Classification of Cerebral Motor Disturbances Robyn Smith Department of Physiotherapy UFS 2012
Classification of Cerebral Motor Disturbances
Robyn Smith
Department of Physiotherapy
UFS
2012
Classification Systems for CMD• Many classification systems have been
developed over the years.• Important that clinicians working with children
with CMD use a common language when communicating with each other.
• Provides tools for physiotherapists to make their own clinical diagnosis & confirm or question diagnoses already made by another healthcare provider.
Remember clinical picture can change over time!!! ....but the lesion/damage sustained to the brain cannot
What are we talking about if we are talking about “tone”?
• Muscle tone refers to the resting tension in a muscle or the amount of tension or resistance to movement in a muscle.
• Muscle tone is what enables us to keep our bodies in a certain position or posture against gravity.
• Changes in muscle tone are what enables us to move to smoothly and in a coordinated manner
What are they talking about hypertonicity, spasticity and rigidity
Modified Ashworth Scale
classification
5. Mixed group
Spastic with •ataxia ,or •dyskinesia
* Pure ataxia or hypotonia is very rare
Classification system using limb involvement
Rare
Don’t confuse with brachial plexus injury
= LMN
Use of the classification in combination
• Common practice to refer to patients as a spastic quadriplegic, or a spastic diplegic or an athetoid with dystonia.
FAR MORE DESCRITIVE
VALUE
Everyone on same page
References
• Paediatric dictate (2009)
• Images courtesy Google (2011)
• Rosenbaum et al. Proposed definition and classification of cerebral palsy, April 2005 in Developmental Medicine and & child neurology 2005:(47)571-576