Abstract
Background and Purpose: Functional mobility in children with Caudal Regression Syndrome depending on the severity of the syndrome is usually limited to wheel chair mobility secondary to lower extremity weakness in general and may further be a result of poor positioning of mal- formed lower extremities for weight bearing. The purpose of this Case Report is to describe the use of an unconventional Prosthesis for ambulation in a 2 1/2 year old girl with Caudal Regression Syndrome without amputation or disarticulation at the knee joint.
Case Description: The child was a 21/2 year old girl diagnosed with Caudal Regression Syndrome. The family did not want to amputate her leg at this age. She was seen in the natural environment through the
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At birth her lower extremity deformities were noted. She did not spend time in the NICU. She had surgery at 6 months old to repair a ventral hernia and at a year to repair her bilateral clubbing on feet. She subsequently attempted serial casting to realign her feet as they began to return to previous position. This was discontinued when she experienced skin breakdown on her feet. She was only taking over the counter daily vitamins. She was able to navigate her home environment by propelling herself using her arms and with her legs in criss- cross form. She could also pull to stand on furniture pushing up on her right LE. She can feed herself and dress herself. She had difficulty manipulating buttons. She was not a picky eater and ate whatever was had from the family pot. There were no concerns with constipation or infrequent urination. She did not verbalize need for use of bathroom but would let caregivers know when she was soiled. She is not potty trained. Old well healed and mobile scars were noted on her abdomen and feet from previous surgeries. In the beginning mom was resistant to introduction of wheelchair mobility because she wanted her child to walk and believed that a wheel chair meant no potential for ambulation. The child enjoyed playing and interacting with …show more content…
The family’s goal was to have the child walking around the home independently. They also had concerns about her ability to function in a classroom as she would soon be eligible to begin pre-school. (A wheel chair evaluation was completed towards the end and child fitted for a manual wheelchair). A visit was made to the Prosthetist for a customized “prosthesis” for the Left leg. This was set to accommodate the knee flexion and plantar flexion on the left leg and secured at the waist. At the base were the shank or shaft and a simple foot. The Right foot had a solid Ankle Foot Orthosis with an attempt to correct increased inversion. During this 4 month period, the family missed four visits secondary to moving to new location and an illness. The treatment plan included gait and balance training using the prosthesis, orthotics with and without the walker; transfer training- sit to stand with Orthotic on Right foot; in and out of car transfers; lower extremity strength and range of motion exercises and encouraging safe outdoor excursions. The family was to practice with walking and balance activities with prosthesis at least 20 minutes 3 days a week. She also had an arm tricycle which she was encouraged to use on the weekends while her sibling used their bicycle. Actual practice was once or twice a week for 15- 20 minutes
...At that time physical therapy was recommended. Erin eventually learned how to roll over, sit up on her own, and walk all through physical therapy. However these milestones were significantly delayed and her balance was always off. Erin took a horrific fall off the couch and landed on her forehead. She was still swollen from the “allergic reaction” from the previous month. A CT-Scan showed no bone fractures but the goose-egg that had developed took months to go away. In 2008 she officially diagnosed with FOP.
Margaret reported no significant developmental delays that she new of. She stated that she began walking early as a child. Margaret also stated that, because they grew up poor, she did not believe her mom was very healthy while pregnant with her, and that she may have drank alcohol during that time, but did not indicate how much. Specific pre-peri-post natal issues, delays, sensiorimotor issues, along with language, motor, cognitive, social/relational problems were not discussed.
She stated that her physical environment provides her with the most support in participating in activities of daily living. For example she is able to perform grooming, feeding, oral hygiene and wheelchair mobility for short distances using one-handed compensatory techniques. However, BM is unable to physically carry out her occupations daily without the assistance of a caregiver which limits her ability to engage in occupational roles such as attending church and meeting friend to crochet. She stated that she has very limited functional mobility within her left extremities which interferes with her occupational performance in bathing, dressing, toilet hygiene and all transfers. She has difficulty bathing the right side of her body and using her left hand for bilateral tasks such as tying her shoes and putting on socks. She has difficulty performing toileting tasks and requires maximal
The severe deformity is best managed by manipulation and serial casting. For best results, this should be performed before an infant reaches 8 months of age. The forefoot is manipulated into the correct position while the hindfoot is supported in the neutral position and a short leg cast is applied. The cast is changed at 1- to 2-week intervals until complete correction has been achieved. Most feet will correct in 6 to 8 weeks. After casting, the foot is maintained in a corrective shoe or an orthosis until the child is walking well.(1,11)In this study, all feet had received a trial of repeated manipulation and casting before the tenotomy procedure but it failed, this was attributed to the older age of patients at the start of manipulation.
The patient’s name is Niko and is he about a year old, his birthday was in January. He was born with Down Syndrome. There is no one in his immediate family born with this condition. The nanny has only been with Niko for a few months, starting in September of 2017. The mother reports a healthy pregnancy, but he was born one month premature.Niko has had an echocardiogram and barium test done. He currently does not take any medications or use any assistive devices. He lives at home with his mother, father, and 13-year-old sister.The nanny stated that she noticed a big change in Niko’s motor skills over the last few weeks. It was reported that Niko still needs contact guard assistance when performing mobility tasks, and is not yet crawling. However,
If children with cerebral palsy are not introduced to normal postural and movement components, it is likely that asymmetries, deformities, and postural deviations may occur. Children with cerebral palsy often require years of therapeutic activities, therefore the possibility of losing the child’s interest and enthusiasm is extreme (Bertoti, 1988). In order to address this issue, hippotherapy is one of the many therapeutic activities that have been introduced to those with disabilities. Hippotherapy is a treatment strategy that utilizes equine movement in various manners whether it is based around an occupational, speech, or physical treatment (PATH International). Hippotherapy is usually administered with the rider sitting on the horse in different positions on a soft pad instead of a saddle. The soft pad allows the horses walking movements to be conveyed through the rider leading to a more intense stimulation of the muscles. A trained instructor leads the horse around the arena at a walking pace with two side walkers who are there to assist the patient in safety. An occupational therapist or physical therapist will ask the patient to perform certain tasks or movements that will help stimulate different muscles to decrease abnormal muscle tones and increase general movement. When riding a horse one
Dandy Walker Syndrome is an abnormal cerebellum malformation that patients with will usually develop motor skill impairments and psychical setbacks. It is also the most common cerebellum defect, and effect a growing amount of patients becoming more frequent. A still highly researched subject, Dandy Walker Syndrome is a condition that derives from either ones genetic makeup, or mutated version of their genetic makeup. The disorder includes a wide range of various signs and symptoms, however, there are few known successful treatments to help the condition.
A review of the literature that highlights bone Osteopenia in children with cerebral palsy and how it is managed has been done. Due to constraints such as time, it was not possible to allow other methods, such as quantitative research using a questionnaire. The method still had to follow a rigorous, well defined method that involves a research
Achondroplasia is an autosomal dominant congenital disorder of enchondral ossification. Achondroplasia is a congenital disorder of bone formation characterized by short stature craniofacial malformation, and vertebral anomalies. A child with achondroplasia has a relatively long, narrow torso with short extremities and a disproportionate shortening of the proximal segments of the limbs. This disorder is usually diagnosed at birth because of a mutation is in the genes encoding fibroblast growth factor receptor 3. If one parent has the condition, the child has a 50 percent chance of getting it. If both parents have the condition, the child has a 25 percent chance of normal stature, a 50 percent chance of having one defective gene, causing achondroplasia
Uner Tan Syndrome is a rare disease where people walk on all fours. They walk with quadrupedal locomotion, commonly referred to as wrist walking. “ It is a condition that in its most extreme form is characterized by cerebellar hypoplasia.” (Shapiro LJ 2014, p.1). Humans with Uner Tan Syndrome show lack of cognitive ability, mental retardation, loss of balance, primitive speech and a quadrupedal gait (walking on four feet).
There are only long-term treatments such as therapies, drugs, and even surgery. Each treatment depends on the severity and types of CP the person has. Self-care includes physical exercise improving their cardiovascular health, but depends on CP and injury. It also includes special education, focuses on the individual as a student and gets them working in the different areas in need. Therapies include, occupational therapy, stretching, and physical therapy. These include, in order of list, improving daily living, flexibility, and muscle strength and function. Medications include muscle relaxants and sedatives. These will help them reduce muscle tension to relieve any pain they will have, and causes them calmness. Surgery is used to help them get food; gastrostomy. CP can affect their digestive system or swallowing in general. They will insert a tube through the abdomen and into stomach to give them their food easier. The only way to know what your child needs with his//her condition is to see a specialist; such as a pediatric neurologist, speech therapist, neurodevelopmental disabilities pediatrician, orthopedic surgeon, physical medicine and rehabilitation, neurologist, pediatrician, and a primary care provider. Keep these people in touch; (Google
1- The child with upper limb prosthesis may ignore it at beginning . The physical therapist tries
He is able to take 30 steps with his walker and with assistance from another person who needs to utilize a gait belt. He is able to sit up on his own in bed. He is incontinent and thus not able to walk to the bathroom urinate by himself. Patient wears diapers and needs assistance changing when he has voided. He is encouraged and assisted to walk to the toilet to try and have bowel movements. Patient is not able to bath self and needs help dressing and undressing. Patient for the most part requires supervision and assistance when doing any sort of physical
I have taken extra time observing our therapists with biomechanics backgrounds that treat patients with abnormal foot patterns. They spend time treating symptoms with the Graston Technique and customizing orthotics to help alleviate pain and discomfort for their patients. As a past research assistant that customized gait cycle tutorials and video recorded patients with gait deviations, it has been exciting to learn the interventions that rehab that patient population. My current job, among old experiences, have been a great real life learning experience that will augment my success in school, clinical rotations, and future
She has developed gross motor skills in order to be able to walk. She has been walking for a few months now, but when she walks she is bow legged on both legs. I asked her mom about it and she said that the doctor is not worried about it that she should grow out of it, he would be worried if it was