Case Introduction
James Walsh, a 55-year-old-male presented symptoms including weakness inferiorly in his right lower limb and difficulty performing simple tasks such as walking or tying his shoelace. He also had some difficulties swallowing and often experiences unpredictable movements due to lack of control. As a result, he primarily uses a wheelchair and requires careful assistance when performing everyday activities.
The function of James’ musculoskeletal system is primarily to facilitate movement as the contraction of his muscles pull on bone to carry out an action. It also contributes to heat production for enzymes to function, stability by resisting unwanted movement and maintains his posture (Saladin, K S., 2007). This is important
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However, James’ case of spastic cerebral palsy alters the interaction between the musculoskeletal and nervous system in some areas which are affected.
Case Examination
James’ condition of spastic cerebral palsy impacts the regulation of muscle tone due to the effect of spinal reflexes when muscles are slightly contracted (Ballard, F., 2016). Muscle tone is dependent on the release of alpha motor neurons in the spinal cord (Albright, A.L., 1995). This is regulated when there is a balance between excitatory impulses and inhibitory impulses. James’ condition of cerebral palsy indicates that there is an imbalance between excitatory impulses and inhibitory impulses. The imbalance between these impulses causes a lack in regulation of muscle tone due to the insufficient release of alpha motor neurons in the spinal cord (Albright, A.L., 1995). James’ excess production of excitatory impulses originates in the golgi tendons of organs and muscle spindle, a specialised sensory receptor in the muscle (Albright, A.L., 1995). The impulse then passes through afferent nerves into the spinal cord and releases excitatory neurotransmitters. In contrast, the lack of ability to generate inhibitory impulses suggest that the regions of the brain responsible for the generation of inhibitory impulses including the basal ganglia, brain stem and cerebellum may be damaged (Albright, A.L., 1995). Consequently, the excess of excitatory impulses may result in
As Jim’s muscles are at maximum demand, his mitochondria are unable to produce the needed ATP through aerobic respiration because oxygen is unable to diffuse fast enough into his muscle fibers. At this time anaerobic
Had visual and mobility problems, difficulty using hands and fingers. Ambulated with a cane and wore a brace on the right lower extremity. Shoulders and upper and lower extremities were weak. Problems with memory, concentration, understanding, completing tasks, and getting along with people. Had difficulty managing money. Was able to feed himself, understood and followed directions. A caregiver or his mother assisted him with all activities and reminded him to take his
He is afebrile. Vital signs are stable. Generally, this is a cachectic man sitting in a wheelchair. No acute distress. Skin is warm and dry. Head is normocephalic, atraumatic. Pupils are equal, round, reactive to light and accommodation. Sclerae is anicteric. Oral mucosa is moist without lesions. No JVD. No thyromegaly. Lymphatics: No cervical, supraclavicular, axillary, or inguinal adenopathy appreciated. Respiratory: Lungs are clear to auscultation bilaterally. Heart: Regular rate and rhythm. Abdomen: Soft, nontender. Positive bowel sounds. Liver and spleen not palpable. Strength is 5/5 throughout. Neurological exam is intact.
There are 3 main different types of cerebral palsy Spastic, Athetoid, Ataxic and a mixed type. Spastic cerebral Palsy is actually the most common type there is, it covers from 70 to 80 percent of most cases. This type of cerebral palsy affects your motor skills and very over the top movement, it’s also caused by damage of the brain and the brains signals to the body and that fails that why it’s harder for them to have balance, move or they have jerky movement. If your right side of the brain is damaged that means the left side of your body is going to have trouble working well and vice versa. Common symptoms of Spastic Palsy is awkward reflexes, stiffness in the body or body parts, abnormal gait, and contractures (tightness of the joints or muscles.
More than 70 percent of patients with cerebral palsy have spastic clinical features. These are be presented as the affected limbs may demonstrate exaggerated deep tendon reflexes, clonus, tremors, hypertonia of the muscles, paresis, and a characteristic scissoring gait with toe-walking. The other forms of cerebral palsy such as athetoid or dyskinetic type that affects 10 to 20 percent of patients, is characterized by abnormally slow, writhing movements of the hands, feet, arms, or legs that are exacerbated during periods of stress and are not observed during sleep. The rarest form, ataxic cerebral palsy affects 5 to 10 percent of patients. Patients having this type of cerebral palsy have predominately impaired balance and coordination. Such
Cerebral Palsy is a generic term that is applied to a non-progressive motor disorder. Approximately (2).% of children born today will have some form of cerebral palsy (CP). There are four main categories in which CP disorders are placed. First, Spastic syndromes due to upper motor neuron involvement are representative of 70% of CP cases (8). Subgroups of this include hemiplegia (21%), quadriplegia (27%), and diplegia (21%), which is a mixture of quadriplegia and paraplegia (8). The hemiplegics of this group often have mild or less severe speech impediments than the other subgroups (8). Second, athetoid and dyskinetic syndromes occur in about 20% of the cases (8). This group has the slow, writhing movements and
The Center For Disease Control and Prevention estimates that every 1 in 323 children in the U.S. have been diagnosed with cerebral palsy and more than 17 million people worldwide are struggling with this condition. Cerebral palsy, or CP, is “a group of disorders that affect a person’s ability to move and maintain balance and posture.” (“Centers For Disease Control and Prevention.”) It is the most common motor disorder among children and there are four main types, those being Dyskinetic Cerebral Palsy, Ataxic Cerebral Palsy, Spastic Cerebral Palsy, and Mixed Cerebral Palsy. The most common type of CP is Spastic CP, which affects an estimated 80% of the people who have been diagnosed with cerebral palsy. (“Centers For Disease Control and
“Cerebral palsy is a term which encompasses a set of neurological conditions that cause physical disability in human development - they affect the brain and nervous system. The word cerebral refers to the area in the brain that is affected, while palsy means complete or partial muscle paralysis, frequently accompanied by loss of sensation and uncontrollable body movements or tremors.” (Nordqvist. C).
We decided to research suit therapy in the context of cerebral palsy. Suit therapy is a system of rubber bands, hooks, and rings that connect a vest, shorts, kneepads, and specially connected shoes (McMahon, Pruitt & Vargus-Adams 2009). There are bungee type cords that continue to tighten and adjust in order to “mimic normal flexor and extensor patterns of major muscle groups in an attempt to correct abnormal alignment” (McMahon, Pruitt & Vargus-Adams 2009). Wearing the suit along with intensive physical therapy, and active motor participation by the patient for a certain amount of time and frequency is meant to retrain the brain what normal muscle movement is and improve sensory and proprioceptive information (McMahon, Pruitt & Vargus-Adams
As noted by the literature, the causes of spasticity are not entirely identified and comprehended. However, it is known that spasticity usually occurs as a result of injury to the central nervous system, which includes the brain and the spinal cord [7]. Stroke often causes lesions on the brain, triggering spasticity and lowering the reflex threshold [2, 7]. The nerves send proprioceptive information to the nervous system through the afferent impulse. Once it
More severe symptoms in children with cerebral palsy may result in basically no muscle control, greatly affecting their lives.” (Cogher, Savage & Smith, 1992)
Spasticity is a problem that appears in the injury of your spinal cord or a part of the brain that controls your involuntary movement. It is from the stretch reflexes being extremely excited with an upper motor neuron lesion. It can interfere with you daily through daily activities, balance, and being able to function on your on. Spasticity is where certain muscles are continuously contracted. It can also cause your muscles to be stiff and tight. Spasticity may interfere with your speech, movement, and your gait. The usual treatments for spasticity are physical therapy (PT), antiseptic agents, and surgical lengthening of the affected muscles or tendons.
The patient may present with spasticity in which there is a continuous contraction of muscles. It is known as spastic cerebral palsy and 75% of children with cerebral palsy experience spasticity (Beaman, Kalisperis, & Miller-Skomorucha, 2013). Spasticity causes changes in the size of muscle unit and decreased volume and longitudinal growth of muscle fibers. Dyskinetic cerebral palsy presents with involuntary and uncontrolled movements. They include tremor, rigidity, choreoathetosis, dystonia, athetosis and ballismus (Beaman, Kalisperis, & Miller-Skomorucha, 2013). Ataxic cerebral palsy is characterized by a lack of control and balance of coordinated movements. There is incoordination, tremor, weakness and wide-based gait (Beaman, Kalisperis, & Miller-Skomorucha, 2013). Additionally, hypotonic cerebral palsy presents with a remarkable reduction of the muscle tone that may affect both the extremities and the trunk (Beaman, Kalisperis, & Miller-Skomorucha,
The human body is made up of many organ systems that consist of organs and tissues of different anatomies and diverse nomenclature. These organs systems, organs and tissues are prone to thousands of diseases, and one of these diseases is cerebral palsy, which is a disease of the nervous system in simple terms. Research relating to cerebral palsy is carried out, whereby the disorder is described, along with its history, and how it affects the nervous system and the brain. The anatomy of the body systems involves with regard to this disorder, the effects of the disorder on these body systems and other body systems are also researched and discussed. Furthermore, the research focuses on the causes of cerebral palsy, its complications, signs, and symptoms, and the diagnosis of the disorder, along with its treatment and side effects of the treatment. A recap of the research focusing on prevention strategies, the anatomy and physiology of cerebral palsy and the nervous system is presented.
As reported by in the Children’s Hemiplegia and Stroke Association cerebral palsy is a condition caused by injury to the parts of the brain that control our ability to use our muscles