The document provides information on cerebral palsy, including:
- It was first described in 1862 and the term originated with Freud.
- It is a non-progressive disorder of motor development caused by disturbances in the developing brain.
- Symptoms can include developmental delays, abnormal muscle tone and movement patterns, unusual posture, and early hand preference.
- It is classified based on affected limbs (diplegia, hemiplegia, quadriplegia) and physiological characteristics (spastic, dyskinetic, ataxic, hypotonic).
- Assessments evaluate multiple body systems and functions like posture, mobility, sensation, and fine motor skills.
This presentation contains detailed knowledge about Down's Syndrome its types, clinical presentation, diagnosis, medical and physio therapeutic management of the condition.
Down syndrome is a condition in which a person has an extra chromosome. Chromosomes are small “packages” of genes in the body. They determine how a baby’s body forms and functions as it grows during pregnancy and after birth. Typically, a baby is born with 46 chromosomes. Babies with Down syndrome have an extra copy of one of these chromosomes, chromosome 21. A medical term for having an extra copy of a chromosome is ‘trisomy.’ Down syndrome is also referred to as Trisomy 21. This extra copy changes how the baby’s body and brain develop, which can cause both mental and physical challenges for the baby.
This presentation contains detailed knowledge about Down's Syndrome its types, clinical presentation, diagnosis, medical and physio therapeutic management of the condition.
Down syndrome is a condition in which a person has an extra chromosome. Chromosomes are small “packages” of genes in the body. They determine how a baby’s body forms and functions as it grows during pregnancy and after birth. Typically, a baby is born with 46 chromosomes. Babies with Down syndrome have an extra copy of one of these chromosomes, chromosome 21. A medical term for having an extra copy of a chromosome is ‘trisomy.’ Down syndrome is also referred to as Trisomy 21. This extra copy changes how the baby’s body and brain develop, which can cause both mental and physical challenges for the baby.
Spina Bifida: Physiotherapy in the management of meningomyeloceleAyobami Ayodele
Spina bifida is a treatable spinal cord malformation that occurs in varying degrees of severity. Meningomyelocele is associated with abnormal development of the cranial neural tube, which results in several characteristic CNS anomalies. About 90% of babies born with Spina Bifida now live to be adults, about 80% have normal intelligence and about 75% play sports and do other fun activities. Most do well in school, and many play in sports.
As part of a class presentation, we attempted to make this to briefly explain what Torticollis meas, the Types of presentation of Torticollis, and Management strategies for a Physiotherapist for Congenital Torticollis especially.
I hope this helps. :)
The pictures and information had been taken from internet, complied to make a brief presentation for the purpose of class presentation.
I do not own any content.
Spina Bifida: Physiotherapy in the management of meningomyeloceleAyobami Ayodele
Spina bifida is a treatable spinal cord malformation that occurs in varying degrees of severity. Meningomyelocele is associated with abnormal development of the cranial neural tube, which results in several characteristic CNS anomalies. About 90% of babies born with Spina Bifida now live to be adults, about 80% have normal intelligence and about 75% play sports and do other fun activities. Most do well in school, and many play in sports.
As part of a class presentation, we attempted to make this to briefly explain what Torticollis meas, the Types of presentation of Torticollis, and Management strategies for a Physiotherapist for Congenital Torticollis especially.
I hope this helps. :)
The pictures and information had been taken from internet, complied to make a brief presentation for the purpose of class presentation.
I do not own any content.
Motor learning: Foundations for clinical practiceMohsen Sarhady
پس از بررسی پارادایمهای توانبخشی حرکتی به معرفی نظریه ی سیستمهای پویا در کنترل حرکت پرداخته شده است و سپس مباحث مختلف یادگیری حرکتی از جمله طبقه بندی مهارتهای حرکتی، مراحل یادگیری حرکتی، انواع تمرین و انواع فیدبک افزوده بیان شده است.
Presentation by Pre-Med (2013) Students of Penang Medical College. This presentation is based on a mini research paper on Multidisciplinary Management of Cerebral Palsy. Group members consist of Nurul Najihah,Daniel Koshy & Maheshwaran
A brief introduction to the topic cerebral palsy, prepared by Dr Yash Oza, PG resident in MS Orthopaedics
Etiology, Classification, assessment, diagnosis, treatment
Early Physiotherapy and Management of Deformities.pptxICDDelhi
Dr. Mansoor Alam is a child developmental specialist from ICD, New Delhi. He is a medicine graduate with specialization in Developmental Disability Management. After his graduation, he joined Spastic Society of Northern India, New Delhi to have a Post-Graduation Diploma in Developmental Therapy under RCI. Later, he went to Bobath Centre in London, (United Kingdom) to have specialized training in Bobath Approach to the treatment of Children with Cerebral Palsy, which is popularly known as Neurodevelopment Treatment (NDT). While, he was in Sydney, Australia, he did an advance course on the Use of Botox in Spasticity Management. He is one of the few professionals in India who attended Gait Analysis Course in Australia. To have in-depth knowledge to work with children neurodevelopmental disabilities, he pursued specialized training programs on GMA (General Movements Assessment), Constrained Induced Manual Therapy (CIMT), Early Intervention, Sensory Integration Therapy, Clinical Pathology and Acupuncture.
He joined SSNI as an associate professional in 1993 and worked for 8 continuous years. He became the technical director of “Udaan for the Disabled, New Delhi” to manage the India’s first Multimode Therapy Project in 2001. The MMT Project was the first project in India which conducted studies on the efficacy of Hyperbaric Oxygen Therapy (HBOT) along with other medical therapies including pediatric Therapy in children with neurodevelopmental disabilities ( Cerebral Palsy and Autism).On completion, the MMT Project, he joined Prerna Welfare Society as the Chief Consultant and Executive Director. In 2013, he started an organization named “Institute for Child Development, New Delhi”. Presently, he is the Executive Director of ICD, New Delhi and associated consultant to many organizations.
Posture is a “position or attitude of the body a relative arrangement of body part
for a specific activity or a characteristic manner of bearing the body”.
what is crouch gait and its Physiotherapy rehabilitation
this type gait mostly seen in spastic diaplegic Cerebral palsy child least common in quadriplegic C P , and hemiplegic C P
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
1. Cerebral palsy
M. Sarhady MSc OT 2013
Occupational Therapy Department
Hamedan University of Medical Sciences
Email: msarhady1980@gmail.com
2. Cerebral Palsy
Was first described by William Little in 1862.
Then it was known as Little disease.
The term Cerebral palsy originated with Freud.
Definition
Cerebral palsy (CP) describes 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. The motor disorders of cerebral palsy are
often accompanied by disturbances of sensation, perception, cognition,
communication, and behavior, by epilepsy, and by secondary
musculoskeletal problems.
3. KEY FEATUR ES OF THE DEF INITION
CP is best seen as a group of closely related conditions,
heterogeneous both in manifestations and causes.
CP is understood to be a disorder of motor development.
CP must be of sufficient severity to cause activity limitation
.
CP is understood to be non-progressive disturbance of the brain
4. PREVALENCE
The Incidence is between 2.4-2.7 per 1000
live births.
In some references: 0.6 to 7cases per 1000
live births
In preterm or low birth weight infants: 40 to
150 per 1000 live births
9. Diplegia
Most common 50%
Premature infants
Intelligence normal
Most children with diplegia
walk eventually
Although walking is delayed
usually until around age
4 years
10. Hemiplegia
Prevalence: 30%
Typically have sensory
changes
Hemiplegic patients also
may have a leg-length
discrepancy
11. Quadroplegia
Significant cognitive deficiencies
that make care more difficult.
Head and neck control which helps
with communication, education,
and seating.
12. Physiological classification
Spastic:
The commonest neurologic abnormality in CP
Characterized by increased muscle tone manifest as increased resistance to stretch
that is velocity dependent
Flexor posture in upper limb and Extensor posture in lower limbs
Dyskinetic: Stereotyped, involuntary movements that are accentuated with effort
Has two types:
Dystonia: abnormal postures due to sustained muscle contractions are the essential feature
Choreo-athetosis:
Choreiform movements: rapid and jerky
Athetoid movements: have a writhing quality
Ataxic:
Ataxic gait(staggering, wide-based gait)
Coordination (finger to nose)
Intention tremor
Hypotonic
17. Functional classification
Gross Motor Function Classification System(GMFCS)
Manual Ability Classification System(MACS)
Bimanual fine motor function scale(BFMFS)
Functional Mobility Scale (FMS)
18. Gross Motor Function Classification System(GMFCS)
Level I: Walks without limitations
Level II: Walks with limitations
Level III: Walks using a hand-held mobility device
Level IV: Self-mobility with limitations; may use powered mobility
Level V: Transported in a manual wheelchair
23. Musculoskeletal Disorders
Foot/ankle:
Equinus: increased tone or contractures of the gastrocsoleus
Equinovarus: combination of spasticity of the posterior
tibialis muscle and the gastrocsoleus, resulting in inversion and
supination of the foot and a tight heel cord
Equinovalgus: spasticity of the gastrocsoleus and the
peroneal muscles, as well as weakness in the posterior tibialis
muscle.
Hallux valgus: valgus deformities of the foot, which may
lead to a painful bunion at the head of the first metatarsal
24. Musculoskeletal…
Knee:
Knee flexion contractures: spasticity in
the hamstring muscles and static positioning in a
seated position
Genu valgus
Hip:
Acquired hip dysplasia: leads to
progressive subluxation and possible dislocation
Windswept deformity
25. Musculoskeletal…
Spine:
Kyphosis: Leading to a posterior pelvic tilt
Lordosis: Associated with hip flexion contractures
Scoliosis: Curves greater than 40 degrees tend to progress
Upper extremity:
The shoulder is often positioned in an adducted and internally rotated
position
Elbow flexion: less than 30 degrees rarely have functional significance
Forearm pronation deformities
Wrist flexion, typically with ulnar deviation
Finger flexion and swan neck: hand intrinsic muscle spasticity
Thumb in palm deformity
29. Background data
Reason for referral
Medical history
Parental concerns
Information from other health professionals
30. Systems assessments
Regulatory system;
Sensory processing system;
Musculoskeletal system;
Neuromuscular system;
Cardiopulmonary system;
Gastrointestinal system;
Postural Control and Balance;
Systems
assessments
Regulatory
Sensory
processing
Musculosk
eletal
Neuromus
cular
Cardiopul
monary
Gastrointe
stinal
Postural
Control
and
Balance
31. Regulatory system
Self-regulation: the internal capacity to tolerate sensory stimulation
from individuals and environment
Capability to modulate the intensity of arousal experienced while
remaining engaged in the interaction/activity
Sleep patterns and routines
Calming/coping strategies used by parents
Infant’s ability to self-calm
Infant’s physiological responses to movement and handling
32. Sensory processing system
Ability to receive, register, and organize sensory input for use in
generating the body’s adaptive responses to human and object
interactions and to the surrounding environment
Awareness of and the ability to orient to sensory information, as well
as integrating combinations of multisensory input for functional
behavior
1. Tactile/Somatosensory
2. Proprioceptive
3. Vestibular
4. Visual
5. Auditory
33. Musculoskeletal system
Exaggerated stretch reflex
Muscle hypoextensibility
Insufficient force production
Abnormal postural alignment
Range of motion restrictions
Contractures and deformities
35. Musculoskeletal…
Insufficient force production
Insufficient force production results in decreased ability to
produce power during active contraction, for example, vertical
jumping or push-off during gait
Inability to sustain adequate force production for a specific
functional task
Insufficient
force
production
Inadequate
number of
motor units
Hypo
extensibility
36. Neuromuscular system
Timing and sequencing of muscle activity
Agonist-antagonist muscle control
Grading of eccentric and concentric muscle activity
Selective motor control
Anticipatory postural control
Motor learning
37. Cardiopulmonary system
1. Physiological Control:
Heart rate, respiratory rate, oxygen saturation, autonomic and
visceral indicators of stress
sighing; yawning; sneezing; sweating; hiccupping; tremoring;
coughing; gagging/choking; color change; respiratory pauses;
2. Endurance:
Fatigue
Poor intake
Poor weight gain
Decreased
endurance
38. Gastrointestinal system
Abnormal extensor tone following feedings
Frequently refuse feeding or take small amounts of food during feeding
Excessive vomiting following meals
Excessive GI discomfort (e.g., gas or burping) during or following feeding
Disliking prone positioning
…
39. Postural Control and Balance
Postural control is the ability to adjust the body’s position in space
for the purposes of orientation, stability, anticipatory control, and
alignment
Postural orientation: maintaining the appropriate relationship between body
segments in a specific environment for a specific task
Postural stability or balance: ability to maintain the center of mass (COM) over
the base of support (BOS)
Alignment (contributes to both orientation and stability): maintaining the most
optimal posture with respect to gravity and the base of support
Anticipatory postural control: ability to modify the sensory and motor systems
in response to changing task and environmental demands
41. Gross Motor Function
Postural Control and Transitions
Range of Motion and Skeletal Alignment
Reflexes
Postural Reactions
Gait: Arm swing, stride length, heel strike, toe-off, and stance
42. Reach and Upper Extremity
Support
In early development, the upper extremities are used to assist with
postural stability and control
As the infant develops greater head and trunk control, arm function
increases
Weight bearing, weight shifting, and reaching in the upper
extremities assist in the development of postural control and
development of scapula-humeral control necessary for reaching in
space
43. Hand Function
Two responsibilities of the hand:
Sensorimotor exploration of objects
Perceptual gathering of information
Functions:
Grasp
Release
Manipulation
44. Play and ADL
Play:
Motivation or interest
Adequate postural control
Social interaction with a variety of people
Gross and fine motor
Regulatory and sensory systems
Duration and frequency of play time
Different positions for play
ADL:
Toleration or enjoyment in: feeding, dressing, bathing,
diapering, and being carried
Positions and routines used for: feeding, dressing, bathing,
diapering, carrying, and sleeping.
45. Analysis of assessment data
Look first at how the infant is moving and interacting
1. How atypical is the response?
2. How often is the atypical or abnormal response elicited and under what circumstances
or conditions?
3. What is going on in other areas of development that may be influencing this behavior?
4. How does the atypical or abnormal movement affect function?
5. Can the responses be managed with specific structuring, environment alterations, or
handling by parent, therapist, or caregiver?
Analyzing why the impairments may be occurring and which
systems are involved
Determine what impairments may be causing the abnormal movement patterns
and behaviors
Assessment data for the eventual development of goals and treatment
strategies.
48. Functional Goal Setting
Functional goals are based on the identified functional
limitations
The treatment goals should identify the expected
functional outcomes and provide the foundation for
treatment planning and selection of intervention
strategies
Therapist may need to educate the family and to assist
them in accepting and writing more developmentally
appropriate goals
49. Functional Goal Setting
A good functional goal should contain the following: subject , action
verb , observable functional performance , conditions of
performance , and criteria for performance:
Subject is the client, who will be demonstrating success of the goal
Action verb should be selected to show some posture or movement (e.g. walking,
standing, reaching, and cup drinking)
Observable function performance is the movement skill that is directly related
to the action verb (e.g. child will move from long sit to side sit, Or will push up onto
extended arms)
Conditions of the performance is the circumstances and environment under
which the goals will be evaluated. e.g.:
Initial OT Goal : In supported sitting, Jenny will bang a toy on a surface using a gross radial grasp.
Follow-Up OT Goal: Sitting in a high chair, Jenny will bang a toy on a surface using a gross radial grasp.
Measurable or qualitative criteria to assess the achievement of the
performance (e.g. Accuracy, distance, and speed can all be used to measure how well the
performance is executed)
50. Treatment Planning
1) Select an Identified Goal
2) List and Prioritize System Impairments
3) Identify and Prioritize Treatment Strategies
4) Assess Outcomes of Treatment Session and Strategy
52. Guidelines for Treatment Planning
1. Communicate with the family on a regular basis
2. Start from a position of strength
3. Goals should be functional
4. Goals should be meaningful to the family
5. Address the regulatory issues first
6. Take time to build a relationship based on trust
7. Create a motivating environment
53. Guidelines…
8. Preparation is not a BAD word
9. Integrate sensory input to enhance motor output
10. Integrate play activities into treatment
11. Allow the child to plan and initiate motor behaviors
12. Allow the child adequate time to problem solve
13. Practice and repetition are essential
14. Therapist handling should decrease as the infant acquires skill
55. Some treatment approaches
Rood’s Sensorimotor Approach:
Facilitation techniques: light stroking, brushing, icing, and joint compression are
used to facilitate movement.
Inhibition techniques: joint approximation (light compression), neutral warmth,
pressure on tendon insertion, and slow rhythmical movement are used to inhibit
unwanted movement (i.e., spasticity).
Bobaths’ Neurodevelopmental Treatment:
Reflex inhibiting postures are used to inhibit primitive reflexes (RIPs).
Sensory stimulation is regulated with great care.
normal movement and posture: Weight bearing, placing and holding, tapping
and joint compression.
Kabat’s Proprioceptive Neuromuscular Facilitation:
Uses diagonal & spiraling patterns of movement
Eleven basic principles
Uses two diagonal patterns crossing the mid-line for each major body part
56. Some treatment approaches…
Carr & Shepherd’s Motor Relearning Program:
Uses dynamical systems model of motor control
Emphasize interaction between performer and environment
Does not accept the hierarchical sequence of motor relearning
Acknowledge critical role of cognition in motor learning
Movement patterns practiced in context of tasks, rather than exercises
Trombly’s Task Focused Approach:
Five general principles:
1. Client centered focus
2. Occupation based focus
3. Person & Environment – enablers/barriers
4. Practice & Feedback - encoding
5. General treatment goals – role fulfillment, problem-solving skills re: best way to
accomplish valued tasks
Constraint-Induced Movement Therapy
TAMO TM
MOVE curriculum