Deutschland Händler
Motion Solutions GmbH,
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Author: zingleader
Greta – Cerebral Palsy – spastic, quadriplegic
Brief description of environment of facility/school
Greta is served through Early Intervention with a trans-disciplinary, family routines-based model and Physical Therapist as primary service provider.
Basic Info about client
- Greta
- Age: 30 months
- Diagnosis: Cerebral Palsy – spastic, quadriplegic
- Brief history:
- born after an uncomplicated pregnancy at 39 3/7 weeks
- at birth, she had a heart rate of 92 but no spontaneous respirations
- Apgars were 3 at birth; 4 at one minute; and 4 at ten minutes
- shortly after birth, Greta had Sarnat stage III encephalopathy and on admission to Newborn Intensive Care Unit at 2 ½ hours of age, she had stage II encephalopathy
- initial EEG showed occasional electrographic seizures. She was cooled for 72 hours and her EEG showed improvement
- receives regularly scheduled botulinum toxin injections to most affected areas (usually upper extremity)
- had trial of Sinemet for motor function, but drug was discontinued due to gastrointestinal side effects (vomiting)
Continue reading Greta – Cerebral Palsy – spastic, quadriplegic
Eli – Cerebral Palsy
Basic Info about client
Client’s Name: Eli
Age: 2 (will be 3 on 4/2/15)
Diagnosis: Cerebral Palsy
Brief history:
Premature birth – 35 weeks gestation
Sustained intrauterine ischemic event with damage to left parietal lobe, right occipital lobe, Macrodactyly left foot
Current Situation: Eli’s primary means of independent mobility is crawling with a non-reciprocating “bunny hop” pattern. He crawls up and down stairs and pulls to standing independently. He has decreased function of his right upper extremity, but consistently uses his right “helper hand”. Spasticity is present through both legs and right arm. Eli demonstrates typical crouch gait alignment in standing, tending toward bilateral ankle plantarflexion, and flexion at both knees and hips. He propels a gait trainer with minimal assist with forearm prompts and does best with ankle prompts to minimize scissoring and anterior rotation of the left side of the body. He requires verbal prompting to step to or step through with his right foot. Eli has bilateral Ankle Foot Orthotics (AFOs) to assist with alignment of his feet and lower legs. Continue reading Eli – Cerebral Palsy
Dempsey – Achondroplasia, Cerebral Palsy
Brief description of environment of facility/school
Dempsey is seen by his school district’s Early Intervention team, with visits from the Physical Therapist twice per month as primary service provider with consultation from Early Childhood Special Education teacher and Service Coordinator.
Basic Info about client
Clients Name – Dempsey
Age – 10 months
Diagnosis – achondroplasia, cerebral palsy
Brief history – Dempsey’s mother experienced premature preterm rupture of membranes (PPROM) at 31 weeks, 3 days gestation and was hospitalized. Dempsey was delivered at 34 weeks, 1 day gestation with birth weight of 2400 grams. His Apgar scores were 3 at 1 minute and 8 at 5 minutes. He required positive pressure ventilation with oxygen and had ongoing care in the NICU for respiratory distress syndrome. MRI indicated severe hypoxic ischemic injury, multifocal cerebral, cerebellar, and intraventricular areas of microhemorrhage. Continue reading Dempsey – Achondroplasia, Cerebral Palsy
Does standing protect bone density in patients with chronic spinal cord injury?
date: 2008;31(2):197-201.
author: Goktepe A.
publication: J Spinal Cord Med.
PubMed ID:18581668
Abstract
BACKGROUND/OBJECTIVE:
To compare the t-scores of proximal femur and lumbar spine of patients with spinal cord injury (SCI) with different levels of weight bearing.
METHODS:
Cross-sectional study comparing 3 groups of patients with SCI: patients with daily standing times of more than 1 hour, patients with daily standing times of less than 1 hour, and nonstanding patients. Seventy-one patients with chronic SCI were recruited. They were assigned to 1 of 3 groups according to their reported daily standing time. The bone density of lumbar and proximal femoral regions was measured with dual-energy x-ray absorptiometry.
RESULTS:
The 3 groups were similar in terms of demographics and clinical variables. No significant difference was found among the mean t-scores of lumbar and proximal femoral regions of the groups. However, the patients in the group that stood more than 1 hour daily had a slight tendency to have higher t-scores than those in the control group.
CONCLUSIONS:
There was no significant difference among the 3 groups. However, standing might be partially helpful in protecting the bone density in SCI by opposing the effects of immobilization.
Bone mineral status in paraplegic patients who do or do not perform standing
date: 1994 May;4(3):138-43.
author: Goemaere S.
publication: Osteoporos Int.
PubMed ID:8069052
Abstract
Bone mineral density (BMD) was assessed by dual-photon X-ray absorptiometry at the lumbar spine (L3, L4), the proximal femur and the femoral shaft, and by single-photon absorptiometry at the forearm in 53 patients with complete traumatic paraplegia of at least 1 year’s duration and in age- and sex-matched healthy controls. The patients did (n = 38) or did not (n = 15) regularly perform passive weightbearing standing with the aid of a standing device. Compared with the controls, the BMD of paraplegic patients was preserved in the lumbar spine and was markedly decreased in the proximal femur (33%) and the femoral shaft (25%). When considering all patients performing standing, they had a better-preserved BMD at the femoral shaft (p = 0.009), but not at the proximal femur, than patients not performing standing. BMD at the lumbar spine (L3, L4) was marginally higher in the standing group (significant only for L3; p = 0.040). A subgroup of patients performing standing with use of long leg braces had a significantly higher BMD at the proximal femur than patients using a standing frame or a standing wheelchair (p = 0.030). The present results suggest that passive mechanical loading can have a beneficial effect on the preservation of bone mass in osteoporosis found in paraplegics.
Bone mineral density in upper and lower extremities during 12 months after spinal cord injury measured by peripheral quantitative computed tomography
date: 2000 Jan;38(1):26-32.
author: Frey-Rindova P.
publication: Spinal Cord.
PubMed ID:10762194
Abstract
OBJECTIVE:
To evaluate the loss of trabecular and cortical bone mineral density in radius, ulna and tibia of spinal cord injured persons with different levels of neurologic lesion after 6, 12 and 24 months of spinal cord injury (SCI).
DESIGN:
Prospective study in a Paraplegic Centre of the University Hospital Balgrist, Zurich.
SUBJECTS AND METHODS:
Twenty-nine patients (27 males, two females) were examined by the highly precise peripheral quantitative computed tomography (pQCT) soon after injury and subsequently at 6, 12 and in some cases 24 months after SCI. Using analysis of the bone mineral density (BMD), various degrees of trabecular and cortical bone loss were recognised. A rehabilitation program was started as soon as possible (1-4 weeks) after SCI. The influence of the level of neurological lesion was determined by analysis of variance (ANOVA). Spasticity was assessed by the Ashworth Scale.
RESULTS:
The trabecular bone mineral density of radius and ulna was significantly reduced in subjects with tetraplegia 6 months (radius 19% less, P<0.01; ulna 6% less, P>0.05) and 12 months after SCI (radius 28% less, P<0.01; ulna 15% less, P<0.05). The cortical bone density was significantly reduced 12 months after SCI (radius 3% less, P<0.05; ulna 4% less, P<0.05). No changes in BMD of trabecular or cortical bone of radius and ulna were detected in subjects with paraplegia. The trabecular BMD of tibia was significantly reduced 6 months (5% less, P<0.05) and 12 months after SCI (15% less, P<0.05) in all subjects with SCI. The cortical bone density of the tibia only was decreased after a year following SCI (7% less, P<0.05). No significant difference between both groups, subjects with paraplegia and subjects with tetraplegia was found for tibia cortical or trabecular BMD. There was no significant influence for the physical activity level or the degree of spasticity on bone mineral density in all subjects with SCI.
CONCLUSIONS:
Twelve months after SCI a significant decrease of BMD was found in trabecular bone in radius and in tibia of subjects with tetraplegia. In subjects paraplegia, a decrease only in tibia BMD occurred. Intensity of physical activity did not significantly influence the loss of BMD in all subjects with para- and tetraplegia. However, in some subjects regular intensive loading exercise activity in early rehabilitation (tilt table, standing) can possibly attenuate the decrease of BMD of tibia. No influence was found for the degree of spasticity on the bone loss in all subjects with SCI
Effect of dynamic weight bearing on neuromuscular activation after spinal cord injury.
date: 2007 Jun;86(6):499-506
author: Edwards LC, Layne CS.
publication: Am J Phys Med Rehabil
PubMed ID:17515690
Abstract
OBJECTIVE:
To determine whether individuals who have a spinal cord injury have neuromuscular and physiologic responses to a personalized exercise program during dynamic weight bearing (DWB).
DESIGN:
Four subjects with spinal cord injuries (T6, T5-6, C2-5, and C5) completed a 12-wk exercise program that included DWB. Surface electromyography (EMG) was recorded from the right gastrocnemius, biceps femoris, rectus femoris, rectus abdominus, and external oblique. Heart rate (HR) and blood pressure (BP) were recorded throughout training. Descriptive statistics were used to analyze the data.
RESULTS:
The results of this study indicate that the subjects actively responded to exercise during DWB, as measured by EMG, HR, and BP.
CONCLUSIONS:
The results suggest that exercise during DWB can induce physiologic and neuromuscular responses in individuals who have a spinal cord injury, and that exercise during DWB may serve as a preparatory program for more advanced rehabilitation.
Leg skin temperature with body-weight-supported treadmill and tilt-table standing training after spinal cord injury
date: 2011 Jan;49(1):149-53. doi:
author: Cotie LM.
publication: Spinal Cord.
PubMed ID: 20479767
Abstract
STUDY DESIGN:
Randomized crossover.
OBJECTIVES:
Effects of body-weight-supported treadmill (BWST) and tilt-table standing (TTS) training on skin temperature and blood flow after spinal cord injury (SCI).
SETTING:
McMaster University, Canada.
METHODS:
Seven individuals with SCI participated in BWST and TTS training (3 times per week for 4 weeks, 4-week detraining between protocols). Skin temperature was measured before and after a single session of BWST or TTS, pre- and post-training. Leg blood flow was measured at rest pre- and post-training.
RESULTS:
Resting skin temperature decreased at four sites after 4 weeks of BWST training in comparison with the pre-training. Four weeks of TTS training resulted in resting skin temperature decreases post-training at the right thigh only. Both BWST and TTS training resulted in altered reactivity of skin temperature at all sites except the right calf in response to a single session of BWST and TTS. Post-BWST training, a single session of BWST stimulated increased temperature at all sites, whereas after TTS training a single session of TTS resulted in temperature decreases at two of the six sites. No changes were observed in resting blood flow with either BWST or TTS training.
CONCLUSION:
Increased resting skin temperature and decreased skin temperature reactivity have been linked to the development of pressure sores. BWST and TTS may stimulate different skin temperature responses and the impact on pressure sore development warrants further investigation.
Tilt table standing for reducing spasticity after spinal cord injury
date: 1993 Oct;74(10):1121-2
author: Bohannon R.
publication: Arch Phys Med Rehabil
PubMed ID:8215868
Abstract
A patient with a T12 spinal cord injury and intractable extensor spasms of the lower extremities participated in tilt table standing trial on 5 nonconsecutive days to determine if the intervention would affect his spasticity and spasms. Each day’s standing trial was followed by an immediate reduction in lower extremity spasticity (measured using the modified Ashworth scale and pendulum testing). Standing was also accompanied by a reduction in spasms that lasted until the following morning. The reduction of spasms was particularly advantageous to the performance of car transfers. Tilt table standing merits further examination as a physical treatment of spasms that accompany central nervous system lesions.