Lecture3 April 8 CP

CEREBRAL PALSY
Cerebral refers to the brain

Palsy refers to a lack of muscle control/physical complication
A group of chronic neurologic impairment
Neither hereditary nor contagious.

ECE 315 Caused by damage to the developing brain
Students with Special Needs
Movement, posture, (sometimes) mental perf. effected. Learning problems,
Asst.Prof.Dr.Mehmet Ata Öztürk intellectual disabilities, sensory problems (hearing, seeing) may accompany.
Usually, greater injury to the brain, the more severe the CP

Lecture 3: Cerebral Palsy
The condition is not progressive, nor is it medically curable
April 8, 2018 A good resource: https://www.cdc.gov/ncbddd/cp/index.html
ECE315 Lecture 3 (Apr.08,2018) Mehmet Ata Öztürk, Ph.D. 2
PREVELANCE CAUSES
• Problems in blood flow to the brain or oxygen supply
issue before birth (10-20% of cases)
• In 1000 live birth, 2-5 • Damage to developing brain
• By 1, 5.2/1000
• By 7, 2/1000
• Hemorrhage
• Infections
• Severe jaundice
these rates show a change
•
http://www.sciencephoto.com/media/307823/view/oligodendrocyte-nerve-cells
in CP rates during follow-up Head/birth trauma For more: https://www.cdc.gov/ncbddd/cp/causes.html
• Premature birth (below 1500 gr., CP risk is 15-20 %)

ECE315 Lecture 3 (Apr.08,2018) Mehmet Ata Öztürk, Ph.D. 3 ECE315 Lecture 3 (Apr.08,2018) Mehmet Ata Öztürk, Ph.D. 4
RISK FACTORS DIAGNOSIS

• Factors related to parents
• Generally before age 3, not reaching developmental milestones
– Late pregnancy (≥ 40) • Motor skill tests
– Early pregnancy (≤ 20)—generally not related to fertility but – Muscle tone, posture
malnutrition – Reflexes (e.g. tonic neck)
– Hand preference
• Factors related to child/ren – Tendency to use either
– Low birth weight (< 1.5 kg) side in 1st 12 months
– Premature birth (< 27 weeks)

– Need for neonatal unit
– Meningitis after birth
• Other factors
– Blood type mismatch
– Viral infection during initial periods of pregnancy
DIAGNOSIS CP TYPES
Neurological classification
• Generally before age 3, not reaching developmental milestones

• Motor skill tests
• Computerized tomography (CT)
• Magnetic resonance imaging (MRI)
https://www.cdc.gov/ncbddd/cp/diagnosis.html
(difficciulty in movement)
(balance issues & loss of the perception of depth)
CP TYPES CP TYPES
Neurological classification Neurological classification
1. Spastic 2. Dyskinetic
– %70-80 of ind.w/CP – % 10-20% of cases
– Damage to the motor area of cortex – Anomaly in muscle tone that impacts whole body
– Damage around motor area (basal ganglia)
– Increase in unwanted reflexes
– Limited ROM – During emotional stress, anomally increases
– Always tense mucles – During sleep, it disappears
– Pos. issue w/muscles controlling speech
– Major impact on flexors (büken),
adductors (yaklaştırıcı), and Sub Group 1 (Athetoid)
inner rotator muscles. Writhing movements , quick , random moves
– Jerky, unforeseeable movements Sub Group 2 (Dystonic)

– If both feet are impacted, scissor walk is observed Rigid posture that escalates around neck &
https://www.youtube.com/watch?v=TP37l54UqTE
head. Communication error between
muscles (wrong muscle groups substitute each other)
CP TYPES CP TYPES
Neurological classification Neurological classification
3. Ataxic 4. Mixed
– 5-10% of cases
– Balance disorders & laxity – 10-15% of case
– Combination of former types
(gevşeklik/looseness)
– Damage to cerebellum
– Most common types are spastic & dyskinetic
– Loss of balance & depth perception

– Difficulty planning & coordinating the moves
– Inbalanced move or placing feet unusually far apart https://www.youtube.com/watch?v=Z7TwzSHnmCk
– Difficulty making quick/detailed movements (write or button)
– Intention tremor is possible (key)
CP TYPES CP TYPES
Anatomical classification Anatomical classification
Paraplegia: Only legs are ipacted

Hemiplegia: 1 part of body Quadriplegia: Both legs and arms
(most common type) (Tetra)
CP TYPES CP TYPES
Anatomical classification
Diplegia: Lower body is effected more
Gross Motor Function Classification System (GMFCS) Gross Motor Function Classification System (GMFCS)
ECE315 LECTURE 6 APR.11,2016 17 ECE315 Lecture 3 (Apr.08,2018) Mehmet Ata Öztürk, Ph.D. 18
Gross Motor Function Classification System (GMFCS)

ASSOCIATED IMPAIRMENTS
ASSOCIATED IMPAIRMENTS SAMPLE INTERVENTION
• Intellectual Disabilities
– Hemiphlegia (spastic): < 40 % • Physical therapy
– Among those with whole body impact : > 70 %
• Visual Impairment The Thera Suit has elastic cords that attach to different areas of
the body and they are positioned to keep the body properly
– Common and diverse aligned to forcibly encourage movement within a normal range of
•
motion.
Hearing & Speech Impairment The design of the suit causes an individual with cerebral palsy to
– About 30 % of children w/CP limit body movement in particular ways in order to force the body
into proper physical alignments and help to replace.
• Seizures Provides proper body alignment which helps improves muscle
– Approximately 40% of children w/CP develop seizures tone as well as body awareness, gross motor skills and balance.
Because the suit helps align and balance the body it also
– Hemiflegia & quadriplegia more prone strengthens the body as well.
http://www.youtube.com/watch?v=75Ay_-Rhkd4&feature=related
https://www.youtube.com/watch?v=XIj2ezFK14k
ECE315 Lecture 3 (Apr.08,2018) Mehmet Ata Öztürk, Ph.D. 21 ECE315 Lecture 3 (Apr.08,2018) 2222
Mehmet Ata Öztürk, Ph.D.
SAMPLE INTERVENTION SAMPLE INTERVENTION

• Physical theraphy:
• Antispastisity medicine
– Diazepam, Dantrolen, Baklofen, etc.
• Brace
• Surgery
EDUCATIONAL TOPICS EDUCATIONAL TOPICS
• There might be issues with academic success. • There might be issues with academic success.
Potential causes? Potential causes?
– Learing difficulties/intellectual dis. – Learing difficulties/intellectual dis.
– Feeding issues – Feeding issues
– Physical environment – Physical environment
– Medication side effects – Medication side effects
– Speech and movement difficulties – Speech and movement difficulties
• There might be social issues.
Potential causes?
– Speech and movement difficulties
– Accessibility limitations
– Demoralization deriving from the
difficulties of coping with daily life events

• Consantrate on posture
• Physical activity topics
• If water temperature is appropriate, pool is ideal
• Strengthen opposite muscles (age progress)
• Increase ROM / maintain • Work on stepping template
• Improve motor function
• Effort on reducing muscle spasms
https://www.youtube.com/watch?v=LcYnTUZJpmE
• They might experience issues with…

• Static & dynamic balance
• Malnutrition
• Delay in motor skills
• Applying force and coordination

Incorporating video games
• Whenever possible, outside w/c
• … or use as a tool
• Though more research and studies need to be

done, a recent study showed that using video
games for children with cerebral palsy help
them improve in different areas including their
visual perception, bodily control as well as
• Add weights to implements, such as bats and racquets, to help with their functional mobility.
tremors or unwanted movements
• USE WAIT/EXTENDED TIME TO FULLFILL TASKS
• If more research shows the same types of
consistency, this could be a huge step since it
is affordable and fun to use on a daily basis.
http://www.slideshare.net/spastudent/effects-of-virtual-
reality-with-cerebral-palsy-children-8317277
FINAL SUGGESTIONS Tasks for next week...
http://www.teachspeced.ca/cerebral-palsy

Lecture3 April 8 CP

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CEREBRAL PALSY

Cerebral refers to the brain

Neither hereditary nor contagious.

Usually, greater injury to the brain, the more severe the CP

April 8, 2018 A good resource: https://www.cdc.gov/ncbddd/cp/index.html

ECE315 Lecture 3 (Apr.08,2018) Mehmet Ata Öztürk, Ph.D. 2

in CP rates during follow-up Head/birth trauma For more: https://www.cdc.gov/ncbddd/cp/causes.html

• Premature birth (below 1500 gr., CP risk is 15-20 %)

RISK FACTORS DIAGNOSIS

– Premature birth (< 27 weeks)

• Generally before age 3, not reaching developmental milestones

(balance issues & loss of the perception of depth)

– Jerky, unforeseeable movements Sub Group 2 (Dystonic)

– Loss of balance & depth perception

Paraplegia: Only legs are ipacted

Diplegia: Lower body is effected more

Gross Motor Function Classification System (GMFCS)

ASSOCIATED IMPAIRMENTS SAMPLE INTERVENTION

SAMPLE INTERVENTION SAMPLE INTERVENTION

EDUCATIONAL TOPICS EDUCATIONAL TOPICS

• They might experience issues with…

EDUCATIONAL TOPICS EDUCATIONAL TOPICS

• Though more research and studies need to be

FINAL SUGGESTIONS Tasks for next week...

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