and etiology
Non-progressive
Brain centered
Lack of muscle control
Pre, peri, or post-natally
Anoxia- lack of oxygen
B. Classifications of neuromuscular involvement Hypertonia- tightened/contracted muscles 50% of people with CP have this type IQ increases overtime Difficulty communicating Flexor spasticity- tight ball Extensor spasticity- pushed out Hypotonia- loose, flaccid muscles Athetosis- Alternating hypertonia and hypotonia Rigidity- stiff Tremor- hands, arms Ataxia- balance issues -Less than 3% have it
C. Classification according to limb involvement Monoplegia- One arm and one leg Hemiplegia- 1/2 of the body
Double hemiplegia- 4 limbs, A+ L-, more on one side Triplegia- 3 limbs, L+
Paraplegia- Legs only Quadriplegia- 4 limbs equally Diplegia- 4 limbs, L+
IV. Handling and positioning A. Rotation
-never lift anyone more than 1/3 of your weight hip trunk B. Inversion -when the hips are higher than the head -head lifting C. Positioning 1. Four basic principles 1. Chin slightly flexed 2. Arms and shoulders down and forward 3. Head and trunk in midline 4. Hips, knees, and ankles at 90 degrees 2. Why and when to position -senses -respiratory -eating 3. Prone – wedges (belly) -wedges are not one size fit all -bring them an activity -sternum to knees (or ankles) -bolster can be added to a wedge (adduction) 4.
I. Management Programs vs. Instructional programs
II. Patterns of normal development Cephalo – Caudel (head to tail) Proximal – Distal (midline first) Mass to Specific Gross to Fine (large movements to small)
Flexion-bending
Extension- straightening
Supine- lying on back
Prone- lying on stomach
Abduction- away from midline
Adduction- to midline
III. Neuromuscular involvement A. Cerebral palsy - definition and etiology
Non-progressive
Brain centered
Lack of muscle control
Pre, peri, or post-natally
Anoxia- lack of oxygen
B. Classifications of neuromuscular involvement Hypertonia- tightened/contracted muscles 50% of people with CP have this type IQ increases overtime Difficulty communicating Flexor spasticity- tight ball Extensor spasticity- pushed out Hypotonia- loose, flaccid muscles Athetosis- Alternating hypertonia and hypotonia Rigidity- stiff Tremor- hands, arms Ataxia- balance issues -Less than 3% have it
C. Classification according to limb involvement Monoplegia- One arm and one leg Hemiplegia- 1/2 of the body
Double hemiplegia- 4 limbs, A+ L-, more on one side Triplegia- 3 limbs, L+
Paraplegia- Legs only Quadriplegia- 4 limbs equally Diplegia- 4 limbs, L+
IV. Handling and positioning A. Rotation
-never lift anyone more than 1/3 of your weight hip trunk B. Inversion -when the hips are higher than the head -head lifting C. Positioning 1. Four basic principles 1. Chin slightly flexed 2. Arms and shoulders down and forward 3. Head and trunk in midline 4. Hips, knees, and ankles at 90 degrees 2. Why and when to position -senses -respiratory -eating 3. Prone – wedges (belly) -wedges are not one size fit all -bring them an activity -sternum to knees (or ankles) -bolster can be added to a wedge (adduction) 4.