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

http://4.bp.blogspot.com/_sRYYJL4UT6s/Sq9hsTfJ8PI/AAAAAAAAGdA/isE5IkBuSeA/s1600-h/relaxed.jpg

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