Precaution/Complication

Question 1

Autism spectrum disorder
P

Answer 1

aware of sensory system and tendencies toward overstimulation

difficulty transitoning b/w activites

cues and warnings may be needed

Question 2

ASD

C

Answer 2

various sensory system stimuli

overwhelmed with sounds, visual input, tactile stimuli, cause shut down not able to participate in PT

Question 3

DS - P

Answer 3

protect joints from extreme ROM secondary to hypotonia and liga laxity

observe for signs of inadequate management of thyroid/cardiopulmonary comorbidities

Question 4

DS - C

Answer 4

behavioral challenges secondary to Young adult and intellecutal disability

OA instability

rare medical complications

Question 5

hemipolymicrogyria -P

Answer 5

significantly increased tone often requires meds

ADRs of these meds - decreased alertness, weakness

forcing mvmts against signficantly increased tone can cause structural problems

Question 6

hemipolymicrogyria - C

Answer 6

increased speed or activity can increase tone in hemiparetic side

Long term use of constraint induced therapy could interfere with B limb use

Significant tone reduction could negatively affect movement, especially if child was relying on tone for stability

Question 7

osteogenesis imperfecta - P

Answer 7

no passive twisting, rotating, or forceful ROM in the extremeties or trunk due to high fx risk, pain, weakness, fatigue

close guarding WB activites to decrease risk of fall or injury

close monitoring os skin when wearing AFOs

Question 8

OI - C

Answer 8

Pt discomfort with AFO due to postsurgical LE swelling

pain may limit activity tolerance

anxiety regarding potential fx

UE deformities may increase difficulty using walker

Question 9

DMD - P

Answer 9

no resisted or forceful ROM to the extremities or trunk due to high fx/risk/damage to mms

pain,weakness,fatigue

assistance with WB activites required during transfers to decrease risk of fall/injury

close monitoring of skin when wearing orthoses

Question 10

DMD -C

Answer 10

Patient discomfort with AFOs and prolonged positioning

anxiety regarding potential fx

Question 11

CP - Postsecondary Education and Transition to Adulthood - P

Answer 11

fatigue

pain

postural asymmetry

decreased balance

Question 12

CP - Postsecondary Education and Transition to Adulthood - C

Answer 12

Medical insurance plan restrictions,

increased time/energy demands for daily task, employment, exercise.

Decline of mobility and increase in secondary impairments from CP.

transition to adult oriented HC providers.

Lack of public transportation accessibility

Question 13

CP -fitness P

Answer 13

appropriate W/C down to decrease risk of injury

moniotor biomechanical alignment issues and adverse effects - MSK related pain

Question 14

CP -fitness C

Answer 14

overuse injuries

Question 15

Brachial Plexus Injury - P

Answer 15

decreased sensation
avoid Overstretching
aware surgeon protocols
UE alignment during WB

Question 16

Brachial Plexus Injury - C

Answer 16

torticollis
decreased sensation
unstable joints
contractors
flaccidity
neglect of UE

Question 17

Brachial Plexus Injury secondary impairments

Answer 17

contracture
abnormal bone growth

Question 18

NICU - P

Answer 18

Monitor vital signs
Monitor behavioral cues
Monitor medical lines and tubes
Determine physiologic cost of examination/intervention outweighs benefits

Question 19

NICU - C

Answer 19

pain and stress
decline in physiologic stability
fracture

Question 20

Developmental Coordination Disorder - P

Answer 20

close positioning of PT to child during training of difficult/new gross motor skills

safety monitoring during all movement due to potential impulsivity of child

Question 21

Developmental Coordination Disorder - C

Answer 21

parents/school staff need to learn about diagnosis and implications and how best to help this child learn, play, and gain age appropriate gross motor skills

Question 22

Toe Walking - P

Answer 22

pain or spasms related to overstretcing the ankle PF’s

Question 23

Toe Walking - C

Answer 23

secondary skin complications related to serial casting

skin breakdown from ill-fitting orthoses

pain in feet/legs

Question 24

Congenital Muscular Torticollis - P

Answer 24

Passive stretching of cervical structures may be contraindicated
Passive stretching can snap SCM

Question 25

Congenital Muscular Torticollis - C

Answer 25

Comorbidities such as plagiocephaly, gastroesophageal reflux, dev delay, cardiac, neurogenic conditions may affect outcomes; parental noncompliance with HEP lack of infant cooperation and separation anxiety

Question 26

relapsed club foot - P

Answer 26

stress fx prevention after serial casting avoidance of high impact activities Prevent compensatory strategies during balance/WB activities

Question 27

relapsed clubfoot -C

Answer 27

stress fx

Question 28

Cerebral Palsy - P

Answer 28

Skin integrity with AFOs Close positioning of PT to child during gait training and transfers Safety monitoring during all movement due to potential impulsivity of child

Question 29

Cerebral Palsy - C

Answer 29

Need for parents to learn about diagnosis Limited financial means

Question 30

Spina Bifida - P

Answer 30

Decreased CR endurance (higher resting HR and increased HR during activities) Increased risk of fracture secondary to osteoporosis Decreased sensation Latex allergy Incontinence during exercise Difficulties with thermoregulation Increased risk of falls Increased spasticity with exercise

Question 31

spina bfida - C

Answer 31

Illness Pronounced spasticity Arnold chiari malformation: leading cause of mortality in SB Fracture pressure sore tethered cord syndrome: progressive decline in LE strength, gait/balance impairments, changes in bladder function, progressive scoliosis symptomatic hydromyelia Symptomatic hydrocephalus VP shunt failure (most common sign: HA)