Physical Disabilities

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Physical Disabilities

• Cerebral Palsy
• Spinal Cord Injury

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Cerebral Palsy

• Medical term that refers to one of a series of
  motor disorders that stem from brain malfunction
• Damage to the immature brain
• Retention of Primitive Reflexes
• Asymmetric Tonic Neck Reflex (ATNR)
• Symmetric Tonic Neck Reflex (TNR)
• Incidence - 7/1000
• Characteristics -
• Non-hereditary, non-contagious, and
  non-progressive
• Cause - time of onset

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Cerebral Palsy Causes and Characteristics

• Prenatal
• Functional disturbances of the mother (may
  produce hemorrhages in fetal brain)
• Rh incompatibility
• Infection

• Perinatal
• Diseases
• Prolonged or difficult labor
• Anoxic conditions
• Premature birth

Accounts for 90 of all Cases
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Cerebral Palsy Causes and Characteristics

• Postnatal (10)
• Brain infections
• Poisoning
• Head trauma
• Types of Cerebral Palsy
• Mild to severe
• Based on muscle tone and limbs involved
• 7 distinct types of CP (5 most common)
• 5 anatomical classifications of limbs involved

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Five Types of Cerebral Palsy

• Spastic - hypertonic muscle tone
• Scissors gait and Hemiplegic gait
• Athetoid - fluctuating muscle tone or dystonia
• Ataxic - deficient sense of balance,
  coordination, and kinesthesis
• Cerebellar/kinesthetic gait
• Hypotonia - Low muscle tone (hypotonia)
• Mixed - combination of types (most common
  spastic/athetoid)

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Adapted Devices

• Wheelchairs - VIDEO
• regular
• sport
• electric/manual
• Braces (AFOs, KFOs, AKFOs)
• Canes -
• T, J, Quad
• Crutches / Walkers
• Team Hoyt video link - http//www.youtube.com/wa
  tch?vf4B-r8KJhlE

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Anatomical Classification for Limbs Involved

• Monoplegia -
• Diplegia -
• Hemiplegia -
• Triplegia -
• Quadriplegia -

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Practical Applications

• Wheelchair positioning
• Transfers

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Spinal Cord Injury (SCI)

• Incidence
• Approximately 10,000 each year in U.S.
• Two categories of spinal cord injury
• paraplegia
• quadriplegia
• Higher lesions less function
• High variability depending on complete or
  incomplete

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Spinal Cord

• Spinal cord 31 pairs of spinal nerves
• Protected by vertebral column
• 24 movable
• 7 cervical
• 12 thoracic
• 5 lumbar
• Spinal cord injuries result from some type of
  trauma
• Movement and Sensation -

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Spinal Cord Injury Classification

• Five-point grading system for extent of injury
  (lesion to spinal cord)
• Complete
• Incomplete with sensation only
• Incomplete with nonfunctional motor ability
• Incomplete with motor function
• Complete recovery

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Concerns with Spinal Cord Injury

• Sensation and Skin Breakdown -
• Temperature Control -
• Contractures -
• Spasms of Spinal Origin -
• Atrophy of Limbs -
• Urination -
• Sexuality -
• Heart and Circulatory Concerns -
• Autonomic Dysreflexia -
• Weight Management and Osteoporosis -
• Depression -