PAEDIATRIC PHYSIOTHERAPY EXAM REVISION
QUESTIONS. ALL EXAM REVISION QUESTIONS AND
CORRECT ANSWERS (ALREADY GRADED A+) (2024 UPDATE)
100% GUARANTEED
Implications of cognitive and behavioral sequalae for PT - ANSWER- On assessment - what
are you actually assessing, history taking e.g. MS history
On child's motor performance - impulsivity (risk taking), poor judgment and anticipation of
consequences of actions, impaired memory, difficulty with multi-tasking
On intervention - therapy strategies: for optimal practice, set up important (context of child),
manageable home program
EVIDENCE: long term PT management in ABI - ANSWER- Limited ABI literature
Draw on adult stroke/neuro and paediatric CP literature
Strong evidence for early intense specific rehab program: improved ST and LT function
Evidence of neuroplasticity > importance of task specificity, intensity and repetition
Serial casting: doesn't work in long term, but for children maintains joint alignment and minimise
bone deformity
Gait training
Balance training
CR training: effect on cognitive function
,Long term PT Mx in ABI - ANSWER- Family centred
Stage of recovery- time post injury
> Recently: working frequently and hard with them to optomise neuroplasticity
> 8 years later: interventions different as you are not anticipating rapid change in function
Goal setting - what matters to patient and family
Assessment - impairment, function, participation
Intervention plan: training motor control (ADLs for children), MS system integrity, adaptive
equipment, fitness and leisure, community and school integration
Coordination with ongoing rehab and medical Rx.
Community participation
Need for long term follow up
PT tool box for ABI - ANSWER- Goal setting: Canadian Occupational performance measure
(COPM), GAS, SMART goals
Assessment: impairment (ROM, mm length, strength), function (activity, standardised Ax),
participation (QOL, CASP, goals)
Interventions: Assessment/monitoring, motor relearning/functional training (ADLs), exercise
(strength, motor control coordination, balance), casting, splinting, taping, positioning, equipment
provision, fitness and leisure, community and school integration
,Training motor control (ADL's) - ANSWER- For a child: ADL's are climbing, balance beams,
dancing, squat, jumping, hopping, climbing, crawling
Playing in crouched positions, on knees
Therefore, maintain MS integrity
Equipment provision e.g. Umbrella chair for patient with TBI and incomplete SCI (correct sitting)
Adaptive equipment allowing for participation at pre-school
Elite athlete children: advanced fitness testing
Generally use 6MWT
In gym - recreation, play, circuit class - interaction with other children in similar situation
Community options - rock climbing, camps, bikes
Benefits of aquatic PT - ANSWER- Reduction in swelling (hydrostatic pressure)
Buoyancy (decreased WB, assistance with some active movements)
Heat (pain relief, relaxation)
Different environment for patients (motivation)
> Benefits come from properties of water
Hydrostatic pressure - ANSWER- Force applied to submerged bodies by water
Starts at atmospheric pressure at water's surface and increases linearly as depth increases
Deeper = more hydrostatic pressure acting on body (more pressure on legs than trunk)
, Hydrostatic pressure: CV changes - ANSWER- Exerts external force on blood vessels in LL >
cascade of physiological changes that lead to central hypervolaemia > increased venous stroke
volume > increased CO, often increased HR
Respiratory changes - ANSWER- CV changes > increased blood returned centrally >
compresses lungs + decreased lung volumes (vital capacity) > can increase WON
If immersed to or above chest weight external forces of hydrostatic pressure leads to reduced lung
volumes from compression of the thorax
Compression - ANSWER- Standing in neck deep water = same as medical grade compression
garments for LL
Pressure at feet is approx 10% greater than upper body, so hydrostatic pressure more effective for
lower limb swelling
Other effects of immersion - ANSWER- Glomerular filtration rate increased by up to 7 times
due to hydrostatic pressure
Some variable evidence of pain gate theory - physical pressure of water over-riding pain nerves
Variable evidence on effects of heat and relaxation and tone inhibition in patients with increased
muscle tone and spasticity
Relative density - comparison of object to relative density of water (1 at 4 degrees C) - ANSWER-
Human body density = 1
More muscle = higher density > 1 = sink
More fat = less density <1 = float
QUESTIONS. ALL EXAM REVISION QUESTIONS AND
CORRECT ANSWERS (ALREADY GRADED A+) (2024 UPDATE)
100% GUARANTEED
Implications of cognitive and behavioral sequalae for PT - ANSWER- On assessment - what
are you actually assessing, history taking e.g. MS history
On child's motor performance - impulsivity (risk taking), poor judgment and anticipation of
consequences of actions, impaired memory, difficulty with multi-tasking
On intervention - therapy strategies: for optimal practice, set up important (context of child),
manageable home program
EVIDENCE: long term PT management in ABI - ANSWER- Limited ABI literature
Draw on adult stroke/neuro and paediatric CP literature
Strong evidence for early intense specific rehab program: improved ST and LT function
Evidence of neuroplasticity > importance of task specificity, intensity and repetition
Serial casting: doesn't work in long term, but for children maintains joint alignment and minimise
bone deformity
Gait training
Balance training
CR training: effect on cognitive function
,Long term PT Mx in ABI - ANSWER- Family centred
Stage of recovery- time post injury
> Recently: working frequently and hard with them to optomise neuroplasticity
> 8 years later: interventions different as you are not anticipating rapid change in function
Goal setting - what matters to patient and family
Assessment - impairment, function, participation
Intervention plan: training motor control (ADLs for children), MS system integrity, adaptive
equipment, fitness and leisure, community and school integration
Coordination with ongoing rehab and medical Rx.
Community participation
Need for long term follow up
PT tool box for ABI - ANSWER- Goal setting: Canadian Occupational performance measure
(COPM), GAS, SMART goals
Assessment: impairment (ROM, mm length, strength), function (activity, standardised Ax),
participation (QOL, CASP, goals)
Interventions: Assessment/monitoring, motor relearning/functional training (ADLs), exercise
(strength, motor control coordination, balance), casting, splinting, taping, positioning, equipment
provision, fitness and leisure, community and school integration
,Training motor control (ADL's) - ANSWER- For a child: ADL's are climbing, balance beams,
dancing, squat, jumping, hopping, climbing, crawling
Playing in crouched positions, on knees
Therefore, maintain MS integrity
Equipment provision e.g. Umbrella chair for patient with TBI and incomplete SCI (correct sitting)
Adaptive equipment allowing for participation at pre-school
Elite athlete children: advanced fitness testing
Generally use 6MWT
In gym - recreation, play, circuit class - interaction with other children in similar situation
Community options - rock climbing, camps, bikes
Benefits of aquatic PT - ANSWER- Reduction in swelling (hydrostatic pressure)
Buoyancy (decreased WB, assistance with some active movements)
Heat (pain relief, relaxation)
Different environment for patients (motivation)
> Benefits come from properties of water
Hydrostatic pressure - ANSWER- Force applied to submerged bodies by water
Starts at atmospheric pressure at water's surface and increases linearly as depth increases
Deeper = more hydrostatic pressure acting on body (more pressure on legs than trunk)
, Hydrostatic pressure: CV changes - ANSWER- Exerts external force on blood vessels in LL >
cascade of physiological changes that lead to central hypervolaemia > increased venous stroke
volume > increased CO, often increased HR
Respiratory changes - ANSWER- CV changes > increased blood returned centrally >
compresses lungs + decreased lung volumes (vital capacity) > can increase WON
If immersed to or above chest weight external forces of hydrostatic pressure leads to reduced lung
volumes from compression of the thorax
Compression - ANSWER- Standing in neck deep water = same as medical grade compression
garments for LL
Pressure at feet is approx 10% greater than upper body, so hydrostatic pressure more effective for
lower limb swelling
Other effects of immersion - ANSWER- Glomerular filtration rate increased by up to 7 times
due to hydrostatic pressure
Some variable evidence of pain gate theory - physical pressure of water over-riding pain nerves
Variable evidence on effects of heat and relaxation and tone inhibition in patients with increased
muscle tone and spasticity
Relative density - comparison of object to relative density of water (1 at 4 degrees C) - ANSWER-
Human body density = 1
More muscle = higher density > 1 = sink
More fat = less density <1 = float
