General Movements Assessment Quiz
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Questions and Answers

Which of the following describes the primary function of the Test of Infant Motor Performance (TIMP)?

  • Evaluating gross motor skills in children with severe disabilities.
  • Screening for autism spectrum disorders in infants.
  • Assessing postural and selective motor control for functional performance. (correct)
  • Assessing early childhood motor skills in children.

    • What age range is the TIMP designed to evaluate?

  • 34 weeks gestational age to 4 months adjusted age. (correct)
  • Birth to 6 months of age.
  • Birth to 12 months of age.
  • 34 weeks gestational age to 12 months adjusted age.

    • In what type of settings is the TIMP performed?

  • Neonatal Intensive Care Units and developmental clinics. (correct)
  • Physical therapy offices and rehabilitation centers.
  • Home health care and general pediatrician offices.
  • Outpatient clinics and hospitals.

    • What is the cost of the TIMP starter kit?

    <p>$189 including test manual and score sheets.</p> Signup and view all the answers

    What is the reliability of the TIMP based on the provided data?

    <p>Test-retest reliability is .89 and inter-rater reliability is .85.</p> Signup and view all the answers

    What is the primary purpose of Prechtl’s General Movements Assessment?

    <p>To identify signs of cerebral palsy in infants</p> Signup and view all the answers

    What age range is appropriate for the Pediatric Balance Scale?

    <p>2 years to 7 years</p> Signup and view all the answers

    How long does the Prechtl’s General Movements Assessment typically take?

    <p>Less than 10 minutes</p> Signup and view all the answers

    Which of the following best describes the scoring method for M-CHAT-R?

    <p>Parent report followed by a detailed follow-up interview</p> Signup and view all the answers

    What is a required training cost for conducting Prechtl’s General Movements Assessment?

    <p>$990</p> Signup and view all the answers

    Which of the following screening tools is valid for detecting autism spectrum disorder?

    <p>M-CHAT-R</p> Signup and view all the answers

    What is one special consideration noted for the Pediatric Balance Scale?

    <p>Ceiling effect</p> Signup and view all the answers

    What is the main focus of the PDMS-3 compared to the PDMS-2?

    <p>Body Transport</p> Signup and view all the answers

    What is the recommended age range for administering the Peabody Developmental Motor Scale?

    <p>Birth to 6 years</p> Signup and view all the answers

    How is the reliability of the Peabody Developmental Motor Scale categorized?

    <p>Test-retest</p> Signup and view all the answers

    What additional features does the PDMS-3 offer compared to the PDMS-2?

    <p>Supplemental Subtest for Physical Fitness</p> Signup and view all the answers

    In which situations is the Peabody Developmental Motor Scale primarily administered?

    <p>Outpatient and early childhood settings</p> Signup and view all the answers

    What is a notable limitation of the Peabody Developmental Motor Scale for very young infants?

    <p>It may not accurately show a delay early in life due to medical diagnoses.</p> Signup and view all the answers

    What is the appropriate time frame for progress testing using the Peabody Developmental Motor Scale?

    <p>Every 3-6-12 months depending on needs</p> Signup and view all the answers

    What are the assessment areas included in the WeeFIM?

    <p>Self-care, mobility, and cognition</p> Signup and view all the answers

    What impact does a higher WeeFIM score on admission have on patient outcomes?

    <p>Shorter length of stay and higher discharge scores</p> Signup and view all the answers

    What is required to properly administer the WeeFIM assessment?

    <p>Formal training and certification testing</p> Signup and view all the answers

    Which categories are assessed by different professionals in the WeeFIM scoring system?

    <p>Self-Care by OT, Transfers by PT, Communication by SLP</p> Signup and view all the answers

    How long does it typically take to administer the WeeFIM assessment?

    <p>10-20 minutes</p> Signup and view all the answers

    What is the main focus of the School Function Assessment (SFA)?

    <p>Facilitating collaborative program planning for students with disabilities</p> Signup and view all the answers

    Which of the following aspects is NOT assessed in the Hammersmith Infant Neurologic Examination (HINE)?

    <p>Fine motor skills</p> Signup and view all the answers

    What indicates a high probability of cerebral palsy according to HINE scores?

    <p>Scores less than 52</p> Signup and view all the answers

    Which of the following is a purpose of Prechtl’s General Movements Assessment?

    <p>To assess spontaneous movement repertoire in infants</p> Signup and view all the answers

    In which age range is the School Function Assessment (SFA) intended to be used?

    <p>Kindergarten through grade 6</p> Signup and view all the answers

    What is a primary benefit of using the SFA in educational settings?

    <p>It allows for quick administration of individual scales</p> Signup and view all the answers

    Which statement accurately reflects the administration of HINE?

    <p>Training is encouraged, with video resources available</p> Signup and view all the answers

    What aspect of student performance does Part II of the SFA specifically evaluate?

    <p>Task supports including assistance and adaptations</p> Signup and view all the answers

    What is the main purpose of the Denver II test?

    <p>To identify young children with developmental problems</p> Signup and view all the answers

    What are the domains covered by the Denver II test?

    <p>Personal-social, fine motor-adaptive, language, and gross motor</p> Signup and view all the answers

    What is indicated about the reliability of the Denver II test?

    <p>Interobserver reliability is reported to be 0.99</p> Signup and view all the answers

    What is a noted potential drawback of using the Denver II test?

    <p>It may over-identify children leading to unnecessary referrals</p> Signup and view all the answers

    How long does it typically take to administer the Denver II test?

    <p>10-20 minutes</p> Signup and view all the answers

    Which of the following materials is NOT needed for administering the Denver II test?

    <p>Musical instruments</p> Signup and view all the answers

    What actions should be taken if a child's Denver II test is interpreted as 'Suspect' or 'Untestable'?

    <p>Rescreen in 1-2 weeks</p> Signup and view all the answers

    What is the age range for using the Denver II test?

    <p>Birth to 6 years</p> Signup and view all the answers

    What is the maximum recommended age for individuals being evaluated with the BOT-2/BOT-3?

    <p>21 years</p> Signup and view all the answers

    Which of the following subtests is included in the BOT-3 but not in the BOT-2?

    <p>Dynamic Movement</p> Signup and view all the answers

    What is the range for test-retest reliability for the BOT-2?

    <p>0.69 - 0.83</p> Signup and view all the answers

    How long does it generally take to administer the complete battery for the BOT-2?

    <p>45-60 minutes</p> Signup and view all the answers

    What type of referencing does the BOT-2 and BOT-3 utilize?

    <p>Norm referenced</p> Signup and view all the answers

    What is the primary recommended setting for administering the BOT-2?

    <p>Outpatient clinics</p> Signup and view all the answers

    What parameter limits the administration of the BOT tests for certain children?

    <p>Use of assistive devices for mobility</p> Signup and view all the answers

    How often should the BOT-2/BOT-3 be administered to monitor progress?

    <p>Every three months or more</p> Signup and view all the answers

    What is the cost for a digital BOT test kit?

    <p>$770</p> Signup and view all the answers

    What is the primary reason for administering the BOT tests?

    <p>To measure motor control and coordination</p> Signup and view all the answers

    What is the primary age range for the use of the M-CHAT-R screening tool?

    <p>16 to 30 months</p> Signup and view all the answers

    How often should the General Movements Assessment be administered to preterm infants?

    <p>2-3 times</p> Signup and view all the answers

    What is a significant predictive value of the Prechtl’s General Movements Assessment?

    <p>Early detection of cerebral palsy</p> Signup and view all the answers

    What is a reported time frame for the Pediatric Balance Scale assessment?

    <p>20 minutes</p> Signup and view all the answers

    What is a notable consideration regarding the Pediatric Balance Scale?

    <p>Ceiling effect</p> Signup and view all the answers

    What is a primary purpose of osteotomy in the treatment of osteonecrosis?

    <p>To reduce joint load by changing the alignment of the femoral head</p> Signup and view all the answers

    What factor is primarily associated with increasing THA instability rates?

    <p>Improper femoral offset and length</p> Signup and view all the answers

    Which treatment is indicated for cases of femoral head collapse due to osteonecrosis?

    <p>Total Hip Arthroplasty</p> Signup and view all the answers

    What is a common timing for acute dislocations after total hip arthroplasty (THA)?

    <p>Within the first 3 months post-surgery</p> Signup and view all the answers

    Which imaging technique is most commonly used to evaluate the extent of osteonecrosis?

    <p>MRI</p> Signup and view all the answers

    What is a key consideration in the design of femoral components during total hip arthroplasty to decrease dislocation rates?

    <p>Custom alignment to match patient anatomy</p> Signup and view all the answers

    Which of the following statements regarding rehabilitation after hip surgery is accurate?

    <p>Rehabilitation protocols vary based on individual needs</p> Signup and view all the answers

    What is the expected incidence of THA instability in primary total hip arthroplasties?

    <p>1-5%</p> Signup and view all the answers

    What is the primary risk factor for low energy hip fractures in elderly patients?

    <p>Weak bone density</p> Signup and view all the answers

    Which type of hip fracture is considered unstable and may require surgical intervention?

    <p>Partially displaced fracture</p> Signup and view all the answers

    Which treatment option is generally recommended for nondisplaced femoral neck fractures in elderly patients?

    <p>Open reduction and internal fixation</p> Signup and view all the answers

    What imaging technique is often used to evaluate osteonecrosis stages?

    <p>MRI</p> Signup and view all the answers

    What classification system is used to describe the severity of femoral neck fractures?

    <p>Garden Classification</p> Signup and view all the answers

    What complication is associated with open reduction, internal fixation of a femoral neck fracture?

    <p>Screw cut out/penetration</p> Signup and view all the answers

    After a hip fracture surgery, what is the recommended postoperative care for the elderly?

    <p>Weight-bearing as tolerated</p> Signup and view all the answers

    What is a common indication for arthroplasty in managing hip fractures in older patients?

    <p>Displaced femoral neck fracture</p> Signup and view all the answers

    Which type of imaging is most useful for confirming intra-articular pathology in the hip joint?

    <p>MRI</p> Signup and view all the answers

    What is a key factor influencing the surgical approach for osteonecrosis treatment?

    <p>Size of the femoral head</p> Signup and view all the answers

    What is a common risk factor for developing osteonecrosis?

    <p>History of significant trauma</p> Signup and view all the answers

    Which type of hip fracture is classified by its anatomical location below the lesser trochanter?

    <p>Subtrochanteric fracture</p> Signup and view all the answers

    What should be prioritized during the non-operative treatment of stable impacted fractures?

    <p>Early mobilization</p> Signup and view all the answers

    What is one form of hip impingement that results from the shape mismatch between the femoral head and acetabulum?

    <p>CAM Impingement</p> Signup and view all the answers

    In evaluating a hip condition, which imaging technique is typically employed for detailed assessment of soft tissues such as labral tears?

    <p>MRI</p> Signup and view all the answers

    What is the primary indication for performing a femoral osteotomy in hip treatment?

    <p>Acetabular Dysplasia</p> Signup and view all the answers

    What is a key goal during the rehabilitation phase immediately following a periacetabular osteotomy (PAO)?

    <p>Regaining hip range of motion</p> Signup and view all the answers

    What complication is most likely to occur as a late symptom due to residual deformity from SCFE?

    <p>Early-onset Osteoarthritis</p> Signup and view all the answers

    Which treatment modality is most likely used for managing labral tears non-operatively?

    <p>Exercise therapy</p> Signup and view all the answers

    What is the recommended time frame for transitioning to full weight bearing after hip arthroscopy?

    <p>5-6 weeks</p> Signup and view all the answers

    Which of the following factors would NOT be an important consideration for managing developmental dysplasia of the hip (DDH)?

    <p>Age-specific medication regimens</p> Signup and view all the answers

    After a surgical procedure for hip conditions, which phase of rehabilitation focuses on achieving active strengthening?

    <p>Weeks 12-16</p> Signup and view all the answers

    What is a common presenting symptom in young adults suffering from labral tears?

    <p>Groin pain</p> Signup and view all the answers

    What important clinical feature often accompanies a hip labral tear diagnosis?

    <p>Catching or locking of the hip</p> Signup and view all the answers

    What consequence may arise from restricting corticosteroid injections in young patients?

    <p>Slower recovery of joint function</p> Signup and view all the answers

    What is the objective of addressing structural deformity during surgical treatment of hip disorders?

    <p>To improve long-term outcomes</p> Signup and view all the answers

    Which of the following evaluation methods is specifically related to testing hip strength in young hip patients?

    <p>Bicycle test (abductors)</p> Signup and view all the answers

    What component of hip examination assesses the risk of impingement?

    <p>Apprehension test</p> Signup and view all the answers

    Which test evaluates hip motion in side-lying position?

    <p>Bicycle test</p> Signup and view all the answers

    Which of the following positions is utilized during impingement testing?

    <p>Extension/ER hip</p> Signup and view all the answers

    What is the primary purpose of the Trendelenberg test in the evaluation of young hip patients?

    <p>Evaluating hip strength and stability</p> Signup and view all the answers

    What treatment option is commonly recommended for cases of femoral head collapse?

    <p>Total Hip Arthroplasty</p> Signup and view all the answers

    Which factor contributes to THA instability after surgery?

    <p>Component Position</p> Signup and view all the answers

    What is a traditional method to treat osteonecrosis of the femoral head?

    <p>Core Decompression</p> Signup and view all the answers

    In relation to hip dislocations, which time frame represents when most acute dislocations occur post-THA?

    <p>Within 3 months</p> Signup and view all the answers

    What is the primary purpose of performing an osteotomy for avascular necrosis (AVN)?

    <p>To rotate the affected femoral head</p> Signup and view all the answers

    What is a common reason for a hip dislocation in primary Total Hip Arthroplasty (THA)?

    <p>Mismatched components</p> Signup and view all the answers

    Which aspect of hip stability is particularly important in relation to soft tissue tension?

    <p>Position during surgery</p> Signup and view all the answers

    What is the complication rate for dislocation in revision THA?

    <p>7-15%</p> Signup and view all the answers

    What is the primary goal of restoring the pelvic ring in treating lateral compression pelvic fractures?

    <p>To stabilize the pelvic structure</p> Signup and view all the answers

    What type of fractures are often associated with acetabular fractures?

    <p>Fractures of the femoral neck or shaft</p> Signup and view all the answers

    In treating anterior-posterior compression fractures, what method is used for low energy stable fractures?

    <p>Protected weight bearing</p> Signup and view all the answers

    What is a significant risk factor for hip fractures in the elderly population?

    <p>Weak bone density</p> Signup and view all the answers

    Which surgical approach is most appropriate for managing intra-articular fractures in young patients prior to THA?

    <p>Anatomic reduction</p> Signup and view all the answers

    What type of fracture is typically associated with a ground level fall in the elderly?

    <p>Femoral neck fracture</p> Signup and view all the answers

    What is indicated by the presence of post-traumatic arthritis following an acetabular fracture?

    <p>Improper initial fracture reduction</p> Signup and view all the answers

    What is the primary management principle for treating hip fractures in younger patients?

    <p>Fixation is prioritized</p> Signup and view all the answers

    What is typically experienced by older patients with pelvic insufficiency fractures?

    <p>Minimal visible fractures on X-ray</p> Signup and view all the answers

    Which classification describes a stable femoral neck fracture in elderly patients?

    <p>Type I</p> Signup and view all the answers

    What is the recommended weight-bearing status for a patient after a surgical procedure on the acetabulum?

    <p>Toe-touch weight bearing or non-weight bearing</p> Signup and view all the answers

    What is a potential complication of surgical treatment for femoral neck fractures?

    <p>Nonunion</p> Signup and view all the answers

    Which option is NOT considered a non-prosthetic surgical technique for a young hip patient?

    <p>Total hip arthroplasty</p> Signup and view all the answers

    What symptoms should be assessed in young hip patients during their history evaluation?

    <p>Pain during activity and stiffness</p> Signup and view all the answers

    Which treatment method is commonly used for intertrochanteric fractures?

    <p>Intramedullary nail</p> Signup and view all the answers

    What type of trauma history is significant when assessing young hip patients?

    <p>Past hip problems and trauma</p> Signup and view all the answers

    Which condition is NOT a known etiology of osteonecrosis?

    <p>Chronic arthritis</p> Signup and view all the answers

    What stage of Ficat-Arlet classification indicates normal MRI findings?

    <p>Stage I</p> Signup and view all the answers

    Which surgical procedure is utilized for core decompression in osteonecrosis?

    <p>Non-vascularized graft</p> Signup and view all the answers

    What complication is common following intertrochanteric hip fractures?

    <p>Loss of fixation</p> Signup and view all the answers

    Which statement is true regarding managing patients with a prior hip fracture?

    <p>They should be regularly evaluated for bone density</p> Signup and view all the answers

    What type of fracture is characterized as unstable on the Garden classification?

    <p>Type IV</p> Signup and view all the answers

    Which of the following factors contribute to osteoporosis in older patients?

    <p>Low activity level and low body weight</p> Signup and view all the answers

    What is the recommended initial treatment for a stable impacted fracture?

    <p>Non-operative care</p> Signup and view all the answers

    What is the main characteristic of SCFE (Slipped Capital Femoral Epiphysis)?

    <p>Unstable growth plate</p> Signup and view all the answers

    Which treatment goal is prioritized in a Periacetabular Osteotomy (PAO) for developmental dysplasia of the hip (DDH)?

    <p>Medialize the hip center of rotation</p> Signup and view all the answers

    Which of the following is NOT a typical presentation of a labral tear?

    <p>Leg length discrepancy</p> Signup and view all the answers

    What is a common consequence of untreated SCFE?

    <p>Late symptoms arising from hip impingement</p> Signup and view all the answers

    What is a primary non-operative treatment option for a labral tear?

    <p>Pain management with NSAIDs</p> Signup and view all the answers

    In regards to hip arthroscopy, which condition is primarily indicated for surgical intervention?

    <p>Loose bodies</p> Signup and view all the answers

    What should be avoided during the first phase of rehabilitation after a PAO?

    <p>Aggressive strengthening</p> Signup and view all the answers

    What is a potential trigger for symptoms in individuals with a shallow acetabulum?

    <p>Increased mechanical load</p> Signup and view all the answers

    What is the expected timeline for full recovery after a hip arthroscopy?

    <p>6-12 months</p> Signup and view all the answers

    What is a key rehabilitation goal following a hip arthroscopy?

    <p>Range of motion within comfort limits</p> Signup and view all the answers

    In cases of DDH, what is an important sign indicating deficient femoral head coverage?

    <p>Inadequate acetabulum development</p> Signup and view all the answers

    What occurs during the weeks 12-16 of rehabilitation following a PAO?

    <p>Complete weight-bearing without assistance</p> Signup and view all the answers

    Which factor greatly affects surgical outcomes in hip surgeries?

    <p>Presence of pre-existing osteoarthritis</p> Signup and view all the answers

    Study Notes

    General Movements Assessment

    • Observed and determined when the newborn is awake, lying on their back, alert and calm
    • The newborn should not have pacifiers, toys or parent interaction
    • Movements are recorded for 3-5 minutes
    • Evaluated from video recording
    • Cost: Training is required and costs $990

    General Movements Assessment- Frequency and Timing

    • Preterm infants: 2-3 times
    • Term/Early Post Term infants: 1-2 times
    • 9-15 weeks: at least 1-2 times
    • Time: less than 10 minutes

    General Movements Assessment - Age Related Assessments

    • Preterm (32 weeks corrected age): Observe type and variety of movements
    • Term: Observe type and variety of movements
    • Around 4 months: Observe “fidgety” movements

    General Movements Assessment - Predictive Value

    • Used for early detection of cerebral palsy

    Pediatric Balance Scale

    • Similar to the Berg Balance Scale
    • Age Range: 2 years to school age (around 7 years)
    • Cost: Free
    • Time: Less than 20 minutes
    • Special Considerations: Ceiling effect

    M-CHAT-R (Modified Checklist for Autism in Toddlers, Revised)

    • Valid for screening toddlers between 16 and 30 months of age
    • Assesses risk for autism spectrum disorder
    • Utilizes parent report with follow-up interview questions
    • If child screens positive, specific follow-up questions are asked

    Peabody Developmental Motor Scale (PDMS)-2 & PDMS-3

    • PDMS-2

      • Reflexes
      • Stationary
      • Locomotion
      • Object Manipulation
      • Grasping
      • Visual-Motor Integration

    • PDMS-3

      • Body Control
      • Body Transport
      • Object Control
      • Hand Manipulation
      • Eye-Hand Coordination
      • Supplemental Subtest: Physical Fitness

    Peabody Developmental Motor Scale (PDMS)-2 & PDMS-3 - Test Information

    • Age and Diagnoses: Birth to under 6 years, used for developmental delay, coordination disorders, and cerebral palsy
    • Norm-referenced: Compares child's results to other children of similar age
    • Reliability:
      • Test-retest: 0.89 - .96
      • Inter-rater: 0.96 - .99
    • Validity: Excellent correlation with AIMS (Alberta Infant Motor Scale)

    Peabody Developmental Motor Scale (PDMS)-2 & PDMS-3 - Cost and Administration

    • Cost:
      • Test Kit: $820
      • PDMS-2 test books: $107/25 books
      • PDMS-3 test books: $159/25 books (includes online scoring code)
      • Fitness score sheets: $45/25
    • Administration Time: 45-60 minutes for entire test, 20-30 for gross or fine motor sections individually
    • Administration Frequency: Initial evaluation, progress testing every 3, 6, or 12 months depending on the setting, needs and child's progress

    Peabody Developmental Motor Scale (PDMS)-2 & PDMS-3 - Setting and Considerations

    • Setting: Outpatient, early childhood, sometimes inpatient
    • Considerations: Very young infants with diagnoses associated with a risk for developmental delay may not show a delay early in life when using this test

    Denver II

    • Not explained in the text.

    Test of Infant Motor Performance (TIMP)

    • Assesses postural and selective motor control of functional performance
    • Age and Diagnoses: 34 weeks gestational age to 4 months (adjusted age)
    • Norm-referenced: Compares child's results to other children of similar age
    • Reliability:
      • Test-retest: 0.89
      • Inter-rater: 0.85
    • Validity: Excellent correlation with the AIMS (Alberta Infant Motor Scale)

    Test of Infant Motor Performance (TIMP) - Cost and Administration

    • Cost:
      • Test Starter Kit: $189 (Includes test manual, age calculator, and score sheets)
      • Score Sheets (25): $68
      • Training: Online Course: $379
      • Additional items NOT included in kit: Red ball, rattle, soft cloth
    • Administration Time: 20-40 minutes
    • Administration Frequency: Occasionally at time of initial evaluation in the NICU, before discharge, set time at facility guidelines, within age frame at follow-up visits.

    Test of Infant Motor Performance (TIMP) - Setting and Considerations

    • Setting: NICU, developmental clinics
    • Considerations: The age of the infant, longevity of follow-up and additional testing should be considered; only trained therapists should handle infants who are fragile

    Bruininks-Oseretsky Test of Motor Proficiency (BOT-2 and BOT-3)

    • BOT-2 is a comprehensive measure of fine and gross motor skills in children and young adults, published in 2005.
    • BOT-2 consists of subtests including Fine Motor Precision, Fine Motor Integration, Manual Dexterity, Upper Limb Coordination, Bilateral Coordination, Balance, Running Speed & Agility, and Strength.
    • BOT-3 was published in 2024, and features several updated subtests such as Dynamic Movement and Strength.
    • BOT can be administered to individuals aged 4-21 years with mild to moderate motor control deficits.
    • BOT-2 is a norm-referenced test with an inter-rater reliability of .98 and a test-retest reliability of .69-.83.
    • Validity of BOT-2 is excellent for the gross motor portion.
    • The complete BOT-2 battery can be administered in 45-60 minutes.
    • The short form takes 15-20 minutes to administer, while specific sections like Gross Motor or Fine Motor can be completed within 25-30 minutes each.
    • The complete BOT-3 battery has an administration time of 50-90 minutes, and individual sections can be completed in 25-45 minutes each.
    • The BOT can be used for evaluations and testing intervals should be at least 3 months.
    • The BOT is often conducted in outpatient settings, schools, clinics, or community settings for screening.

    Denver II Developmental Screening Test

    • Denver II was introduced in 1967 to identify developmental problems in children up to 6 years old.
    • The test assesses four developmental domains: personal-social, fine motor-adaptive, language, and gross motor.
    • Denver II is administered to children from birth to six years of age.
    • It is a norm-referenced test with an inter-observer reliability of .99 and a test-retest reliability of .90.
    • The test is free and no longer commercially available, but forms can be obtained online.
    • Administration time is typically 10-20 minutes.
    • Denver II is used in pediatric offices, developmental clinics, and early childhood development programs.
    • It is a screening tool to identify children at risk for developmental delays.

    Peabody Developmental Motor Scales (PDMS-2)

    • The PDMS-2, published in 2000, assesses gross and fine motor skills in children aged birth to 71 months.
    • It is normed referenced and has a test-retest reliability of .89-.95 and an inter-rater reliability of .93-.95.
    • The PDMS-2 can be administered in 30–40 minutes.

    WeeFIM

    • The WeeFIM is an adaptation of the Functional Independence Measure (FIM) for children and adolescents.
    • It is a widely used measure of functional independence for children and adolescents.
    • Assesses self-care, mobility, and cognition in children and adolescents.
    • WeeFIM is commonly used in inpatient rehabilitation settings but can be used in other inpatient settings.
    • Formal training and certification are required for administering, and a site license is necessary for use.
    • Administration typically takes 10-20 minutes and is often administered by a multidisciplinary team.

    School Function Assessment (SFA)

    • SFA is a criterion-referenced assessment designed to measure a student's functional performance and participation in school settings.
    • It is used to measure the functional abilities of students with various disabilities, from Kindergarten through grade 6.
    • SFA consists of three parts:
      • Participation: Measures a student's participation in various school activities,
      • Task Supports: Assesses the types of assistance and adaptations a student needs to participate.
      • Activity Performance: Measures a student's performance in various activities related to school.
    • Each section can be completed in 5-10 minutes.

    Hammersmith Infant Neurological Examination (HINE)

    • HINE is a comprehensive assessment of neurological function in infants aged 3-24 months.
    • It assesses various neurological aspects including cranial nerve function, movements, reflexes, and protective reactions.
    • Training is encouraged and videos are available online with a paid membership.
    • HINE scores greater than 64 are predictive of independent walking, while scores less than 52 are highly predictive of cerebral palsy and severe motor impairments.

    Prechtl’s General Movements Assessment

    • This assessment is used to detect subtle neurological abnormalities in infants from birth to 20 weeks post term.
    • It is based on the observation of spontaneous movements of the infant lying on their back.
    • Observation is conducted for 3-5 minutes, and scored based on the type and quality of movements observed.
    • Training is required and costs $990.
    • It is a valuable tool for early detection of cerebral palsy and other neurological conditions.

    Pediatric Balance Scale

    • This assessment is similar to the Berg Balance Scale but adapted for children aged 2-7 years.
    • It is a free assessment tool that takes less than 20 minutes to administer.
    • The tool focuses on balance and coordination, so it may have a ceiling effect for children with more advanced motor skills.

    Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R)

    • M-CHAT-R is a screening tool used to identify toddlers aged 16-30 months at risk for autism spectrum disorder (ASD).
    • It is a parent report questionnaire that gathers information about the child's behaviors and social interactions.
    • It is followed up with an interview, which assesses the areas where the child scored poorly on the initial questionnaire.
    • The tool helps healthcare professionals identify children who may benefit from further evaluation.

    Hip Fractures

    • Hip fractures are categorized by energy level, high energy in younger patients, and low energy in older patients.
    • Low energy hip fractures are commonly caused by ground level falls and represent 90% of cases.
    • Risk factors for hip fractures include:
      • Age: Increased age.
      • Sex: Female gender.
      • Geography: Urban living.
      • Health: Dementia, delirium.
      • Habits: Alcohol and caffeine consumption.
      • Other factors: Medications, prior hip fractures.

    Hip Fractures: Management

    • Management principles for hip fractures include:
      • Fixation: Fix young, replace old.
      • Non-operative: Only consider for patients with stable fractures and those who are medically unfit for surgery.
      • Surgery: Evaluate patient's health and correct any medical conditions before surgery.
      • Mobilization: Aim for early mobilization after surgery with weight bearing as tolerated (WBAT) in elderly patients.

    Femoral Neck Fractures

    • Femoral neck fractures are further categorized by the Garden classification into displaced and non-displaced fractures.
    • Non-displaced fractures are stable and include type I and type II.
    • Displaced fractures are unstable and include type III and type IV.
    • Management of non-displaced fractures includes:
      • Open reduction and internal fixation (ORIF): Utilize multiple screws.
    • Complications of ORIF include:
      • Nonunion: 5-25%
      • Screw cut out or penetration: 4-6%
      • Avascular necrosis (AVN): 10-40%
    • Management of displaced fractures:
      • Older patients (>60 years): Consider hemiarthroplasty or total hip arthroplasty.
      • Complications of arthroplasty include fracture or dislocation.

    Intertrochanteric Hip Fractures

    • Intertrochanteric fractures are common in the elderly and are often associated with osteoarthritis.
    • Risk factors and incidence are similar to femoral neck fractures.
    • Treatment involves stabilizing and compressing the fracture with either:
      • Intramedullary nail (IMN) or dynamic hip screw (DHS).
    • Postoperative management includes:
      • Weight bearing as tolerated (WBAT).
      • No range of motion restrictions.
      • Strengthening exercises when healing is evident.

    Subtrochanteric Femur Fractures

    • These fractures occur at or below the lesser trochanter and are a high stress region of the femur.
    • Treatment involves:
      • Intramedullary nail (IMN): Often with open reduction.
      • Fixed angle plate devices: Can include a 95-degree dynamic compression screw or a blade plate.
    • Subtrochanteric fractures have a higher incidence of delayed union and malunion and can be associated with osteoporosis medications.

    Avascular Necrosis (AVN)

    • AVN is caused by vascular insult to the bone.
    • Three main causes: medical steroids, excessive ethanol consumption (ETOH), and trauma.
    • AVN is also associated with conditions like sickle cell disease, Gaucher disease, myeloproliferative disorders and transient osteoporosis.
    • Management options for AVN vary:
      • Nonsurgical: Protected weight bearing and short-term use of bisphosphonates.
      • Surgical: Core decompression, vascularized or non-vascularized grafts, or osteotomy.
    • The Ficat-Arlet staging system assesses the progression of AVN through six stages.

    Hip Instability

    • Hip instability refers to dislocations in total hip arthroplasty (THA).
    • Incidence is higher with revision THA than with primary THA.
    • Factors contributing to THA instability include component position, acetabular alignment, and soft tissue tension.
    • Timing of treatment for dislocation depends on severity and patient's condition.

    Pelvic Fractures

    • Pelvic fractures are classified by the type of compression:
      • Lateral compression: Ramus fracture or sacrum fracture vs SI fracture.
      • Anterior-posterior compression: Saddle fracture or symphysis fracture/SI disruption.
      • Vertical shear: Anterior and posterior ring fracture.
    • Treatment goals include restoring the pelvic ring.
    • Management approach depends on the stability of the fracture and the patient's characteristics.

    Acetabular Fractures

    • Acetabular fractures involve intra-articular disruptions.
    • Treatment involves anatomic reduction and protected weight bearing, but can be associated with post-traumatic arthritis.

    Young Hip Patient: Non-THA Surgery

    • Young hip patients can experience hip pain requiring non-arthroplasty surgical interventions.
    • Non-prosthetic surgical techniques address a variety of conditions, such as:
      • Post-traumatic: Malunion or nonunion.
      • Pre-arthritic: Dysplasia, slipped capital femoral epiphysis (SCFE), Perthes disease, AVN.
      • Intra-articular: Impingement, labral tear, loose bodies.

    Young Hip Patient: Assessment

    • History taking should focus on pain, mechanical symptoms, stiffness, and abductor fatigue.
    • Physical examination involves evaluating gait, leg length, hip strength, Trendelenberg sign, range of motion, and performing specific tests for impingement and apprehension.
    • Diagnostic imaging, such as X-rays and MRIs, are crucial to assess the underlying pathology and guide management.

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    Related Documents

    Pediatric Assessments PDF
    Hip Fractures Treatment & Surgery PDF

    Description

    Test your knowledge on the General Movements Assessment, including techniques for evaluating newborn movements and their predictive values. This quiz covers vital age-related assessments and contrasts with other balance scales for pediatric populations. Ideal for those involved in early detection of conditions like cerebral palsy.

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