Term
| Osgood-Schlatter syndrome = |
|
Definition
| tibial tubercle swelling due to patellar t. pull |
|
|
Term
| Osgood Schlatter: prevalent population |
|
Definition
| girls playing sports; 10-15yo |
|
|
Term
| Osgood Schlatter: outcome |
|
Definition
| self-limiting; by 15yo, tubercle fuses to tibia |
|
|
Term
| Osgood Schlatter: Symptoms (3) |
|
Definition
activity-related pain
limp
acute/chronic |
|
|
Term
|
Definition
neoprene brace
ice p activity
decr activity |
|
|
Term
|
Definition
| amb on toes AFTER 18-24 mos |
|
|
Term
| Idiopathic Toe Walking: R/O... |
|
Definition
| nero disorders (hypertonicity, CP) |
|
|
Term
| Idiopathic Toe Walking: Rx |
|
Definition
stretch gastroc-soleus, ant tib
serial casting (if contractured)
carbon fiber foot plate + FO (for MILD ITW)
carbon fiber foot plate + SMO (for hyperpronation) |
|
|
Term
| Idiopathic Toe Walking: Sensory Rx ideas (2) |
|
Definition
brush feet
no socks in grass/sand/mud
(decr sensitivity to feet may >> incr ability to WB on flat foot) |
|
|
Term
| Idiopathic Toe Walking: observation |
|
Definition
| can child achieve foot flat in full squat? play in foot-flat? |
|
|
Term
| Clubfoot (talipes equinovarus - TEV): description |
|
Definition
forefoot add
small calcaneus
hindfoot in varus
ankle equinus |
|
|
Term
|
Definition
unknown etiology; strong genetic component
multiple babies >> incr risk |
|
|
Term
|
Definition
1/1000 live births
M:F 2:1 |
|
|
Term
|
Definition
serial casting immediately after birth (1x/wk, 6-12 wk)
sx at 1yo to release post mm; bracing
PT for gait training |
|
|
Term
|
Definition
bar from foot to foot
worn 23hr/day >> worn at night
restricts transitional skills |
|
|
Term
|
Definition
| infection of bone by bacteria (S. Aureus, H. influenzae) |
|
|
Term
|
Definition
| begins in metaphysis; spreads rapidly |
|
|
Term
| Osteomyelitis: method of spread |
|
Definition
| spread through blood (through scratch, open fx, sore throat) |
|
|
Term
| Osteomyelitis: common sites |
|
Definition
|
|
Term
|
Definition
(p infection healed)
ROM
gait training
strengthening
GMS |
|
|
Term
|
Definition
|
|
Term
|
Definition
| most common type of osteochondrodysplasias |
|
|
Term
| Achondroplasia: associated with... |
|
Definition
dwarfism
autosomal dominant condition |
|
|
Term
| Achondroplasia: impairments (6) |
|
Definition
cuboid shaped vertebral bodies (spinal compression)
lumbar lordosis, scoliosis
short tubular bones
tibia vara
abnormal limb:trunk ratio (short prox limb)
hypotonia in infant |
|
|
Term
| Achondroplasia: Rx (infants) (3) |
|
Definition
GMS
decr early unsupported sitting (decr kyphosis)
handling/positioning to decr effects of hypotonia |
|
|
Term
| Achondroplasia: Rx (children) (3) |
|
Definition
|
|
Term
| Arthrogryposis Multiplex Congenita (AMC) = |
|
Definition
non-progressive neuromuscular syndrome present at birth;
rare congenital disorder
contractures in ≥2 areas of body |
|
|
Term
|
Definition
unknown
theory:
begins in 1st trimester
decr fetal mvmt
neurogenic/myopathic disorder >> motor weakness >> jt immobilization |
|
|
Term
| AMC: possible factors (3) |
|
Definition
hyperthermia
prenatal viral infection
vascular compromise |
|
|
Term
|
Definition
neuromuscular (7%)
congenital anomalies (6%)
chromosomal abnormalities (2%)
contracture syndromes (35%)
AMYOPLASIA (43%) (classic form) |
|
|
Term
| AMC: affected jts (least to most involved) (6) |
|
Definition
shldr
elbow
knee
wrist
hip
foot (nearly always involved) |
|
|
Term
|
Definition
|
|
Term
|
Definition
hips flexed, dislocated
knees ext
club feet
shldr IR
elbow flex
wrist flex, ulnar dev |
|
|
Term
|
Definition
hips abd, ER
knees flex
club feet
shldr IR
elbow ext
wrist flex, ulnar dev |
|
|
Term
|
Definition
multiple jt contractures (2º to jt fusion, not mm shortening)
fibrotic jt capsule |
|
|
Term
| AMC: fxnl limitations (3) |
|
Definition
limited mobility (rolling, creeping, transitional mvmt)
limited ambulation
decr endurance |
|
|
Term
|
Definition
KEY: accurate, frequent A/PROM
bracing/casting
fxnl mvmt more important than quality of mvmt |
|
|
Term
| JRA = abbreviation for... |
|
Definition
| juvenile rheumatoid arthritis |
|
|
Term
|
Definition
| persistent arthritis (>6wk) in ≥1 jts in child <16yo |
|
|
Term
|
Definition
unknown
autoimmune inflammatory disorder triggered externally in the **genetically predisposed** |
|
|
Term
| JRA: subtypes (as per Am. College of Rheumatology) (3) |
|
Definition
polyarticular (40%)
oligoarticular (PAUCIarticular) (50%)
systemic disease (10%) |
|
|
Term
| JIA = abbreviation for... |
|
Definition
| juvenile idiopathic arthritis (6 subtypes) |
|
|
Term
| JCA = abbreviation for... |
|
Definition
| juvenile chronic arthritis (7 subtypes) |
|
|
Term
|
Definition
| arthritis in ≥5 jts during 1st 6 mos of disease |
|
|
Term
| Polyarticular JRA: distribution, description |
|
Definition
symmetric
lg/sm jts; often C spine, TMJ
jts swollen, warm (not red) |
|
|
Term
| Polyarticular JRA: rheumatoid factor |
|
Definition
|
|
Term
| Polyarticular JRA: age at onset |
|
Definition
occurs throughout childhood
peak 1-3yo |
|
|
Term
| Polyarticular JRA: gender |
|
Definition
|
|
Term
| Polyarticular JRA: uveitis |
|
Definition
5% of kids
chronic uveitis (asymptomatic inflammation of eye >> fxnl blindness) |
|
|
Term
|
Definition
|
|
Term
| Polyarticular JRA: worst time of day |
|
Definition
|
|
Term
| Pauciarticular (oligoarticular) JRA = |
|
Definition
| ≤4 jts involved during first 6mos |
|
|
Term
| Pauciarticular (oligoarticular) JRA: jts involved |
|
Definition
knee >> ankles/elbows
Ø hip, hand |
|
|
Term
| Pauciarticular (oligoarticular) JRA: presentation |
|
Definition
| swollen, warm jts; not always painful |
|
|
Term
| Pauciarticular (oligoarticular) JRA: age at onset |
|
Definition
throughout childhood
peak 1-2 yo |
|
|
Term
| Pauciarticular (oligoarticular) JRA: gender |
|
Definition
|
|
Term
| Pauciarticular (oligoarticular) JRA: rheumatoid factor |
|
Definition
|
|
Term
| Pauciarticular (oligoarticular) JRA: uveitis |
|
Definition
|
|
Term
| Pauciarticular (oligoarticular) JRA: Px |
|
Definition
| excellent, except for eyesight |
|
|
Term
|
Definition
variable # of jts involved
**fever 1-2x/d, c rash** (usually in afternoon/evening) |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Systemic JRA: rheumatoid factor |
|
Definition
|
|
Term
|
Definition
| mod to poor (faster progression) |
|
|
Term
| JRA: clinical manifestation (during flare-up) (11) |
|
Definition
jt swelling, pain, morning stiffness
limited ROM; contractures
mm atrophy/weakness/poor endurance
fatigue
decr aerobic capacity
acute/chronic uveitis
gait deviations
osteopenia
difficulties c ADLs
activity restrictions
daily fluctuation of pain, stiffness, activity level |
|
|
Term
| JRA: duration of flare-ups |
|
Definition
|
|
Term
|
Definition
NSAIDs (Naproxen, tolmetin, ibuprofen)
disease-modifying anti-rheumatic meds (methotrexate; bad for liver)
systemic glucocorticoids (for systemic JRA) |
|
|
Term
|
Definition
jt exam: P/AROM, swelling, redness, warmth
mm exam: MMT, atrophy
aerobic capacity (not 2º to disease, but rather 2º to hypoactivity)
pain: VAS, PPQ, color-coded body map, parent input, pain behaviors (guarding, bracing, rubbing, rigidity)
gait: cadence/step/symmetry, foot/ankle biomechanics |
|
|
Term
|
Definition
therapeutic pool!! (warm)
pain mgmt
maintain/improve joint ROM (stretch, serial casting, bracing [wrist/elbow])
HEP: stretch every morning, daily exercise
strengthening & exercise |
|
|
Term
| JRA: PT Rx - strengthening & exercise |
|
Definition
target mm surrounding involved jts
isometrics during acute inflammation
participation in PE class
fxnl mobility (disencourage wagons, use supportive shoes)
Ø self-care (refer to OT) |
|
|
Term
| Osteogenesis Imperfecta (OI) = |
|
Definition
| fragility of bone; congenital disorder of CT |
|
|
Term
|
Definition
|
|
Term
|
Definition
severe & disabling
multiple fx @ birth; high mortality |
|
|
Term
|
Definition
milder form; fx p birth
numerical classification system |
|
|
Term
|
Definition
osteoporosis (frequent fx)
bowing of long bones
spinal deformities
mm weakness
ligt laxity
frequent jt dislocation
developmental delay
other (blue sclera, hearing loss, excessive sweating, easy brusing) |
|
|
Term
| OI: medical mgmt - pharmacologic |
|
Definition
| vitamins/drugs (ineffective in preventing fx) |
|
|
Term
| OI: medical mgmt - fx mgmt |
|
Definition
sx: rods in long bones; osteotomies for bowing
PT p fxs |
|
|
Term
|
Definition
| osteoporosis >> fx >> immobilization >> disuse osteoporosis >> fx... |
|
|
Term
| OI: PT Rx (infancy) - goal |
|
Definition
|
|
Term
| OI: PT Rx (infancy) - education |
|
Definition
positioning, handling, gentle play time
neutral jts, midline orientation |
|
|
Term
| OI: PT Rx (infancy) - developmental activities |
|
Definition
**UE WB**
normal falling for prot ext is **discouraged**
not PTS s full support
pool exercise |
|
|
Term
| OI: PT Rx (preschool) - hx |
|
Definition
many fx by 4 yo
mm weakness
fragile bone
popcorn calcifications (2º to previous fxs) |
|
|
Term
| OI: PT Rx (preschool) - goal |
|
Definition
protective WB
self-mobility for independence |
|
|
Term
| OI: PT Rx (preschool) - treatment |
|
Definition
equipment assessment
strengthening of weak mm (usually hip ext/abd)
trike, scooter board, overhead reaching
aquatic program |
|
|
Term
| OI: (preschool) - developmental milestones |
|
Definition
| developmental milestones delayed, but promising |
|
|
Term
| OI: (school age) - frequency of fx |
|
Definition
|
|
Term
| OI: PT Rx (school age) - bracing |
|
Definition
| TLSO, KAFO (>>fx @ top/bottom of brace) |
|
|
Term
| OI: PT Rx (school age) - HEP |
|
Definition
strengthening
stretching
aerobic (non-WB) |
|
|
Term
| Motor Neuron Disorders (2) |
|
Definition
Spinal Muscle Atrophy
Duchenne Muscular Dystrophy |
|
|
Term
|
Definition
| disorder of ant horn cells, peripheral nn, neuromm jxn, or mm tissue |
|
|
Term
| Motor Neuron Disorders: impairments |
|
Definition
**progressive** weakness
mm atrophy/contractures
progressive disability
shortened life span |
|
|
Term
| Duchenne Muscular Dystrophy = |
|
Definition
| disorder at mm tissue (dystrophin absent or abnormal) |
|
|
Term
|
Definition
| disorder at anterior horn cell (death of cells) |
|
|
Term
|
Definition
| Duchenne Muscular Dystrophy |
|
|
Term
| DMD: _______ mm dystrophy (not duchenne...) |
|
Definition
|
|
Term
|
Definition
progressive mm weakness/degeneration @ 3-5yo
post calf hypertrophy |
|
|
Term
|
Definition
1/3500 MALE births
X-linked |
|
|
Term
|
Definition
dystrophin = anchor in intracellular lattice of mm cells
loss of dystrophin >> decr ability to regenerate mm, loss of myofibrils |
|
|
Term
|
Definition
IQ avg = 85
(dystrophin is active in brain) |
|
|
Term
|
Definition
gene therapy (inject dystrophin)
myoblast transfer (inject mm precursor)
pharmacologic (steroids)
sx (contractures) |
|
|
Term
|
Definition
PROM limitations p 5yo
fatigue; inability to keep up c peers
incr lordosis
scap winging
scoliosis
waddle gait
Gower's sign
toe walking
pseudohypertrophy (calf, deltoid, quads, FA ext)
walking = difficult p 8-10yo
diaphragm fxn decr in pre-teen years |
|
|
Term
| DMD: impairments in infancy |
|
Definition
| none; possible developmental delay (esp c amb) |
|
|
Term
|
Definition
family support
education
baseline ROM/MMT |
|
|
Term
|
Definition
stretching LE (gastroc, TFL)
standing/walking 2-3 hr/day
breathing ex
e-stim |
|
|
Term
|
Definition
| overexertion, immobilization = detrimental to mm |
|
|
Term
| DMD: mm to target (c submax ex [cycling, swimming]) (4) |
|
Definition
abs
hip ext
hip add
knee ext |
|
|
Term
|
Definition
significant disability
lose ability to walk (use RGOs or powered mobility) |
|
|
Term
|
Definition
mechanical lifts
care for all ADLs
breathing ex, postural drainage
ventilator |
|
|
Term
| SMA = abbreviation for... |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
childhood-onset/infantile type I (Werdnig-Hoffman acute)
childhood-onset type II (Werdnig-Hoffman chronic)
juvenile-onset type III (Kugelberg-Welander) |
|
|
Term
| SMA: childhood-onset type I = |
|
Definition
weak fetal mvmt in last months of pregnancy
rapidly progressive
severe hypotonia
death within 1st year |
|
|
Term
| SMA: childhood-onset type II = |
|
Definition
rapid progression in 1st year (not birth) that stabilizes
mod hypotonia
shortened lifespan |
|
|
Term
| SMA: juvenile-onset type III = |
|
Definition
slowly progressive
mild impairment
weakness p first ambulating |
|
|
Term
| SMA: type I - impairments |
|
Definition
contractures (club foot)
scoliosis
severe delay
weakness in first 4 mos (limited/absent anti-gravity mvmt) |
|
|
Term
| SMA: type I - PT mgmt (3) |
|
Definition
ROM
position for comfort
safe feeding program (OT) |
|
|
Term
| SMA: type II - impairments |
|
Definition
contractures
orthotics
independence c mobility |
|
|
Term
| SMA: type II - progression of weakness (3) |
|
Definition
symmetrical
prox -> dist
LE>UE |
|
|
Term
| SMA: type III - clinical presentation |
|
Definition
similar to DMD!
prox weakness (pelvis, shldr girdles)
waddling gait
compensatory mvmt (Gower's)
NOT as much toe walking as DMD |
|
|
Term
|
Definition
daily HEP
positioning
strengthening
respiratory care |
|
|
