Paediatric Physical Therapy programme: ​​Module 2 ​

MANAGE​MENT OF MUSCULOSKELETAL IMPAIRMENTS

1. CONGENITAL MUSCULAR TORTICOLLIS
  • Etiology and pathophysiology
  • Anatomy of the SCM
  • Differential Diagnosis
  • Impairments (according to the ICF model)
  • Typical activity limitation
  • PT examination
  • Findings in congenital muscular torticollis
  • Plagiocephaly and facial asymmetry
  • PT intervention
  • Biomechanics of stretching and recommended stretching protocol
  • Orthotic devices
  • Instruction to care givers
  • Medical Management – Plagiocephaly
  • Anticipated outcomes of PT intervention 

2. ARTHROGRYPOSIS MULTIPLEX CONTENITA
  • Etiology
  • Progress in primary prevention
  • Diagnosis
  • Clinical manifestation
  • Medical Management
  • Stretching and Splinting
  • PT in the pre-school period
  • Examination, goals, intervention strategies and stretching and orthotics
  • PT in the school age
  • Transition to adulthood

3. OSTEOGENESIS IMPERFECTA
  • Classification
  • Pathophysiology
  • Medical Management
  • Impairment – Diagnosis and problem Identification
  • Examination/Evaluation and intervention during infancy pre-school and school going period and adolescence
  • Transition to adulthood

4. MUSCULAR DYSTROPHY
  • Role of PT
  • PT evaluation/examination
  • Muscular Dystrophy – dystrophic associated protein and muscular dystrophy
  • Duchene’s MD
  • Management considerations- in infancy to pre-school age, early school age.
  • Vignos functional Rating Scale for DMD
  • Clinical Protocol for functional testing in DMD
  • PT interventions
  • Adolescent period
  • Continuation of standing/walking
  • Exercise/custom equipment
  • Becker’s Muscular Dystrophy
  • Congenital MD
  • Childhood onset Facio-scapulohumeral MD
  • Congenital Myotonic MD
  • Emery-Dreifuss MD

5. SPINAL MUSCULAR ATROPHY
  • Diagnosis
  • Pathology
  • Classification – type one, Chronic type two
  • Juvenile-onset spinal muscular atrophy type three

6. ORTHOPAEDIC CONDITIONS 1
  • Torsional conditions
  • Foot progression angle
  • Hip rotation, femoral ante version and Retroversion
  • Thigh-foot axis, tibia torsion
  • Internal tibial torsion – intervention
  • Metatarsus adducts
  • Calcaneovalgus
  • Foot alignment problems
  • Genu varum
  • Genu Valgum
  • Flat foot
  • Clubfoot
  • Blount’s disease/Tibia vara
  • DDH – clinical examination
  • Intervention - Pavlik harness

7. ORTHOPAEDIC CONDITION 11
  • Causes of Limping
  • History and physical exam
  • Other diagnostic tests
  • Common diagnosis by age – 0 to 5 years
  • Osteomyelitis
  • Septic arthritis
  • Transient synovitis
  • Occult fractures
  • Kohler Syndrome
  • Additional causes of limp – ages 5 to 10 years
  • Legg-Calve Perthe's disease
  • Discoid lateral Meniscus
  • Sever Disease 
  • Growing Pains
  • Ages 10–15 years causes of limping
  • SCFE (slipped femoral capital femoral epiphysis)
  • Osgood-Schlatter syndrome
  • Oseto Chondroitin Dissecans
  • Idiopathic Toe-walking
  • Achondroplasia
  • Leg Length Inequality
  • Origin/impairments
  • Clinical examination 
  • Limb lengthening
  • Role of PT in limb lengthening
  • Case study

8. JUVENILE IDIOPATHIC ARTHRITIS
  • Diagnosis/classification
  • Primary/secondary clinical manifestation
  • Medical management
  • Prognosis and PT examination
  • Participation/activity restrictions
  • Joint structure/function
  • CHAQ (Childhood Health Assessment Questionnaire)
  • Joint exam – pattern of joint and soft tissue restrictions and clinical adaptation in JRA/JIA
  • Muscular structure/function and physical fitness
  • Assessment of pain
  • Growth disturbance/postural abnormalities
  • Management of joint health
  • Orthopedic surgery and role of PT
  • Fitness training
  • Functional mobility

9. SPINAL CONDITIONS
  • Development of the spine
  • Scoliosis
  • Classification based on spinal curve location
  • Idiopathic scoliosis
  • Origin/incidence/pathophysiology/natural history
  • Congenital Scoliosis
  • Origin/incidence/pathophysiology
  • PT treatment for idiopathic and congenital scoliosis
  • Non-surgical interventions
  • Surgical interventions
  • Post-op management
  • Neuromuscular scoliosis
  • Intervention and surgical options
  • Kyphosis – congenital
  • Scheuermann’s disease
  • Lordosis
  • Spondylolysis and spondylolisthesis - clinical symptoms, risk of progression 
  • Non-surgical intervention
  • Surgical intervention

Module 3 ​