Podcast
Questions and Answers
Which of the following describes the primary function of the Test of Infant Motor Performance (TIMP)?
Which of the following describes the primary function of the Test of Infant Motor Performance (TIMP)?
What age range is the TIMP designed to evaluate?
What age range is the TIMP designed to evaluate?
In what type of settings is the TIMP performed?
In what type of settings is the TIMP performed?
What is the cost of the TIMP starter kit?
What is the cost of the TIMP starter kit?
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What is the reliability of the TIMP based on the provided data?
What is the reliability of the TIMP based on the provided data?
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What is the primary purpose of Prechtl’s General Movements Assessment?
What is the primary purpose of Prechtl’s General Movements Assessment?
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What age range is appropriate for the Pediatric Balance Scale?
What age range is appropriate for the Pediatric Balance Scale?
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How long does the Prechtl’s General Movements Assessment typically take?
How long does the Prechtl’s General Movements Assessment typically take?
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Which of the following best describes the scoring method for M-CHAT-R?
Which of the following best describes the scoring method for M-CHAT-R?
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What is a required training cost for conducting Prechtl’s General Movements Assessment?
What is a required training cost for conducting Prechtl’s General Movements Assessment?
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Which of the following screening tools is valid for detecting autism spectrum disorder?
Which of the following screening tools is valid for detecting autism spectrum disorder?
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What is one special consideration noted for the Pediatric Balance Scale?
What is one special consideration noted for the Pediatric Balance Scale?
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What is the main focus of the PDMS-3 compared to the PDMS-2?
What is the main focus of the PDMS-3 compared to the PDMS-2?
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What is the recommended age range for administering the Peabody Developmental Motor Scale?
What is the recommended age range for administering the Peabody Developmental Motor Scale?
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How is the reliability of the Peabody Developmental Motor Scale categorized?
How is the reliability of the Peabody Developmental Motor Scale categorized?
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What additional features does the PDMS-3 offer compared to the PDMS-2?
What additional features does the PDMS-3 offer compared to the PDMS-2?
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In which situations is the Peabody Developmental Motor Scale primarily administered?
In which situations is the Peabody Developmental Motor Scale primarily administered?
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What is a notable limitation of the Peabody Developmental Motor Scale for very young infants?
What is a notable limitation of the Peabody Developmental Motor Scale for very young infants?
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What is the appropriate time frame for progress testing using the Peabody Developmental Motor Scale?
What is the appropriate time frame for progress testing using the Peabody Developmental Motor Scale?
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What are the assessment areas included in the WeeFIM?
What are the assessment areas included in the WeeFIM?
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What impact does a higher WeeFIM score on admission have on patient outcomes?
What impact does a higher WeeFIM score on admission have on patient outcomes?
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What is required to properly administer the WeeFIM assessment?
What is required to properly administer the WeeFIM assessment?
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Which categories are assessed by different professionals in the WeeFIM scoring system?
Which categories are assessed by different professionals in the WeeFIM scoring system?
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How long does it typically take to administer the WeeFIM assessment?
How long does it typically take to administer the WeeFIM assessment?
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What is the main focus of the School Function Assessment (SFA)?
What is the main focus of the School Function Assessment (SFA)?
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Which of the following aspects is NOT assessed in the Hammersmith Infant Neurologic Examination (HINE)?
Which of the following aspects is NOT assessed in the Hammersmith Infant Neurologic Examination (HINE)?
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What indicates a high probability of cerebral palsy according to HINE scores?
What indicates a high probability of cerebral palsy according to HINE scores?
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Which of the following is a purpose of Prechtl’s General Movements Assessment?
Which of the following is a purpose of Prechtl’s General Movements Assessment?
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In which age range is the School Function Assessment (SFA) intended to be used?
In which age range is the School Function Assessment (SFA) intended to be used?
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What is a primary benefit of using the SFA in educational settings?
What is a primary benefit of using the SFA in educational settings?
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Which statement accurately reflects the administration of HINE?
Which statement accurately reflects the administration of HINE?
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What aspect of student performance does Part II of the SFA specifically evaluate?
What aspect of student performance does Part II of the SFA specifically evaluate?
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What is the main purpose of the Denver II test?
What is the main purpose of the Denver II test?
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What are the domains covered by the Denver II test?
What are the domains covered by the Denver II test?
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What is indicated about the reliability of the Denver II test?
What is indicated about the reliability of the Denver II test?
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What is a noted potential drawback of using the Denver II test?
What is a noted potential drawback of using the Denver II test?
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How long does it typically take to administer the Denver II test?
How long does it typically take to administer the Denver II test?
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Which of the following materials is NOT needed for administering the Denver II test?
Which of the following materials is NOT needed for administering the Denver II test?
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What actions should be taken if a child's Denver II test is interpreted as 'Suspect' or 'Untestable'?
What actions should be taken if a child's Denver II test is interpreted as 'Suspect' or 'Untestable'?
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What is the age range for using the Denver II test?
What is the age range for using the Denver II test?
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What is the maximum recommended age for individuals being evaluated with the BOT-2/BOT-3?
What is the maximum recommended age for individuals being evaluated with the BOT-2/BOT-3?
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Which of the following subtests is included in the BOT-3 but not in the BOT-2?
Which of the following subtests is included in the BOT-3 but not in the BOT-2?
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What is the range for test-retest reliability for the BOT-2?
What is the range for test-retest reliability for the BOT-2?
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How long does it generally take to administer the complete battery for the BOT-2?
How long does it generally take to administer the complete battery for the BOT-2?
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What type of referencing does the BOT-2 and BOT-3 utilize?
What type of referencing does the BOT-2 and BOT-3 utilize?
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What is the primary recommended setting for administering the BOT-2?
What is the primary recommended setting for administering the BOT-2?
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What parameter limits the administration of the BOT tests for certain children?
What parameter limits the administration of the BOT tests for certain children?
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How often should the BOT-2/BOT-3 be administered to monitor progress?
How often should the BOT-2/BOT-3 be administered to monitor progress?
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What is the cost for a digital BOT test kit?
What is the cost for a digital BOT test kit?
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What is the primary reason for administering the BOT tests?
What is the primary reason for administering the BOT tests?
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What is the primary age range for the use of the M-CHAT-R screening tool?
What is the primary age range for the use of the M-CHAT-R screening tool?
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How often should the General Movements Assessment be administered to preterm infants?
How often should the General Movements Assessment be administered to preterm infants?
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What is a significant predictive value of the Prechtl’s General Movements Assessment?
What is a significant predictive value of the Prechtl’s General Movements Assessment?
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What is a reported time frame for the Pediatric Balance Scale assessment?
What is a reported time frame for the Pediatric Balance Scale assessment?
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What is a notable consideration regarding the Pediatric Balance Scale?
What is a notable consideration regarding the Pediatric Balance Scale?
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What is a primary purpose of osteotomy in the treatment of osteonecrosis?
What is a primary purpose of osteotomy in the treatment of osteonecrosis?
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What factor is primarily associated with increasing THA instability rates?
What factor is primarily associated with increasing THA instability rates?
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Which treatment is indicated for cases of femoral head collapse due to osteonecrosis?
Which treatment is indicated for cases of femoral head collapse due to osteonecrosis?
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What is a common timing for acute dislocations after total hip arthroplasty (THA)?
What is a common timing for acute dislocations after total hip arthroplasty (THA)?
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Which imaging technique is most commonly used to evaluate the extent of osteonecrosis?
Which imaging technique is most commonly used to evaluate the extent of osteonecrosis?
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What is a key consideration in the design of femoral components during total hip arthroplasty to decrease dislocation rates?
What is a key consideration in the design of femoral components during total hip arthroplasty to decrease dislocation rates?
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Which of the following statements regarding rehabilitation after hip surgery is accurate?
Which of the following statements regarding rehabilitation after hip surgery is accurate?
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What is the expected incidence of THA instability in primary total hip arthroplasties?
What is the expected incidence of THA instability in primary total hip arthroplasties?
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What is the primary risk factor for low energy hip fractures in elderly patients?
What is the primary risk factor for low energy hip fractures in elderly patients?
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Which type of hip fracture is considered unstable and may require surgical intervention?
Which type of hip fracture is considered unstable and may require surgical intervention?
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Which treatment option is generally recommended for nondisplaced femoral neck fractures in elderly patients?
Which treatment option is generally recommended for nondisplaced femoral neck fractures in elderly patients?
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What imaging technique is often used to evaluate osteonecrosis stages?
What imaging technique is often used to evaluate osteonecrosis stages?
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What classification system is used to describe the severity of femoral neck fractures?
What classification system is used to describe the severity of femoral neck fractures?
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What complication is associated with open reduction, internal fixation of a femoral neck fracture?
What complication is associated with open reduction, internal fixation of a femoral neck fracture?
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After a hip fracture surgery, what is the recommended postoperative care for the elderly?
After a hip fracture surgery, what is the recommended postoperative care for the elderly?
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What is a common indication for arthroplasty in managing hip fractures in older patients?
What is a common indication for arthroplasty in managing hip fractures in older patients?
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Which type of imaging is most useful for confirming intra-articular pathology in the hip joint?
Which type of imaging is most useful for confirming intra-articular pathology in the hip joint?
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What is a key factor influencing the surgical approach for osteonecrosis treatment?
What is a key factor influencing the surgical approach for osteonecrosis treatment?
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What is a common risk factor for developing osteonecrosis?
What is a common risk factor for developing osteonecrosis?
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Which type of hip fracture is classified by its anatomical location below the lesser trochanter?
Which type of hip fracture is classified by its anatomical location below the lesser trochanter?
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What should be prioritized during the non-operative treatment of stable impacted fractures?
What should be prioritized during the non-operative treatment of stable impacted fractures?
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What is one form of hip impingement that results from the shape mismatch between the femoral head and acetabulum?
What is one form of hip impingement that results from the shape mismatch between the femoral head and acetabulum?
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In evaluating a hip condition, which imaging technique is typically employed for detailed assessment of soft tissues such as labral tears?
In evaluating a hip condition, which imaging technique is typically employed for detailed assessment of soft tissues such as labral tears?
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What is the primary indication for performing a femoral osteotomy in hip treatment?
What is the primary indication for performing a femoral osteotomy in hip treatment?
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What is a key goal during the rehabilitation phase immediately following a periacetabular osteotomy (PAO)?
What is a key goal during the rehabilitation phase immediately following a periacetabular osteotomy (PAO)?
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What complication is most likely to occur as a late symptom due to residual deformity from SCFE?
What complication is most likely to occur as a late symptom due to residual deformity from SCFE?
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Which treatment modality is most likely used for managing labral tears non-operatively?
Which treatment modality is most likely used for managing labral tears non-operatively?
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What is the recommended time frame for transitioning to full weight bearing after hip arthroscopy?
What is the recommended time frame for transitioning to full weight bearing after hip arthroscopy?
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Which of the following factors would NOT be an important consideration for managing developmental dysplasia of the hip (DDH)?
Which of the following factors would NOT be an important consideration for managing developmental dysplasia of the hip (DDH)?
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After a surgical procedure for hip conditions, which phase of rehabilitation focuses on achieving active strengthening?
After a surgical procedure for hip conditions, which phase of rehabilitation focuses on achieving active strengthening?
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What is a common presenting symptom in young adults suffering from labral tears?
What is a common presenting symptom in young adults suffering from labral tears?
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What important clinical feature often accompanies a hip labral tear diagnosis?
What important clinical feature often accompanies a hip labral tear diagnosis?
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What consequence may arise from restricting corticosteroid injections in young patients?
What consequence may arise from restricting corticosteroid injections in young patients?
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What is the objective of addressing structural deformity during surgical treatment of hip disorders?
What is the objective of addressing structural deformity during surgical treatment of hip disorders?
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Which of the following evaluation methods is specifically related to testing hip strength in young hip patients?
Which of the following evaluation methods is specifically related to testing hip strength in young hip patients?
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What component of hip examination assesses the risk of impingement?
What component of hip examination assesses the risk of impingement?
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Which test evaluates hip motion in side-lying position?
Which test evaluates hip motion in side-lying position?
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Which of the following positions is utilized during impingement testing?
Which of the following positions is utilized during impingement testing?
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What is the primary purpose of the Trendelenberg test in the evaluation of young hip patients?
What is the primary purpose of the Trendelenberg test in the evaluation of young hip patients?
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What treatment option is commonly recommended for cases of femoral head collapse?
What treatment option is commonly recommended for cases of femoral head collapse?
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Which factor contributes to THA instability after surgery?
Which factor contributes to THA instability after surgery?
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What is a traditional method to treat osteonecrosis of the femoral head?
What is a traditional method to treat osteonecrosis of the femoral head?
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In relation to hip dislocations, which time frame represents when most acute dislocations occur post-THA?
In relation to hip dislocations, which time frame represents when most acute dislocations occur post-THA?
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What is the primary purpose of performing an osteotomy for avascular necrosis (AVN)?
What is the primary purpose of performing an osteotomy for avascular necrosis (AVN)?
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What is a common reason for a hip dislocation in primary Total Hip Arthroplasty (THA)?
What is a common reason for a hip dislocation in primary Total Hip Arthroplasty (THA)?
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Which aspect of hip stability is particularly important in relation to soft tissue tension?
Which aspect of hip stability is particularly important in relation to soft tissue tension?
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What is the complication rate for dislocation in revision THA?
What is the complication rate for dislocation in revision THA?
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What is the primary goal of restoring the pelvic ring in treating lateral compression pelvic fractures?
What is the primary goal of restoring the pelvic ring in treating lateral compression pelvic fractures?
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What type of fractures are often associated with acetabular fractures?
What type of fractures are often associated with acetabular fractures?
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In treating anterior-posterior compression fractures, what method is used for low energy stable fractures?
In treating anterior-posterior compression fractures, what method is used for low energy stable fractures?
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What is a significant risk factor for hip fractures in the elderly population?
What is a significant risk factor for hip fractures in the elderly population?
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Which surgical approach is most appropriate for managing intra-articular fractures in young patients prior to THA?
Which surgical approach is most appropriate for managing intra-articular fractures in young patients prior to THA?
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What type of fracture is typically associated with a ground level fall in the elderly?
What type of fracture is typically associated with a ground level fall in the elderly?
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What is indicated by the presence of post-traumatic arthritis following an acetabular fracture?
What is indicated by the presence of post-traumatic arthritis following an acetabular fracture?
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What is the primary management principle for treating hip fractures in younger patients?
What is the primary management principle for treating hip fractures in younger patients?
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What is typically experienced by older patients with pelvic insufficiency fractures?
What is typically experienced by older patients with pelvic insufficiency fractures?
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Which classification describes a stable femoral neck fracture in elderly patients?
Which classification describes a stable femoral neck fracture in elderly patients?
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What is the recommended weight-bearing status for a patient after a surgical procedure on the acetabulum?
What is the recommended weight-bearing status for a patient after a surgical procedure on the acetabulum?
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What is a potential complication of surgical treatment for femoral neck fractures?
What is a potential complication of surgical treatment for femoral neck fractures?
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Which option is NOT considered a non-prosthetic surgical technique for a young hip patient?
Which option is NOT considered a non-prosthetic surgical technique for a young hip patient?
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What symptoms should be assessed in young hip patients during their history evaluation?
What symptoms should be assessed in young hip patients during their history evaluation?
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Which treatment method is commonly used for intertrochanteric fractures?
Which treatment method is commonly used for intertrochanteric fractures?
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What type of trauma history is significant when assessing young hip patients?
What type of trauma history is significant when assessing young hip patients?
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Which condition is NOT a known etiology of osteonecrosis?
Which condition is NOT a known etiology of osteonecrosis?
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What stage of Ficat-Arlet classification indicates normal MRI findings?
What stage of Ficat-Arlet classification indicates normal MRI findings?
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Which surgical procedure is utilized for core decompression in osteonecrosis?
Which surgical procedure is utilized for core decompression in osteonecrosis?
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What complication is common following intertrochanteric hip fractures?
What complication is common following intertrochanteric hip fractures?
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Which statement is true regarding managing patients with a prior hip fracture?
Which statement is true regarding managing patients with a prior hip fracture?
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What type of fracture is characterized as unstable on the Garden classification?
What type of fracture is characterized as unstable on the Garden classification?
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Which of the following factors contribute to osteoporosis in older patients?
Which of the following factors contribute to osteoporosis in older patients?
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What is the recommended initial treatment for a stable impacted fracture?
What is the recommended initial treatment for a stable impacted fracture?
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What is the main characteristic of SCFE (Slipped Capital Femoral Epiphysis)?
What is the main characteristic of SCFE (Slipped Capital Femoral Epiphysis)?
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Which treatment goal is prioritized in a Periacetabular Osteotomy (PAO) for developmental dysplasia of the hip (DDH)?
Which treatment goal is prioritized in a Periacetabular Osteotomy (PAO) for developmental dysplasia of the hip (DDH)?
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Which of the following is NOT a typical presentation of a labral tear?
Which of the following is NOT a typical presentation of a labral tear?
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What is a common consequence of untreated SCFE?
What is a common consequence of untreated SCFE?
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What is a primary non-operative treatment option for a labral tear?
What is a primary non-operative treatment option for a labral tear?
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In regards to hip arthroscopy, which condition is primarily indicated for surgical intervention?
In regards to hip arthroscopy, which condition is primarily indicated for surgical intervention?
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What should be avoided during the first phase of rehabilitation after a PAO?
What should be avoided during the first phase of rehabilitation after a PAO?
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What is a potential trigger for symptoms in individuals with a shallow acetabulum?
What is a potential trigger for symptoms in individuals with a shallow acetabulum?
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What is the expected timeline for full recovery after a hip arthroscopy?
What is the expected timeline for full recovery after a hip arthroscopy?
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What is a key rehabilitation goal following a hip arthroscopy?
What is a key rehabilitation goal following a hip arthroscopy?
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In cases of DDH, what is an important sign indicating deficient femoral head coverage?
In cases of DDH, what is an important sign indicating deficient femoral head coverage?
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What occurs during the weeks 12-16 of rehabilitation following a PAO?
What occurs during the weeks 12-16 of rehabilitation following a PAO?
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Which factor greatly affects surgical outcomes in hip surgeries?
Which factor greatly affects surgical outcomes in hip surgeries?
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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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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.
