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Jessica Lewis

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Viewing 15 posts - 1 through 15 (of 46 total)
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  • in reply to: Infant Development #488977
    Jessica Lewis
    Participant

    There are varying thoughts in different references about which roll comes first, prone to supine or supine to prone. It relies so much on tummy time tolerance and the baby. Our chart is based off of the information gathered from our references. I think the important thing to focus on when taking the test is when it would definitely be abnormal for a child not to be rolling. The test writers likely will know that there is a gray area around this and their goal is to ultimately write a good test questions. Ones that have too much gray will not perform well and they don’t want this to be the case. I think understanding that rolling in general should be completed independently in both directions by 6(ish) months is a good place to start. Understanding the general time frames of each is also helpful, but bigger picture is more important.

    Same thing for reflexes integration. Some have huge spans of time when it could be integrated and different references say different things. Think bigger picture and know that the question writers for the tests want to write solid questions that are challenging but have a definitive answer. Things like reflexes and some of those early developmental milestones have wide ranges and they will make sure you have enough information to make an evidence-based choice that doesn’t fall into a gray area.

    in reply to: hip surveillance guidelines #486188
    Jessica Lewis
    Participant

    Hi Juliana!

    Great question! I think the best thing to do in the case of hip surveillance is to recognize that both sets of guidelines have similar trends…the level of surveillance increases as the GMFCS level increases and WGH patterns have their own unique set of rules. If you are expected to choose something that is very specific, my guess would be to rely on the AACPDM guidelines rather than the specifics of the AusACPDM guidelines.

    Jessica

    in reply to: LLD and shoe lifts #486186
    Jessica Lewis
    Participant

    Hi Kellie!

    The Campbell text was not the primary source used when writing for this question. Texts can vary in recommendations regarding shoe lifts – when one is needed and internal vs external. We tried to make the options outside of the most common insert values to help you narrow it down to the best answer. I agree with Campbell that intervention is typically not utilized for a LLD <2.5 cm (which excludes the 1.5 cm option). 6 and 8 cm LLD would be far too large to consider an internal shoe lift. This leaves 3 cm as the best answer. I can see the dilemma here because right around an inch is when you consider internal vs external. However, given the information in the question, 3 cm would be the best answer.

    Jessica

    in reply to: DCD Clinical Practice Guidelines #485377
    Jessica Lewis
    Participant

    Thank you Juliana!

    in reply to: DCD Clinical Practice Guidelines #485113
    Jessica Lewis
    Participant

    The CPG states that “compliance with task-oriented home programs for motor skills training intervention correlated with positive changes in motor proficiency and postural control compared with children who received a core stability-focused home program.” Core stability training when combined with functional training can be a beneficial treatment strategy for these children. Core training completed in isolation is not expected to produce functional gains (similar to strengthening in isolation for children with CP does not improve function, strengthening must be completed during functional tasks for functional outcomes to be achieved). So, to make a long answer short – yes to both of your questions!

    in reply to: Head Positioning in Brachial Plexus Injury #484886
    Jessica Lewis
    Participant

    Hello Elizabeth!

    This one has me stumped a little bit too. I tried looking up the reference in the Campbell text (Basciani 1995) but I was not able to get the full PDF. Campbell uses the terminology “habitually positioned away from the involved arm” which makes me wonder if they mean flexed away or turned away. The APTA clinical summary is a little more clear in stating that the child will tilt towards the side of the injury. The APTA information’s reference is from 2006 but the information referenced within that reference is from 1984…ugh! Other search results didn’t help me clarify this topic any further. My best guess would be that the child would likely develop a tilt in the direction of the BPI, like the APTA states, with the head turning away from the injury (similar to what you might expect from a child with hemiplegia). Sorry I’m not able to clarify this any further for you, but hopefully this reasoning will help a little bit!

    Jessica

    in reply to: Wound Care #484220
    Jessica Lewis
    Participant

    Yes! The 4th edition of Campbell does have a great burn chapter if you have this edition of the text. It’s harder to find if you have newer editions. Thank you for pointing this out Caroline and for you other recommendations!

    in reply to: uncontrolled manifold #484219
    Jessica Lewis
    Participant

    This is not a commonly discussed component of the dynamic systems theory, however here is what I understand it to be: The uncontrolled manifold theory believes that the body uses synergies to ensure flexible and stable performance of motor tasks. The body is using variable degrees of freedom to its benefit. This concept is also known as the “principle of abundance.”

    in reply to: Rancho Pediatric Levels of Conciousness #484214
    Jessica Lewis
    Participant

    I don’t think that children have to move through each stage of the RLFC. It would depend on how severe the TBI is and how long the child takes to recover. Sometimes, each stage is not identifiable if the TBI is mild. I would say the most important thing to know about each stage is how the child will learn best and how to structure your PT session to make it the most successful

    in reply to: Lab Values #484211
    Jessica Lewis
    Participant

    It’s always hard to say what the exam writers will think, but I think that the most important values are found in a complete blood count – red blood cells, hemoglobin, white blood cells, and platelets. I also think CK values are important to know for our neuromuscular kiddos.

    in reply to: SCI/MM L3 AD Recommendation #484204
    Jessica Lewis
    Participant

    For question 13/14: When reading the questions focus more on the information about the motor level and not necessarily the lesion level. We realize that clinically an L3 could look very different across different individuals and that we should make decisions solely on lesion level (for both SCI and MM). Our reasoning that someone with 3+ quads could potentially do household distances with AFOs and not the more bulky KAFOs (although for distances outside of the house, KAFOs would be needed if they are not using the manual wheelchair).

    Working on question 64/65…

    in reply to: Wound Care #484190
    Jessica Lewis
    Participant

    Unfortunately, Helen and I don’t have any really great resources for wound care. Most of the primary pediatric text books do not include any of that information. Most of my information comes from my PT school days. I can work on trying to find a good resource for you over the next week and send it your way though if I find one!

    in reply to: Aging Out of an Outcome Measure #484186
    Jessica Lewis
    Participant

    The Peabody is a norm referenced assessment so we need to be careful using the Peabody for multiple assessments overtime because that’s not what it is designed to do…

    Back to your question though, yes there are concerns about a ceiling affect for a child that is about to age out of a norm referenced test.
    By initial observation of a child, if you feel like their motor skills are delayed, the assessment would still provide meaningful information during the evaluation. If you think they will be borderline average with their skills, you might consider using a different assessment. So ultimately, it would be a judgement call for the physical therapist. For the exam, I don’t think they will create a lot of gray area for these concepts if they want you to choose an exam.

    in reply to: Motor control theories #484179
    Jessica Lewis
    Participant

    Heidi…we are working on a response! Not ignoring you 🙂

    in reply to: Aquatic Therapy #484176
    Jessica Lewis
    Participant

    Any pediatric topic is up for grabs when it comes to the exam. We don’t know if it will or will not have aquatics related questions, but it is good to prepare for everything!

Viewing 15 posts - 1 through 15 (of 46 total)