Paediatric Physical Therapy programme: Module 1

MANAGEMENT OF NEUROLOGIC DISORDERS

1. CHILD WITH CEREBRAL PALSY
What is CP? Definition
Impairments – Primary, Secondary, and Associated
Classification – GMFCS, MACS, 
Classification - Clinical Presentation
Activity limitations seen in child with CP
Screening
Examination – GMFM and GMPM
Diagnosis
Prognosis – motor growth curves, milestones for prognostic determination of                future walking ability and independent function
Summary of evidence regarding management of impairments and activity                      limitation
Medical management –overview of what is spasticity and its management
Orthopedic surgical management techniques
Gait deviations in spastic CP

2. CHILD WITH DOWN’S SYNDROME
  • Hypertonia
  • Classification
  • General goals of PT
  • Clinical presentation
  • Activity limitation and participation
  • Gross motor delays
  • Sensory integration problems
  • Screening in Down’s syndrome 
  • AAI symptoms ages 3-5
  • Prognosis – motor development guideline in Down’s syndrome
  • Hypotonic and lung development
  • Interventions in Downs’s syndrome 
  • Ball training and treadmill training
  • Postural control training
  • Aerobic exercise
  • Focus on obesity
  • Foot pronation and orthotics – SMOS
  • Communication/Learning style​
3. DEVELOPMENTAL COORDINATION DISORDER
  • Definition/Diagnostic criteria
  • Long-term prognosis
  • Clinical manifestations in a child with DCD
  • Primary impairments including motor control and motor learning deficits
  • Secondary impairments
  • Pathophysiology
  • Activity limitations including fine and gross motor, personal factors, environmental factors
  • Role of PT
  • Clinical assessment
  • Intervention – task specific approaches and cognitive approaches
  • Consultation re: physical activity
4. MYELODYSPLASIA
  • Types
  • Patho-physiology and embryology
  • Etiology
  • Perinatal management
  • Impairments – Primary and secondary
  • International Myelodysplasia study group criteria for assigning motor levels
  • Neuro-Dysfunction including seizures, neurogenic bowel/bladder
  • Age-specific examination and PT intervention 
  • Expected motor ability in Thoracic level Mylodysplasia, High lumbar level L1-L2, L3 level, L4 – L5 level, S1 level and S2-S3 levels
5. SPINAL CORD INJURY
  • Epidemiology
  • Advances in recovery
  • Medical Diagnosis and acute management
  • Medical complications, long-term medical management and prevention of secondary complication
  • Spasticity and pain
  • Skin breakdown/pressure ulcers
  • Orthopedic management including impairments, classification, functional assessment, PT management, Bed Mobility/transfer, wheeled mobility and ambulation
6. BRACHIAL PLEXSUS INJURY
  • Etiology/incidence
  • Pathophysiology
  • Impairments 
  • Natural history/prognosis
  • PT examination – ROM, muscle strength and motor function
  • Mallet’s classification
  • PT goals
  • Medical management
  • Indications for timing of neurosurgery
  • Orthopedic concerns/surgery
7. ACQUIRED BRAIN INJUREIS: TRAUMA, NEAR-DROWNING AND TUMORS
  • Traumatic brain injury – pathology
  • Secondary brain injury
  • Prognosis
  • Near drowning – epidemiology, pathology and prognosis
  • Brain Tumors – epidemiology, pathology and prognosis
  • PT treatment/management for a child with ABI
  • Rancho pediatric levels of consciousness and Rancho levels of cognitive functioning (RLCF)
  • Examination based on RLCF – ROM, muscle strength, motor performance postural control and balance and gait
  • PT goals/treatment strategies as related to RLCF levels
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