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Pediatric Physical Therapy: Elsevier Health Sciences

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Pediatric Physical Therapy: Elsevier Health Sciences Question: Discuss about the Pediatric Physical Therapy?   Answer: August Weismann first designed redolent of the theory of “the immortal germ-plasm”, which accounts for the genetic mechanisms of “inheritance”. In the context of human development, this theory becomes more persistence and become known as neuro maturational theories. It is found that the neuromaturational theory is mainly focused on the sequence and rate of motor development, which are considered as essentially invariant among the infants who are recognized as “normal.” The motor skill development of a normal infant is helpful to reflect the hierarchy of the development of CNS (Campbell & Palisano, 2006). This theory most importantly went through a detail discussion of the infant’s maturity; higher cortical brain centers used to inhibit reflexive brain centers, which may include brain stem. In this theory, more coordinated and refined movements are considered as the result of “increasing cortical control,” which are found to replace more reflexive, immature movement patterns. On the other hand, unlike neuromaturational theory, dynamic system theory showed that perceptual input is connected with movement and cannot be detached from the mobility it generates (Case-Smith & O’Brien, 2013). It is recognized that movement and perception interact in a continuous manner in the context of learning. For example, proprioceptive systems, as well as vestibular and visual mechanism, help the infants to the Orient body and head in order to gain balance. It is also found that grasping patterns could be refined based on kinesthetic and tactile feedback in conjunction along with “visual input” (Batshaw et al., 2013) Therefore, an infant’s movement or mobility creates her or his perception of the world.   A. Hands To Feet Play In Supine Increase of flexor control Development of the eye-hand coordination The child starts grabbing on to feet and shines – LE are externally rotated and flexed. As the child demonstrates increasing thoracic extension, it is found that there is less extension of flexion rotation than extension rotation (Gordon et al., 2011). Rolling supine to prone Inrease ability to keep head in middle Increase ability to extend neck Increase heap flexion Increase spinal mobility Sitting Independently The child gains proper control of the head.   Child starts propping forward without UE support   Child has straight back without lodosis   Scapula becomes free.   Extension of hips (preventing collapse).   The child starts weight shifting.   Pulling to stand through a half-kneel position   In nine months a child starts to stand through half kneeling position   Elongation of the “weight-bearing limbs.”   The child tries to take full weight in stand   The child rotates in stand   Pelvis rotates over the “face-side leg”.   Cruising along furniture   Tries to stand on foot   Pelvis rotates over the “face-side leg”.   Rotates while standing   Elongation of the weight bearing limbs or body parts.   3. The Child Appears To Be Less Than Three Months. The child is prone to lift his head 45º with an asymmetric extension. The child is also trying to get a better control of trunk extensors. However, child’s head is rarely in a middle position. UEs help in increasing abduction of the child (Bo et al., 2014). However, it is found that the child is facing restriction to move his neck. Therefore, it can be said that head and neck asymmetry is restricting the child’s movement. 4. The child looks like three to four months old. The child is lying straight with legs in “frog style” orientation. The child’s chin comes down to the chest. From the picture, it looks like the head righting started. If the child persists in this position, then the child has chances to develop ATNR (asymmetric tonic neck reflex) (Bhat et al., 2011). 5. From the picture, it looks like the child may be six months old. To get this position (as shown in slide 3) from the position showed in slide 1, the child went through many stages, such as- In normal condition new born child has little control over their head movement, however, from the beginning, the child attempts to lift his or her head off the surface when he or she is placed in prone (Semple et al., 2010). Then the child tries to lift his or her head up and by three months it is observed that the child becomes enable to prop on his or her forearms. After that, the development of neck extensions is followed by the development of the neck flexors. This is because the child starts learning to stabilize his or her head in the middle. In addition, the child starts demonstrating an active chin tuck with downward “visual gaze”. Within six months the combined effort of neck flexors, as well as extensors, works together allows the child to extend neck with the help of cervical extensors. In the mean time, the child uses capital flexors in order to stabilize the head to get a better visual attention of the attractive objects (Deblinger et al., 2011). 6. From the picture, it looks like the child looks like one-year-old. To get this position (as shown in slide 4) from the position showed in slide 3, the child went through many stages, such as- The child increases elbow extension The child may start belly crawl or assumes quadruped. Start sitting with a narrower base of support. The child starts movement of pelvis over the femur The child starts climbing on stairs or furniture. Decrease LE positioning. The child starts utilizing different LE positions. The child develops control on creeping speed. The child starts walking with one hand held. 7. The child shown in slide 6 developed palsy and has different postures than a “normal” child, such as- its are in clinching orientation. No significant eye movement From the sitting posture, it can be said that the child did not develop a good backbone structure. 8. The child shown in slide 7 developed palsy and has different postures than a “normal” child, such as- The child has a low muscle tone Muscles are stiffened. The child has a poor muscle control as well as poor reflection.   References Batshaw, M. L., Roizen, N. J., & Lotrecchiano, G. R. (2013). Children with disabilities. Bhat, A. N., Landa, R. J., & Galloway, J. C. C. (2011). Current perspectives on motor functioning in infants, children, and adults with autism spectrum disorders. Physical Therapy, 91(7), 1116-1129. Bo, K., Berghmans, B., Morkved, S., & Van Kampen, M. (2014). Evidence-based physical therapy for the pelvic floor: bridging science and clinical practice. Elsevier Health Sciences. Campbell, S. K., & Palisano, R. J. (2006). Physical therapy for children (p. 564). Elsevier Saunders. Case-Smith, J., & O’Brien, J. C. (2013). Occupational therapy for children. Elsevier Health Sciences. Deblinger, E., Mannarino, A. P., Cohen, J. A., Runyon, M. K., & Steer, R. A. (2011). Trauma‐focused cognitive behavioral therapy for children: impact of the trauma narrative and treatment length. Depression and anxiety, 28(1), 67-75. Gordon, A. M., Hung, Y. C., Brandao, M., Ferre, C. L., Kuo, H. C., Friel, K., … & Charles, J. R. (2011). Bimanual Training and Constraint-Induced Movement Therapy in Children With Hemiplegic Cerebral Palsy A Randomized Trial. Neurorehabilitation and Neural Repair, 25(8), 692-702. Semple, R. J., Lee, J., Rosa, D., & Miller, L. F. (2010). A randomized trial of mindfulness-based cognitive therapy for children: Promoting mindful attention to enhance social-emotional resiliency in children. Journal of Child and Family Studies, 19(2), 218-229.

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