Orthotic treatment for cp patients (ridoy)

cerebral palsy treatment by P&O

1. BANGLADESH HEALTH PROFESSION INSTITUTE (BHPI) School of Prosthetics and Orthotics   Presenting on : Orthotic treatment for Cerebral palsy (AFO & KO) 3 rd Year Student Presenting By: Md.Nayeem Hasan Roll: 04 7/14/2017 1

2. Content Objective. Introduction. Classification. Sign & Symptom. Causes. Clinical Features. Diagnosis. Materials. Parts of AFO. Treatment . Pressure control system. Biomechanics. Treatment goal . Conclusions. References. 7/14/2017 2

3. Objective To know about the pathology. To know about the Orthotic Treatment. To know the function of those devices (AFO & KO). To know the biomechanical features. 7/14/2017 3

4. Introduction Cerebral Palsy : It is a group of permanent movement disorders that appear in early childhood. Cerebral palsy is actually caused by brain injury. Cerebral Palsy is considered a neurological disorder caused by a non-progressive brain injury or malformation that occurs while the child’s brain is under development. 7/14/2017 4

5. Cont. 7/14/2017 5

6. Cont. The brain injury only can happen during brain developing Immediately Before birth. During birth and Shortly after birth. 7/14/2017 6

7. Classification of CP Physiologic . Topographic . Severity . 7/14/2017 7

8. Sub-classification of Cerebral palsy Cerebral Palsy : physiologic : Athetoid . Ataxic . Spastic/Rigid. Mixed ( Any Combination). 7/14/2017 8

9. Athetoid Due to damage in basal ganglia. Difficulties in controlling and cordoning movement. Speech, Grabbing , sowaling some involuntary movement. 7/14/2017 9

10. Ataxic Due damage in the cerebellum. Low muscle tone. Poor coordination of movement. Affects balance and depths perception. 7/14/2017 10

11. Spastic Due to damage in the motor cortex. Movements are limited due to spastic muscle. Can vary on a day by day basis. Few muscle more and some are less affected. 7/14/2017 11

12. Mixed Cerebral Palsy 7/14/2017 12

13. Sub-classification of Cerebral palsy Cerebral Palsy: Topographic: Monoplegic (monoplegia is a paralysis of a single limb, usually an arm) Paraplegic (Paraplegia describes complete or incomplete paralysis affecting the legs and possibly also the trunk, but not the arms) Hemiplegic (hemiplegia means that the paralysis is on one vertical half of the body) Triplegic (Triplegic cerebral palsy is a type of cerebral palsy that paralyzes three parts of the body) Quadriplegic (Four limb are affected) Diplegic (tightness" or "stiffness"—in the muscles of the lower extremities of the human body) 7/14/2017 13

14. Cont. 7/14/2017 14

15. Sub-classification of Cerebral palsy Cerebral palsy: Severity: Mild Moderate Severe 7/14/2017 15

16. Cont. 7/14/2017 16

17. Sign & Symtomes Low muscle tone (baby feels ‘floppy’ when picked up). Unable to hold up his/her own head while lying on their stomach or in a supported sitting position. Muscle spasms or feeling stiff. Poor muscle control, reflexes and posture. Delayed development (can’t sit up or independently roll over by 6 months). Feeding or swallowing difficulties. Prefers to use one side of their body. 7/14/2017 17

18. Causes Genetic. Infection during pregnancy (Placenta,Uterus ). Prolonged labor. Multiple Birth (Lack of Magnesium sulphate ). Jaundice. Low blood sugar. Hypoxia. Brain hemorrhages. 7/14/2017 18

19. Clinical Features of CP Patient Contracture Hypotonia Hypertonia Lack of coordination Difficult to listen ,speak,Eat Postural Problem Genu valgum Genu varum Recurvetum Paralysis etc . 7/14/2017 19

20. Diagnosis Physical examination Appear at the age of 4 months to 5 years. MRI CT scan 7/14/2017 20

21. Materials Metal ( Stainless steel,Aluminium,Copper) Carbon fibers Leather Bamboo Plastic (Thermoseting & Thermoplastic ) Resin Plastic polymers Rubber Wood EVA Nylon Wool Etc. 7/14/2017 21

22. Texture of Orthotic devices Rigid Semi-rigid Soft 7/14/2017 22

23. Parts of an AFO 7/14/2017 23

24. Cerebral Palsy (Probably treatment) Management: Occupational Therapy Prosthetic & Orthotic treatment Speech & language Therapy Adaptive Epuipment Surgical. 7/14/2017 24

25. Ankle Foot Orthosis (AFO) An ankle-foot orthosis, or AFO, is a support intended device to control the position and motion of the ankle, compensate for weakness, or correct deformities. 7/14/2017 25

26. Types of AFO Posterior leaf spring Ankle foot Orthosis Posterior shell Solid Ankle Foot Orthosis (SAFO) Hinged Ankle Foot Orthosis Patellar Tendon Bearing Ankle Foot Orthosis Dynamic Ankle Foot Orthosis 7/14/2017 26

27. Posterior Leaf Spring Ankle foot Orthosis Indicate for weak dorsiflexors. Narrow calf shell & Ankle trim behind the malleolar. Resist the planter flexion(during early stance). Help to dorsiflex in swing phase by recoil the shape. It has less medio-lateral stability. 7/14/2017 27

28. Posterior shell Solid Ankle Foot Orthosis (SAFO ) Mostly indicated for Drop foot (Weak dorsi & Planter flexion) Cover the calf, ankle and foot. Restore the gait as much as normal as possible. Control the varus and valgus of ankle. However there is no true dorsi-flexion and planter-flexion take place. 7/14/2017 28

29. Hinged Ankle Foot Orthosis Indicted for resist the excessive planter-flexion & dorsi-flexion. Control the suitable planter flexion at early stance phase. Control the suitable dorsi flexion at swing phase. Also control the valgus and varus moment. 7/14/2017 29

30. Patellar Tendon Bearing Ankle Foot Orthosis Distribute the body weight Achieve the reciprocal inhibition of planter flexor and invertors muscle (By sung fit) Reduce the weight from the foot 7/14/2017 30

31. Dynamic Ankle Foot Orthosis It’s a thin , flexible and wraps around the patients entire foot. Improve alignment. Control the varus & valgus moment of ankle. Allow the little movement of ankle joint. 7/14/2017 31

32. Knee Orthosis (KO) Knee orthosis are the devices which hold the knee for the ultimate purpose of prevent deformity or correct alignment. An orthosis designed to control knee motion; extends from the upper portion of the thigh & crossing the knee. 7/14/2017 32

33. Adaptive devices 7/14/2017 33 Different wheelchairs. Adaptive Tricycle Stool Scooters and Standing Equipment Stair Glides/Elevators and Mechanical Lifts Car Seats Communication Devices Commode and Bath Chairs Writing tools

34. Cont. 7/14/2017 34

35. Pressure control system 7/14/2017 35

36. Cont. 7/14/2017 36

37. Biomechanical function 7/14/2017 37

38. Treatment goal for lower extremity of CP Patient’s Correction (Body Alignment). Support. Accommodation. Improve Function. Improve balance. Improve Stability. Improve Gait. 7/14/2017 38

39. Conclusions Cerebral palsy is mainly refers to the brain injury. Due to the injured brain patients loses the motor function which affect the normal gait.Orthotic treatment help them and improve their normal gait as much as possible. 7/14/2017 39

40. References http://www.oandplibrary.org/op/pdf/1977_03_045.pdf http://www.physio-pedia.com/Orthotics_in_Cerebral_Palsy https://www.crispinorthotics.com/introduction-to-orthotics/conditions/knee/cerebral-palsy-cp-knee/ ULO Manual… http://www.abclawcenters.com/wp-content/uploads/2015/12/Post_2014.05.12_michigan-cerebral-palsy-lawyer-shares-144208_4_scissor-560x381.jpg https:// www.google.com/search?q=cerebral+palsy&ie=utf-8&oe=utf-8&client=firefox-b https :// www.google.com/search?q=types+of+AFO&ie=utf-8&oe=utf-8&client=firefox-b https://www.google.com/search?q=ankle+valgus&ie=utf-8&oe=utf-8&client=firefox-b https://www.cerebralpalsyguide.com/treatment/mobility-aids/ 7/14/2017 40

41. 7/14/2017 41 Thank You