Jessica Lewis
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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!
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
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!
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.”
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
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.
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…
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!
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.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!
From what I can remember, the test has some solo questions and some case questions. We tried to do a mix of both to help you prepare for both styles. Our test writing software does not allow us to combine the styles (because we use a random question generator and we don’t want the case study questions to be scrambled) so we had to separate the two.
I think it is helpful to read through some article in a journal like Pediatric Physical Therapy or just Physical Therapy Journal and see if you can understand the stats in those basic articles. This helps me try to translate the research info knowledge into something that is actually real.
If you were to assess the full passive range of motion of a neonate’s hips, the external rotation would be 90 degree or greater. The resting posture of the hip within the joint is ~30 degrees of external rotation due to anteversion (60 degrees) being greater than antetorsion (30 degrees) at birth. The 100 degrees of external rotation is related to PROM of the hip joint and the 30 degrees of external rotation is related to the position of the head of the femur in the acetabulum.
