Cerebral Palsy

ISBN-13: 9783319745572 / Angielski / Twarda / 2020 / 3145 str.

Freeman Miller; Steven Bachrach; Nancy Lennon

Spis treści

Section 1  Etiology

 

The Child, The Parent and the Goal

Prematurity

Congenital malformation

Infections

Congenital Metabolic

In utero Stroke

Problem during delivery

Post natal encephalopathy

 

Section 2 Epidemiology

 

Over-view of the past 50 Years

American experience

European Experience

Asian experience

African experience

 

Section 3 Pathology

 

Physical pathology

Current Imaging -PET

Muscle changes at the cellular level

Gross Anatomic Muscle changes in CP

Neuro-motor junction changes

Bone Alterations in CP

 

Section 4 Diagnosis

 

Over view of when and how to evaluate

Who should get Imaging

Indications for metabolic work up

Indications for full genetic work up

Prognosis assessment - role of PE -Pathologic Reflexes

Classification Terminology

 

Section 5 General Medical Concerns

 

Over view of Normal Natural history

The Irritable Child with CP

Pain in The Non-communicative Patient

Post-operative Pain Management

 

Section 6 Neurologic Problems

 

Seizures - Diagnosis, Natural History

Seizures - Medical Management

Seizures - Ketogenic Diet - Indication and Description

Seizures - Role of VNS

Seizures - Role of Surgical Removal

Seizure Surgery - Workup and technique Description

Pseudo-seizures - Diagnosis and Treatment

Hydrocephalus Diagnosis and treatment indications

Shunting for Hydrocephalus

Surgical Ventriculostomy for Hydrocephalus

 

Section 7 Psychologic and Psychiatric Problems

 

Attention Deficient associated with CP

Autism and CP as Comorbidities

Family Stress Secondary to Disability

Impact on Siblings

Depression associated with CP

Mood disorders (Bipolar and CP)

Thought disorder and CP

 

Section 8 Gastro-intestinal Problems

 

Over view and natural of feeding issues with growth and development

Aspiration - risks, work up, when is it a problem

Gastrostomy feeding - when indicated

Tracheostomy or diversion - When indicated and how done

Weight and growth in the child with CP

Feeding Therapy - Indications how long (Maybe in therapy section)

GE reflux - Work up and medical Management

GE Reflux - Work up and Surgical Management

Poor Intestinal Motility

Constipation - Implications long term and treatment

 

Section 9 Genito-Urinary

 

Toilet training and bladder control - Expectations and when to work up

Neurogenic Bladder

Renal stones - risks, prevention and management

Undescended Testicles -

 

Section 10 Ear Nose and Throat

 

Drooling - diagnosis, measurement and medical management

Drooling - management with local injections - Botulinum

Drooling - Surgical treatment options and outcomes

Hearing Evaluation - When and How

Cochlear Implant Indication and role in CP

Upper Airway Obstruction - Indication for adenoid and tonsillectomy

 

Section 11 Pulmonary

 

Bronchopulmonary Dysplasia - Natural History, etiology and outcome

Bronchopulmonary Dysplasia - Medical management

Reactive airways - Chronic aspiration

Airway obstruction - Work up and medical management

Airway obstruction - Indication and options for surgical management

 

Section 12 Endocrine

 

Pitutary-hypohoseal dysfunction

Adrenal insufficency

Short Stature - Work up and treatment indications

Pillow angel treatment - indication ethics approach

Glucose intolerance due to intramuscular fat

Premature or Delayed Sexual Maturation

 

Section 13 Eyes

 

Testing Sight - how when and the outcome

Strabismus

Cortical blindness

 

Section 14 Dental

 

Routine hygiene, When and how for child with CP

Dental Caries - When to treat, how often to check outcome

Gum Hypertrophy - etiology, and management and outcome

Malignments - when to treat and expected outcome

Bruxism - Management and long term outcome

Lip biting - Management and long term outcome

 

Section 15 Neuromuscular Function

 

Neurologic Control of the Muscluosketal System

Muscle tone - Spasticity - Assessment

Movement disorders - Description and assessment

Medical Management of Spasticity

Medical Management of Movement disorders

Local treatment - Botulinum, Phenol, Neurectomy

Inthrathecal Baclofen Therapy

Dorsal Rhizotomy

Deep Brain Stimulation

Ataxia - Disorder of Balance, Description and Assessment

Assessing dynamic Balance

 

Section 16 Gait in CP

 

Normal Gait

Overview and Natural history of CP Gait

Use of Diagnostic Gait Analysis to Guide Treatment

Using Gait Analysis as an Outcome Assessment

Managing Hemiplegic Gait

Diplegic Gait

Torsional Malignments

Stance phase - Crouch and Back Kneeing

Swing Phase - Toe drag

Gait with Movement Disorders

Gait in Ataxia

Complications of Gait Management and Gait Analysis

 

Section 17 Upper Extremity

< 

Overview of Natural History and Outcome

Assessment of the Upper Extremity for Diagnostic Assessment

Assessment of the Upper Extremity for Outcome Evaluation

Tone Management - Botulinum, Neurectomy, Rhizotomy

Single Event Multi-level Surgery Approach

Shoulder

Elbow

Forearm and Wrist

Thumb

Fingers

 

Section 18 Spine

 

Overview and Natural History

Non-operative Management of CP scoliosis

Surgical Planning - Medical Evaluation Pre-op

Role and Response to Spinal Cord Monitoring

Anesthesia for CP Spinal Fusion

Surgical Management of Scoliosis (operative Procedure)

Surgical Management of Kyphosis and Lordosis

Post-operative Management

Managing Early Onset Scoliosis in CP

Managing Complications related to Spinal Fusion

Cervical Spinal Problems in CP

Lumbar Spondolethesis

Ambulatory child CP and Scoliosis

Scoliosis and Hip dislocation - Management considerations

 

Section 19 Hip

 

Summary Overview

Etiology and Natural History

Screening and Surveillance

Prophalactic Treatment

Reconstruction of Common Posterior Lateral Displacement

Reconstruction of the Atypical- Anterior or Inferior Displacement

Palliative or Salvage Treatment

Complications of CP hip Management

 

Section 20 Knee

 

Summary of Knee problems

Patella-femoral instability

Apophositis and stress fractures

Rotatory or torsion Instability

Fixed knee flexion Contracture

Hyper-extension knee deformity

Knee extension Contracture and Stiff Knee Gait

Tibial Torsion and Bowing

 

Section 21 Ankle, Foot, and Toes

 

Over view of the FOOT in CP

Natural History of Foot posture in Children with CP

Equinus

Ankle Varus and Valgus

Planovalgus

Varus

Calcaneovalgus

Hallux

Claw toes, Over Lap, and Crossing Toes

Toe Nail Problems

Complications of Managing Foot Problems

 

Section 22 Physical Therapy

 

Over view and history of therapy for CP

Early Intervention - techniques and outcome

Habilation therapy - in middle childhood - role and outcome

Short High Intensity VS Long-term Low frequency

Rehabilitation Therapy -(Post op) Frequency and Approach

Role of Therapy in Teenagers to prevent function loss

Educational Therapy - Technique outcome, how not medical therapy

Therapy Theories - NDT ECT outcome expectations

Hydrotherapy

Strength Training

Cardiovascular Endurance training

Hippotherapy

Robotic training, Suspended Treadmill training

 

Section 23 Occupational Therapy

 

Over view theories and expectations

Early intervention expectations and outcome

UE Habilation techniques - Outcomes

Constrained use - Enforced use Therapy Techniques and expected outcome

UE splinting VS use encouragement

Evaluation for Driver Training and adaptations

 

Section 24 Speech Therapy

 

Over view of ST and expect outcome

Feeding Therapy Indications, techniques, outcome

Speech therapy, When techniques and expected outcome.

Augmentative communication, When and expected outcome how to evaluate

Training oral control for Drooling - Techniques and outcome

 

Section 25 Augmentative and Complimentary Therapies

 

Over view of the wide range

Swimming with Dolphins

Hyperbaric Oxygen

Acupuncture

Pressure suits and vests

Elastic Space suits

Votja Technique

ECT ECT ECT

 

Section 26 Durable Medical Equipment

 

Standers - Which, when how long, who and what is the benefit

Reclining - Side Lyers, wedges, beds - Benefit for who and when

Gait trainers - Who when how long - Benefit

Walkers - WHO WHEN how long and what is the benefit

Crutches, and canes and sticks -

UE - Self feeders - WHO W WH outcome

 

Section 27 Wheel Chairs

 

General Over view of issues to be considered

Wheel chair VS stroller - difference and why and when and outcome

Power Wheel chair - WHEN WHO outcome

Early power wheeled toy mobility - Benefit outcome

Consideration of the appropriate WHEEL chair for permanent use

One arm drive chair for who and when

 

Section 28 Orthotics

 

General Overview when indicated benefits and risks

Control Foot posture - Arch supports, UCBL and SMO

Ankle control

Knee control options

Hip control

UE orthotics

O autorze

Dr. Freeman Miller was Co-director of the Cerebral Palsy Program and the Clinical Director of the Gait Analysis Laboratory at the Alfred I. duPont Hospital for Children for 30 years. He continues as an emeritus staff member at Alfred I. duPont Hospital for Children providing consultative services and is active in the research program. His clinical practice of pediatric orthopedics is limited to children with cerebral palsy. For the past 25 years, Dr. Miller has held Adjunct Professor appointments in the Departments of Mechanical Engineering and Physical Education at the University of Delaware. He is also a member of the University BIOMS program, which is an interdisciplinary graduate program in biomedical engineering. Current and past research interests include investigation of surgical outcomes of CP surgery through gait analysis, mathematical modeling of the hip joint in children with CP, hip monitoring and management for children with CP, and management of spinal deformity in CP.

Dr. Miller has published approximately 200 articles in peer-reviewed journals. He has been invited to give many lectures in over 35 different countries. As a coauthor with Dr. Bachrach, he published a book Cerebral Palsy: A Guide for Caregiving directed at families and nonmedical care providers, which was published in 1995, second edition in 2006, and in 2017 was revised and released as the third edition. A medical textbook, Cerebral Palsy, with 1080 pages outlining musculoskeletal care of the child with cerebral palsy, was written by Dr. Miller and published in 2005 by Springer-Verlag

Dr. Steven Bachrach was Co-director of the Cerebral Palsy Program and Chief of the Division of General Pediatrics at the Nemours/Alfred I. duPont Hospital for Children in Wilmington, DE, for nearly 30 years. He is Board Certified in Pediatrics and Neuro-developmental Disabilities, and his clinical practice encompassed both general pediatrics and the care of children with developmental disabilities. He continues as an emeritus staff member at Alfred I. duPont Hospital for Children, primarily involved in educational and research efforts. Dr. Bachrach also served for 20 years as Medical Director of the HMS School for Children with Cerebral Palsy in Philadelphia, PA, and currently serves on their Board of Directors. He is also a consultant to the Alyn Hospital in Jerusalem, Israel.

Dr. Bachrach has a faculty appointment as Professor of Pediatrics, Clinical and Educational Scholarship Track, at the Sidney Kimmel Medical College of Thomas Jefferson University. He has been a member of the American Academy of Cerebral Palsy and Developmental Medicine for over 35 years and has often been a presenter at their annual meetings. His research focus has been on children with cerebral palsy, and especially the evaluation and treatment of osteoporosis in children who are non-ambulatory.

ren who are non-ambulatory. Dr. Bachrach has published over 30 articles in peer-reviewed journals, as well as a number of book chapters and abstracts. As a coauthor with Dr. Miller, he published the book Cerebral Palsy: A Guide for Caregiving, which was aimed at a lay audience and published by Johns Hopkins Press in 1995, second edition in 2006, and the third edition in 2017.

Dr. Bachrach has been married for 46 years and has 4 children and 14 grandchildren, all of whom he enjoys spending time with.

Ms. Nancy Lennon a physical therapist, is the manager of the Cerebral Palsy (CP) Program at the Nemours/Alfred I. duPont Hospital for Children in Wilmington, Delaware, where she works with Dr. Miller and Dr. Bachrach. She has many years of experience in the Gait Analysis Laboratory and in Nemours Biomedical Research, where she collaborates with Dr. O ’Neil. Ms. Lennon has a Bachelor of Science degree in physical therapy from the University of Delaware and a Master of Science degree from Hahnemann University. She has 30 years of clinical experience in working with children and families affected by cerebral palsy, 15 years of experience conducting clinical research, and 5 years of experience coordinating family engagement and advisory activities at the hospital.

Margaret E. O ’Neil is a Professor in the Programs in Physical Therapy, Department of Rehabilitation and Regenerative Medicine at Columbia University, Vagelos College of Physicians and Surgeons. She conducts research, advises graduate students, and teaches content in pediatric physical therapy and research. She has received grant funding from several federal and professional organizations. In her research, she examines objective measures of physical activity for youth with cerebral palsy and effectiveness of activity-based interventions (including active video games and virtual reality) to promote fitness and activity. She collaborates with an interprofessional team to conduct her research and they have published widely on these topics.

She co-teaches clinical workshops on measurement and intervention strategies to promote strength and fitness in children with disabilities. She serves as a grant reviewer for multiple agencies and is a member of the APTA and AACPDM where she serves on multiple committees.