Physical Disabilities

1
Physical Disabilities

• By
• Richard Baird
• Michelle Dodd

2
Physical Disabling Conditions

• Cerebral Palsy
• Spina Bifida
• Muscular Dystrophy
• Spinal Cord Injury

3
Cerebral Palsy

• A neurological disorder characterized by motor
  problems, general physical weakness, lack of
  coordination, and perceptual difficulties.

4
Types of CP

• Spastic CP- stiff and difficult to move
• Athetoid CP- involuntary and uncontrolled
  movement.
• Ataxic CP- disturbed sense of balance and depth
  perception.
• Mixed CP- there is a combination of any of the
  above.

5
History of CP

• First recognized as a medical condition in 1861
• The term CP came into use in the late 1800s
• CP used to be called Littles Disease after Dr.
  William J. Little who first published work on the
  condition

6
Pregnancy Elements of CP

• Complicated labor and/or delivery
• Premature birth and low birth weight
• Multiple births
• Nervous system defects
• Other physical defects
• Maternal bleeding in the last three months of
  pregnancy

7
Signs of CP in the First Few Months of Life

• Lack of Alertness
• Irritability
• An abnormal high pitched cry
• Trembling of the arms and legs
• Poor feedings abilities
• Abnormal posture to one side of the body
• Seizures, eye fluttering, body twitching
• Abnormal reflexes

8
Signs of CP in the First Six Months of Life

• A change in muscle tone from low to high
• The child holds their hands in fists
• One side of the body moves more freely than the
  other
• Poor feeding abilities

9
Risk Factors for CP

• Mother 40 or over
• Mother or father younger than 20
• African-American ethnicity
• The child being fifth or later in the siblings.
• Weighing less than 3.5 pounds
• Premature infant
• Infection of mother during early pregnancy
• Mother having a weak central nervous system

10
Causes of CP

• Injury to the brain before, during, or shortly
  after birth
• Failure of the brain not developing properly
• Neurological damage to the brain
• Infection
• Lack of oxygen to the brain
• Bleeding in the Brain

11
Treatment of CP

• Physical Therapy- help to develop gross motor
  skills
• Occupational Therapist- help to develop small
  muscles
• Speech and Language Therapist
• Surgery- usually to improve muscle development
• Drugs- prevent seizures
• Sensory Integration Therapy
• Adaptive Equipment

12
Statistics of CP

• 2 of every 1,000 born in U.S. have CP
• 5000 infants and toddlers diagnosed each year
• 1200-1500 preschoolers diagnosed each year
• 500,000 people have CP in the U.S.

13
Spina Bifida

• A developmental defect of the spinal column.

14
Types of Spina Bifida

• Spina Bifida Occulta- oblique split in one or
  several of the vertebral structures.
• Spina Bifida Cystica- a malformation of the
  spinal column in which a tumor-like sac is
  produced on the infants back.
• Spina Bifida Myelomeningocele- type of spina
  bifida cystica in which the characteristic
  tumor-like sac contains both spinal fluid and
  nerve tissue.
• http//health.allrefer.com/health/myelomeningocele
  -children-spina-bifida-degrees-of-severity.html

15
Diagnosis of Spina Bifida

• MASFP- blood test that looks for high levels of
  alpha-fetoprotein which may show that there is a
  neural tube defect
• Ultrasound- this can determine if there are
  defects in the spine
• Amniocentesis- doctor removes fluid from the
  amniotic sac to detect sources of
  alpha-fetoprotein because this shows that the
  spinal cord could be leaking

16
Risk Factors of Spina Bifida

• Presence of a neural tube defect in a previous
  child
• Lack of folic acid
• Certain medications
• Diabetes
• History of miscarriage
• Being a first born
• Teenage mothers

17
Causes of Spina Bifida

• Fetal alcohol syndrome
• Largely unknown

18
Long Term Effects of Spina Bifida

• Loss of sensation
• Mental retardation
• Paralysis
• Permanent loss of bladder and bowel control
• Seizures
• Weakness

19
Treatment of Spina Bifida

• Physical Therapy
• Occupational Therapy
• Assistive devices
• Medication
• Surgery to cover defects with skin to prevent
  infection
• Surgical correction with various organ systems
• Ventriculoperitoneal shunt- a tube from the brain
  to the abdomen to drain excess fluid

20
A Way to Prevent Spina Bifida

• Mothers should consume high levels of folic acid
  while pregnant.
• This reduces the possibility of spina bifida and
  neural tube defects by 50 to 70 percent.

21
Statistics of Spina Bifida

• 95 of children with spina bifida have parents
  with no history of it in their family
• 6 in every 100,000 births have spina bifida
• 240 people in U.S.

22
Muscular Dystrophy

• What is MD?
• A group of more than 30 genetic diseases
  characterized by progressive weakness and
  degeneration of skeletal muscles that control
  movement. Some can be seen in infancy, while
  others may not appear until later in life.

23
Types of Muscular Dystrophy

• Childhood Onset
• Duchenne MD most common form of MD. Only affects
  boys. Caused by degenerative muscle fibers in the
  legs before it spreads to the arms.
• Becker MD less severe than Duchenne MD. Some
  patients can walk in their 30s, while others are
  unable to walk past adolescence
• Congenital MD Along with muscle and joint
  problems, patients suffer from respitory and
  swallowing difficulties, vision and speech
  problems, and seizures.
• Emery-Dreifuss MD Primarily affects boys. Causes
  slow wasting of the arm and upper leg muscles and
  symmetric weakness. Heart problems are extremely
  likely.

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Types of Muscular Dystrophy

• Adolescent Onset
• Facioscapulohumeral MD (FSHD) initially affects
  muscles of the face, shoulders, and upper arms,
  with progressive weakness. Life expectancy is
  normal, but some individuals become severely
  disabled.
• Limb-Girdle MD Weakening of muscles primarily in
  the shoulders and hips. Most people are severely
  disabled within 20 years of disease onset

25
Types of Muscular Dystrophy

• Adult Onset
• Distal MD Primarily affects distal muscles.
  Typically less severe than other forms and
  involves fewer muscles.
• Myotonic MD Most common adult form of MD.
  Affects the central nervous system and other body
  systems. Neck and facial muscles are typically
  first to weaken.
• Oculopharyngeal MD (OPMD) Patients typically
  first report problems in the face and with
  swallowing. They may find it difficult to walk,
  climb stairs, kneel, or bend. Most people usually
  lost the ability to walk

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Diagnosis

• Blood and urine tests
• Exercise Tests
• Genetic Testing
• MRI
• Muscle Biopsies
• Neurophysiology Studies

27
How many people have MD?

• Most common forms are in children which affects
  approximately 400-600 male births each year in
  the US
• The amount of people living with MD varies
  between types Some types affect over 30,000
  Americans, while another type has only 300
  recorded cases

28
Treatment

• Physical Therapy
• Respiratory Therapy
• Speech Therapy
• Corrective Orthopedic Surgery
• Drug Therapy

29
Research Goals

• Studies are being done to understand MD and
  develop new techniques to diagnose, treat,
  prevent and ultimately cure the disorder.

30
Spinal Cord Injury

• Key terms
• Paraplegia Paralysis of the bottom half of the
  body, including both legs
• Tetraplegia (Quadriplegia) Complete paralysis of
  the body from the neck down

31
How common is SCI

• Studies suggest around 40 cases of spinal cord
  injury per million people in a population
• Given the US population, this is about 11,000 new
  cases each year
• It is estimated that there are somewhere between
  183,000 230,000 alive today in the US with
  spinal cord injury

32
Leading Causes of SCI

• 1 Car accidents (38.5)
• 2 Acts of violence (24.5)
• 3 Falls (21.8)
• 4 Sports (7.2)
• 5 All Others (7.9)
• Other causes are vascular disorders, tumors,
  infectious conditions, spondylosis, and
  developmental disorders

33
Who is most likely to suffer a Spinal Cord Injury

• Most people are between the ages of 16 and 30.
• Males are 4 times more likely to suffer from SCI
  than females

34
SCIs Affect on the Rest of the Body

• Breathing usually causes short, shallow
  breathing, or requires the help of a tracheotomy
• Irregular heartbeat and low blood pressure SCI
  often affects the cardiac accelerator nerves,
  causing the heart to beat too fast or too slow
• Blood clots People with SCI are at triple the
  risk for blood clots
• Spasms The spinal cord can no longer control
  reflex movements. These movements can sometimes
  become so exaggerated that they require medical
  care
• Bladder and Bowel Problems The nerves that
  control these functions are in the lower part of
  the spinal cord. Most people with SCI need a
  catheter to control these functions.
• Pneumonia One of the leading causes of death in
  people with SCI

35
Life After Spinal Cord Injury

• About 40 of people with paraplegia return to
  work within 10 years
• About 30 of people with tetraplegia eventually
  return to work within 10 years
• Approximately 5 of people discharged from the
  hospital with a SCI are released to a nursing
  home. Most people return to their prior homes.
• Living expenses for a person with tetraplegia is
  about 460,000 in the first year after the
  accident.
• Living expenses for a person with paraplegia is
  about 260,000 in the first year after the
  accident
• The leading cause of death among people with SCI
  is kidney failure

36
Stem Cell Research

• Stem cells have the ability to develop into many
  different cell types in the body. Scientists are
  working on how to grow these cells in a
  laboratory in order to use them to treat
  different diseases, disorders, and injuries, or
  to test new drugs.

37
Christopher Reeve

• An actor, best known as Superman who was
  injured in a horseback riding accident in 1995
  which left him paralyzed from the neck down
• The Christopher Reeve Foundation has made extreme
  strides in spinal repair research, stem cell
  research in particular

38
Carl Riccio

• Outstanding high school athlete, recognized in
  multiple sports who became paralyzed after an
  accident during a wrestling match in his junior
  year of high school

39
Carl Riccio

• Carls Dads account of the day
• When I got out to the mat that day, my
  beautiful, strong, athletic son looked me in the
  eyes and said Dad, I cant move anything and
  tears ran down his face. At that moment I knew my
  life was different. That moment is with me every
  night, it never changes, I wake up crying. I had
  to hold it together. My youngest boys were there
  and were panicked and crying. My wife and older
  kids were on the other side of the country at
  Peter Jr.s (Villanova) opening of the baseball
  season. That was how our new life began. My wife
  eventually got to the hospital and has led us
  through this turbulent year.
• http//www.carlricciotrust.com/news.asp

40
Questions

• Which of the following is NOT a type of CP?
• Spastic CP
• Athetoid CP
• Muscular CP
• Ataxic CP

41
Questions

• True or False
• Cerebral palsy is caused by Damage to the brain.

42
Questions

• What causes Spina Bifida?
• Fetal Alcohol Syndrome
• Child Abuse
• Largely Unknown
• Both A and C

43
Questions

• What reduces the risk of Spina Bifida?
• Alcohol Consumption
• Protein Consumption
• Folic Acid Consumption

44
Questions

• Which of the following is not a form of Muscular
  Dystrophy
• Duchenne MD
• Limb-Girdle MD
• Distal MD
• All of these are forms of MD

45
Questions

• What is the leading cause of Spinal Cord Injury?
• Car accidents
• Developmental Disorders
• Child Abuse
• Most people are born with SCI

46
References
Frequently Asked Questions. Retrieved March 12,
2006, from the University of Alabama at
Birmingham Web site http//www.spinalcord.uab.edu
/show.asp?durki20183 NINDS Muscular Dystrophy
Information Page. Retrieved March 12, 2006, from
the National Institute of Neurological Disorders
and Stroke Web site http//www.ninds.nih.gov/diso
rders/md/md.htmWhat_is Cerebral Palsy A Guide
for Care. Retrieved March 12, 2006, from The
Alfred I Dupont Institute Cerebral Palsy Web
site http//gait.aidi.udel.edu/res695/homepage/pd
_ortho/clinics/c_palsy/cpweb.htm All Refer
Health. Retrieved April 11, 2006, from URAC and
ADAM Web site http//health.allrefer.com/ Hardma
n, M. L., Drew C. J., Egan M. W. (2006).
Human Exceptionality School, Community, and
Family. Eighth Edition. New York Pearson, Allyn
and Bacon.
47
References

• Frequently Asked Questions. Retrieved March 12,
  2006, from University of Alabama at Birmingham
  Web site http//www.spinalcord.uab.edu/show.asp?d
  urki20183
• NINDS Muscular Dystrophy Information Page.
  Retrieved March 12, 2006, from National Institute
  of Neurological Disorders and Stroke Web site
  http//www.ninds.nih.gov/disorders/md/md.htmWhat_
  is
• Spinal Cord Basics Tutorial What Happens
  Following a Spinal Cord Injury. Retrieved March
  17, 2006, from Christopher Reeve Foundation Web
  site Spinal Cord Basics Tutorial What Happens
  Following a Spinal Cord Injury Christopher
  Reeve Foundation
• Carls Blog. Retrieved March 17, 2006, from The
  Carl Riccio Trust Web site The Carl Riccio
  Special Needs Trust