Cerebral Palsy examination

Also see Cerebral Palsy

LOOK STANDING

• Spine

• Pelvic obliquity

• Hip - Trendelenburg

• Knee

• Feet - Jack's Test, Tip toe

WALK

• Sagittal - hip, knee, ankle, rockers

• Coronal - hip, knee, ankle, rockers

• Transverse - thigh, shin, foot (pronation posture of foot)

SIT

• Spine

• Pelvic obliquity

SUPINE

• Knees down to end of couch with lower legs off end

• Active ROM - hip, knee, foot & ankle

• Hip

  • FFD (Thomas test)

  • Abduction

  • Rotation (hips extended & knees flexed off end of couch)

• Knee

  • FFD

  • Hamstring tightness

  • Popliteal angle - flex hip to 90deg. & extend knee (angle in front of knee, not in popliteal fossa)

• Ankle

  • Silverskold's Test - equinus improves with knee flexion, indicating gastrocnemius is tighter than soleus.

PRONE

• Hip

  • Tibial rotation (malleolar plane)

  • Thigh-foot angle (3rd toe to mid heel & thigh)

  • Duncan-Ely Test for rectus femoris tightness

  • IR & ER - lay forearm on post. pelvis & palpate greater trochanter (idea of amount of anteversion or retroversion of neck)

  • Staheli test - for flexion posture of hip (hips flexed over end of couch, support pelvis posteriorly & passively extend hip)

LATERAL

• Ober's Test - for TFL tightness - knee flexed & hip in neutral, extend knee & observe hip - positive if hip abducts

• Abductor power

NOTES:

• Total Flexor Pattern -> eliminates clonus pattern

• Clasp-knife phenomenon (correlates with cospastisity in swing)