Foundations For Professional Health Practice

Introduction to Foundations For Professional Health Practice

Cerebral palsy (CP) is developmental non broadminded disorders which occurs during brain growth in fetus. It is mainly the disorder of activities of move and posture[1], which leads to limitations in activity [1]. The disability in crusade are often accompanied by other disabilities like speech disorders[2], visual dysfunction[3],auditory problems, attacks of seizures (4), digestive and nutrition problems (5), pulmonary dysfunction[6], teeth problems [7], abnormal deformity and muscle contraction of limbs [8] and various reasoning disorders, some degree of mental obstruction [9] and epilepsy [10]. The occurrence of CP has been reported approximately range of 0.6 to 5.9 cases per one enormous live births[11]. Because of high prevalence of this disorder, it is necessary to help them to teach them how to deal with the disabilities. In this regards, it is require to understand their true necessity within the domain of therapy.

As needs are misunderstand by service providers which results in inefficient to provide proper rehabilitation service. Thus, the balance between need and provision of the service in this field is lost and it would lead to difficulty in managing the case. Therefore, understanding the true needs of the focused group subjects that means the outlook of the subjects are considered and Rehabilitation is planned accordingly. Many research / articles is being done in various countries newly in the wants of various groups [12-14] and researchers effort to discover their true desires.

Severity of the disability varies from mild like person chiefs almost normal life to unadorned condition, allied with numerous comorbid conditions.

Aim:

This study is aimed to examine the presence of developmental disabilities in CP

Expected Outcome:

To monitor the amount of mental obstruction, vision impairment , hearing loss, as well autism spectrum disorders/syndromes among children.

Study Approach to Foundations For Professional Health Practice

Prevalence will be calculated for each of the disabilities overall and by various demographic details including gender, race severity of the disability. White, black, and “other” will be the categories cast-off for the race precise rates. These categories do not include children of Hispanic origin [6].

Experimental Frame Work:

Mental Retardation

When intelligent quotient (IQ) is <70 then it is considered as mental retardation on the root of psychometric test. When written statement about absent IQ or thoughtful mental retardation by psychiatrist about child's intellectual functions will be acceptable. International Cataloguing of Diseases has given the categories to define the severity of mental retardation: mild (IQ: 50–70), reasonable (IQ: 35–49), severe (IQ: 20–34), and profound (IQ: <20). Intellectual quotient is too low or mental impairments are common in spastic quadriplegia.

Hearing Loss

 Hearing loss is determined as bilateral, unadulterated tone hearing damage at frequencies of 500hz, 1000hz, and 2000hz be around or lesser 40 decibels, unassisted, in the healthier ear [15]. In the not present of a measured, bilateral hearing loss, the circumstances of the children met the case description if their source chronicles include a description, by a licensed as well certified audiologist or qualified physician, of a hearing loss of lesser than 40 dB in the healthier-. Severity mainly known based on the following hearing impairment heights -measured in the healthier ear: moderate hearing loss of 40–64 dB, severe hearing loss of 65–84 dB, and deep (hearing loss of >85 dB) [15].

Vision Impairment

When Visual perception is 20/70 it is defined as Vision damage. If records or documentations are available by a qualified physician or vision professionals about functionality of child’s eye and if there is any abnormality present child will be considered as patient with vision impairments (e.g., light perception only) or a statement describes the child has low vision or no vision. Severity of visual impairment is generally known as based on the mentioned vision impairment levels: low vision visual insight of 20/70 to 20/400 and no vision visual acuity inferior than 20/400.

Seizure disorder

Children who have cerebral palsy commonly suffer seizures with more or less frequency. Evidence are suggestive of intellectual disability in children with epilepsy and CP

Delayed Developmental growth

Any type of CP have developmental disability and growth retardation. Disabilities like low weight, abnormal shortness defected sexual development. Muscles and extremities are under developed than the normal structure commonly seen in Spastic hemiplegic children, affected side structure will not grow as normally as normal side.

Spinal deformities and disabilities. Deformities of the spine include Scoliosis, kyphosis, and lordosis which are associated with other structural deformation which will result in functional motor disabilities. These disabilities may cause secondary complications like difficulty in walking, sitting, standing, it may cause back pain. Improper pressure and malalignment of the joints may result in weak bones and ultimately decrease in bone mass density which leads to osteoporotic changes in the bones.

Speech and language disorders

Language disorder comprise of difficulty in articulation, forming words, clarity in voice, inability to communicate properly and as a result unable to convey the thoughts which is commonly interpreted as cognitive dysfunction, which will further demoralise the child to put further efforts.

Drooling 

Because of poor control of throat muscles, mouth and tongue incoordination result in drooling of saliva.

Incontinence

 It’s most common complication in CP due to feeble pelvic ground muscles and poor control of bladder function.

Sensory and Perceptual Dysfunction  

Sensory dysfunction is common in CP child they may experience pain or hyper sensation against mild touch. CP patients are hypersensitive especially on touch.

Learning Disabilities

Language disorder as a outcome of brain damage cause learning disabilities. Child will have difficulty in processing various information and interpret it. 

Chronic Illness and infectious conditions

Lung disease, pneumonia, heart disease are most likely to occur in adult CP.

Contractures and irregularities

Because of mal development, weakness, in coordination, muscular imbalance and painful condition may result in development of contractures which enhances spasticity and result in joint deformities.

Nutritional disorder

Muscular imbalance or poor control result in difficulty in swallowing, sucking, feeding in CP children. Because of the difficulties if child will not get proper nutrition it will result in various national disorder and child remains underweight.

Dental problems

Certain Medicine may create some dental problems as a side effect of the medicine. Gum diseases and poor dental hygiene are most common in CP children.

Inactivity and involuntary movement

Because of presence of involuntary movements and other developmental impairments result in inactivity in child. CP children need more energy during daily routine activities. Movement impairments and other dysfunctions it will be difficulty for them to participate in sports or any other activities. Inactivity leads to reduced overall health and healthy existence.

Research Questions

  • How developmental disabilities affect the quality of life?
  • What are the disabilities present in cerebral palsy patients?

Outcome Measure:

QOL- Quality of life and HRQOL-health related quality of life HRQOL questionnaire will be used.

References for Foundations For Professional Health Practice

Bax M, Goldstein M, Rosenbaum P, Leviton A, Paneth N. Proposed definition and classification of cerebral palsy. Developmental Medicine and Child Neurology April. 2005;47(8):571–6‏.

Odding E, Roebroeck ME, Stam HJ. The epidemiology of cerebral palsy: incidence, impairments and risk factors. Disable Rehabil. 2006;28(4):183–91‏.

Oriady Zanjani, M. Cerebral palsy in viewpoint of speech- language pathology nature, assessment and treatment. Hamedan: Noore elm Publications 2005; 41

Akhundian J. Epilepsy in children with cerebral palsy. Children disease of Iran. Mashhad University of Medical Sciences. Imam Reza hospital. Department of Pediatrics Twelfth year Number 3 2003; 21-25 .

Shevell MI, Dagenais L, Hall N. Co-morbidities in cerebral palsy and their relationship to neurologic subtype and GMFCS level. Neurology. 2009;72(24):2090–6‏. 

‏ Seif Workinger M. Cerebral Palsy Resource Guide for Speech-Language Pathologists. Translated by Zamani p & Mousavi N. Tehran: Danzhh. 2009

Oriadi Zanjani, M.Cerebral palsy from the standpoint of, speech and language pathology. Nature, assessment and treatment. Hamadan: Nore elm Publishers.

Ameri E, Yeganeh A.. Prevalence of foot deformity in cerebral palsy patients in 3 to 20 years old to referring Shafa Yahyaeian in Tehran. Journal of Hamadan University of Medical Sciences and Health Services. 2008;Volume 14(Number 1) Serial No 43.34-38.

Khayatzadeh Mahany M, Amirsalari S, Karimloo M. Accompanying Problems in Children with Cerebral Palsy and their Relationship to type and Level of Motor Disability. Medical scientific Journal of Gondi Shapoor of Ahvaz, 2012;Volume 10(Number 12012):59–67. 

Sarvestani Bigham, M M. Cerebral palsy theories, Techniques , treatments. Tehran: Danzhh. 2006;106 

Ardakani M, Olyaei GH, Abdolvahab M, Bahgeri H, Jalili M, Faghih Zadeh S. The effects and maintenance of constraint-induced therapy on spasticity and function of upper extremity in hemiplegic cerebral palsy children 6 to 12 years old Department of Rehabilitation Tehran University of Medical Sciences. Modern Rehabilitation. 2011;(3,4):41–47. 

Kersten p, George S, McLellan L, Smith J.A, & Mullee M.A. Disabled people and professionals differ in their perceptions of rehabilitation needs. Public Health Medicine 2000; No3,pp 393-399‏.

Fauqueir Country Disability Services board, need assessment report 2009; (4‏).

Nieuwenhuijsen C, van der Laar YM, Donkervoort M, Nieuwstraten W, Roebroeck ME, Stam HJ. Unmet needs and health care utilization in young adults with cerebral palsy. Disability and Rehabilitation Rotterdam. 2002;(30):1254–1262‏.

Rabin I. Children with hearing impairment. In: Swaiman KF, ed. Pediatric neurology. St. Louis, MO: CV Mosby; 1989:895–908

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