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PEDIATRICS, CEREBRAL PALSY, DOWN SYNDROME, SPINA BIFIDA, JUVENILE…

- - - - Patella alta
      - Genu Valgum
    - - Equinus
        
        Equinovalgus
        
        Equinovarus
      - Bunions/Hallux Valgus
      - Calcaneus
  - - - Most common: C/S
      - Posterior Spinal cord Compression or myopathy
      - Effects
        
        instability
        
        radicular pain
        
        myopathy
        
        neurological defects
    - - More common in GMFCS Level IV &V
      - Progressive, rapid decline when curve > 50 deg
      - Effects
        
        Pelvic Obliquity
        
        Seating
        
        Decubitus Ulcers (pressure sores)
        
        Heart/Lungs
    - - Risk:
        
        s/p selective dorsal rhizotomy (tx: for spasticity)
      - Most common: GMFCS I-III
- - - - (+) pelvic obliquity
      - (+) partial foot amputation
    - - Community mobility limitations
    - - Contractures
        
        Hip CC (vs. dysplasia) affect ambulation
      - Pain
        
        Back
        
        Shoulder
        
        2* to:
        
        WC propulsion
        
        WB during walking (with crutches)
      - Orthotic needs:
        
        fit
        
        alignment
        
        pressure distribution
- - - - Structural changes in feet 2* chronic mm imbalance
      - Scoliosis
      - Pain
        
        back
        
        calf
    - - Loss of sensation in LE/Trunk
      - LE weakness
      - Loss of B/B control
    - - dimple
        
        discoloration
        
        tuft of hair
        
        vertebral alignment variation