Understanding CP: Exercise Rehabilitation PDF

9/24/2023 Exercise Rehabilitation Understanding Cerebral Palsy: James Czencz Physiotherapist / PhD Candidate [email protected] @CzenczH https://www.linkedin.com/in/james-czencz/ Neuromuscular Rehabilitation - HESC3592 – Week 4 1 Part A – Pathophysiology 1. 2. Able to understand Cerebral...

9/24/2023 Exercise Rehabilitation Understanding Cerebral Palsy: James Czencz Physiotherapist / PhD Candidate [email protected] @CzenczH https://www.linkedin.com/in/james-czencz/ Neuromuscular Rehabilitation - HESC3592 – Week 4 1 Part A – Pathophysiology 1. 2. Able to understand Cerebral Palsy definition? What are the characteristics of CP? 1. Motor type 2. Anatomical distribution 3. Describe the prevalence of CP in Australia 4. Have a basic understanding of how CP is diagnosed. 5. Understand the main functional classifications? 6. Describe other impairments associated with CP. 7. Identify other co-morbidities that may be present. 2 Part B – Guided Case Studies Image: https://myperfectwords.com/blog/writing-a-case-study 3 1 9/24/2023 Part C – Hearing from the experts Guarav (Adult with CP) James (Senior EP) Tracey (Allied Health Assistant) 4 What is Cerebral Palsy? “Cerebral palsy (CP) has been defined as “a group of permanent disorders of the development of movement and posture, causing activity limitation, that are attributed to non-progressive disturbances that occurred in the developing fetal or infant brain” Image:: https://www.medicalnewstoday.com/articles/152712#causes (Rosenbaum, Paneth et al. 2007) 5 Clinical Characteristics Image: https://cerebralpalsyscotland.org.uk/get-information/types-of-cerebral-palsy/ (Novak et al., 2017). 6 2 9/24/2023 Types and classifications 7 Prevalence (Smithers-Sheedy, Waight et al. 2022) 8 Diagnosis 1. Usually between 12 and 24 months of age 2. Involves 1. comprehensive birth history 2. MRI 3. Physical examination (Novak et al., 2017). Tools like the General Movement Assessment (GMA) can assist with early detection and assessment! Video print of a 14-week-old infant showing fidgety movements as time evolves 9 3 9/24/2023 Gross Motor Function Classification System - Categorises gross motor function - GMFCS Levels I -V - Often used to describe function but has not been validated in adults Not just about severity of motors systems, but by all associated impairments Palisano et al., 2008 10 Proportion of people by GMFCS Proportion of people by GMFCS 15% 39% 13% 10% 23% GMFCS I GMFCS II GMFCS III GMFCS IV GMFCS V Deloitte Access Economics, 2019 11 Other functional scales 12 4 9/24/2023 Other impairments Primarily CP affects movement and balance, however; • Sensory problems • Vision impairments Impairment • Cognitive deficits Proportion of CP Population 2018, %) • Behaviour and emotion • Pain • Mood • Fatigue Epilepsy 29 Hearing 46 Intellectual 63 Speech 35 Vision 11 Associated Impairments of CP (ACPR, 2018) 13 Severity of associated impairments by GMFCS Severity of associated impairments by GMFCS 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% Severe ID (IQ < 50) Visual Impairment GMFCS I Epilepsy GMFCS II Behavioural problems GMFCS III GMFCS IV Hip displacement Feeding tube GMFCS V Deloitte Access Economics, 2019 14 Comorbidities • Obesity • Cardiovascular disease • Metabolic syndromes • Poor mental health 15 5 9/24/2023 16 6