What is the Hueter-Volkman Principle?
Growth plates produce increased growth in response to tension & decreased growth in response to excessive compression.
What is Flexure Drift?
Bone remodeling where bone from the convex side of the bone moves to the surface of the concave side to straighten.
Happens in asymmetrical growth*
What is a normal angle of inclination?
120-135 degrees
What is Coxa vara?
Less than 120 degrees angle of inclination
What is Coxa valga?
Greater than 135 degrees angle of inclination
What is femoral torsion?
The angle formed by an axis drawn through the head and neck of the femur and an axis through the condyles.
What is Antetorsion?
Head and neck of the femur rotated forward
*Normal at birth. Can cause in-toeing
What is Retrotorsion?
Head and neck of the femur rotated backward
What is Femoral Version?
The position of the head of the femur in the acetabulum relative to the posterior pelvis (frontal plane)
What is Anteversion?
Positions the head of the femur anteriorly in the acetabulum resulting in external rotation of the thigh.
What is Retroversion?
Positions head of the femur posteriorly resulting in internal rotation of the thigh.
Feet flat is normal until what age?
4-5 years old
Gait matures during what age range?
1-7 years
What are indicators of mature gait and what age do you typically see them?
- ) Single-leg stance: adult value by age 3 ½ -4 yrs
- )Velocity: greatest increase from age 1 to 3 yrs
- ) Cadence: highest in new walkers with most rapid decrease from age 1-2 yrs.
- )Step length: increases throughout childhood. Greatest increase 1 to 4 years.
- )Pelvic span to ankle spread ratio: increase over time – narrowing BOS
What is Ehlers-Danlos Syndrome?
An abnormal collagen Type V
What are impairements of Ehlers-Danlos Syndrome?
- Developmental Delay
- Hyper extensibility of the skin & joints
- Scarring
- Hernias
- Easy bruising
- Muscle hypotonia
- Structural cardiac abnormalities
What are activity limitations and participation restrictions of Ehlers-Danlos Syndrome?
- Avoid physical activities that put bones and joints at risk
- May encounter social stigma
- May limit choice of hobby or activities as isometric and strenuous weight-bearing exercise must be avoided
Interventions for Ehlers-Danlos Syndrome?
- Child and family education to minimize injury
- Strengthening and fitness programs to reduce injuries
- Pain management as needed
- Assistive devices and functional training as needed
What are impairments of Juvenile Idiopathic Arthritis?
ROM limitations, joint space narrowing and destruction.
What are activity limitations and participation restrictions of Juvenile Idiopathic Arthritis?
- May limit mobility and self care activities
- May impair handwriting
What are interventions for Juvenile Idiopathic Arthritis?
- Child & Family Education
- ROM
- Strengthening & fitness programs
- Pain management
- Environmental & lifestyle modifications
- Splinting
- Assistive device & mobility aid selection
What is Hemophilia?
Missing protein (clotting factor) required for blood clotting
What are impairments of Hemophilia?
- Joint destruction, leading to premature arthritis and chronic pain
- Muscle disuse atrophy
- ROM limitations
- Potential nerve compression
- If bleeding occurs in the brain, sensory, motor, or cognitive impairments may develop: If bleeding is severe death may results
What are activity limitations and participation restrictions of Hemophilia?
- Pain may lead to diminished interaction with peers and absence from work/school
- Functional limitations due to pain and joint swelling
