Nutrition for an immobilized child
high protein, high calorie diet prevents negative nitrogen balance
supplement with NG/G may be indicated
provide small frequent servings
IV fluids may be used to maintain adequate hydration
Muscle atrophy definition
loss of muscle mass
Muscle atrophy causes decreased ____ and ____
strength and endurance
For kids with muscle atrophy, returning to baseline strength could take ______
weeks or months depending on the severity
_____ heal faster in children than adults
fractures
Children may not have as long of ____ with fracture
immobilization
True injuries that cause fractures rarely occur in
infancy
_______ is needed for an infant who presents with fractures
further investigation
xray results of fractures at various stages of healing is usually a result of _______
nonaccidental trauma/abuse
compartment syndrome
increase in a muscle compartment’s pressure causing neurovascular compromise
when there’s no space to accommodate swelling, blood cannot get through
could lead to necrosis
treatment: some cases, fasciotomy
Compartment syndrome evaluation, the 6 Ps
Pain
Pulselessness
Pallor
Paresthesia
Paralysis
Pressure
Juvenile Rheumatoid Arthritis
chronic childhood arthritis
causes inflammation of the joint synovium and surrounding tissue
usually diagnosed prior to 16, peak onset 1-3
cause unkown
Juvenile Rheumatoid Arthritis clinical manifestations
swelling and loss of motion in the affected joint(s)
scoliosis
complex spinal deformity resulting in spinal curvature
idiopathic scoliosis is usually diagnosed pre-adolescence
treated with bracing
surgical management of scoliosis is used in curvature
greater than 45-50 degrees
osteomyelitis
infectious process in the bone (foot, femur, tibia, pelvis)
bacteria adheres to bone resulting in infection, edema, vascular congestion, small vessel thrombosis
osteoomyelitis treatment
long term (6 week course) IV antibiotic therapy to treat infection (central access, physical therapy)
Developmental dysplasia of the Hip (DDH)
Related to abnormal development of the hip that may occur any time in fetal development, infancy or childhood
Shallow acetabulum, subluxation, or dislocation
Varying degrees of severity
When newborn is diagnosed- use of Pavlik harness that keeps the hips abducted, worn continuously 22-24 hours/day- up to 6 months of age
Club foot
Also referred to as talipes equinovarus
Complex deformity of the ankle and foot, varying severity (foot is plantarflexed and is pointed inward)
Cerebral Palsy (CP)
CP - disorder of posture and movement from static brain injury perinatally or postnatally, which limits activity – varying degrees of severity
Impacts on mobility
Delayed gross development
Alterations of muscle tone
Abnormal posture
Abnormal motor peformance
CP treatment
Aims of therapy involving mobility
1) establish locomotion
2) gain integration of
motor functions
Mobilizing devices/adaptive equipment
- ankle foot orthoses
(AFOs)
- wheelchair/strollers
(customized to specific
needs)
Muscular Dystrophy (MD)
gradual, progressive degeneration of muscle fibers
Characterized by progressive weakness and wasting of symmetric groups of skeletal muscles, with increasing disability and deformity over time
there’s different types
MD treatment
Treatment: supportive measures (PT, ortho procedures, airway clearance devices/therapies, ventilator support)
newer treatment - gene therapy
Duchenne Muscular Dystrophy
DMD – most severe and most common MD of childhood
X linked recessive trait, males affected almost exclusively
