New Course from Beverly Cusick PT, MS, C/NDT, COF
In children born premature and those with diplegic cerebral palsy (CP), findings obtained with diffusion tensor imaging (DTI) have brought significant challenges to the common definition of CP as “a motor disorder caused by a static lesion to the upper motor neurons resulting in spasticity”.
Ms. Cusick discusses findings by researchers that question the definition and challenge the common notion that spasticity is present, that it causes contracture formation and gait pathology in children with diplegia, and that it is a suitable target for “spasticity reducing” interventions. She discusses the confusion over the difference between increased tone and hyperreflexia; challenges to the validity of the Modified Ashworth Scale and the Modified Tardieu Scale as spasticity tests; and presents abundant reported evidence of shortfalls of effectiveness of, and complications associated with commonly-administered spasticity treatments including intrathecal baclofen, botulinum toxin-A injections, and selective dorsal rhizotomy.
Ms. Cusick concludes the program with a presentation of several science-based management strategies for children with diplegic cerebral palsy and suggestions for clinical research involving clinicians in orthotics and associated rehabilitation team members.
(Note: Course lecture and handouts are in English.)