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Paediatric Assessment-Neurological

Discussion in 'Pediatrics' started by pods86, Mar 21, 2011.

  1. pods86

    pods86 Member


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    Hi All, as a long time reader (rare poster) on this forum I have found that often in the case studies that people present there is continually responses requesting more information and detail of the assessment-particularly the neuro section. As a clinician with limited paediatrics experience what do those more experienced practitioners suggest should be covered as a basic minimum in a standard podiatry paediatric consult? ans what tests do you find particularly useful

    I do understand that if anything neurological is suspected the patient should be referred on for specialist input! :drinks
     
  2. Bug

    Bug Well-Known Member

    For the lower limb a good place to start regardless of age group is:

    Reflexes: Noting as present/absent, hyperresponsive or normal
    - Patella
    - Ankle
    - Plantar

    Tone: Noting as hyper/hypotonia or normal
    - Active
    - Passive

    Presence of tremor at voluntary or involuntary movement

    Presence of any primative reflexes

    Presence of clonus

    Sensory - light/deep touch

    Then there are observational signs ie: Gowers

    There are some good lower body neuro assessments on Youtube: http://www.youtube.com/watch?v=x_N1-eukSG0&feature=related

    Trick is knowing what is normal at what age and also conducting it in a way to get the most accurate response.
     
  3. drsarbes

    drsarbes Well-Known Member

    I might add;

    General observation( development per age, symmetry, etc...)

    Muscle strength (group) ;

    General assessment of gait.


    Steve
     
  4. AThandi

    AThandi Welcome New Poster

    Having just qualified I find it difficult to determine the Normal ranges in a child as I havent examined too many.
     
  5. drsarbes

    drsarbes Well-Known Member

    "Having just qualified I find it difficult to determine the Normal ranges in a child as I havent examined too many."

    Isn't that what school and training is for?

    If you do not feel competent to examine a child then you should not see them. I would suggest finding someone who can help you along, perhaps spend some time with other practitioners who see peds and get a bit of experience before taking them on by yourself.

    Good luck.

    Steve
     
  6. pods86

    pods86 Member

    Athandi, I have found it really useful to watch other practitioners not necessarily within podiatry aswell. Local physios, watching OT , Speech Pathologists ax. I have definately picked up not necessarily specific skills but great info when ax age for stage develpment and even just strategies for dealing with difficult behaviour.
     
  7. Kerrie

    Kerrie Active Member

    Don't worry you will get the confidence and I can speak from experience. I qualified 2 years ago nearly and have found that the best way to learn is to just do it. 10 minutes of your own clinical assessment is worth a week in the class room (the good old words of my lecturers) and it is soo true.
    Granted that paeds can be intimidating as not only do you have to consider the fact that they are still growing and may not be like this next year but you also have mummy chewing your ear off about whether it's normal. That is what I found to be the hard part.
    One little piece of advice that I will give to all newly qualified's encountering paeds in a biomechanical setting is to learn when the growth spurts are in boys and girls as it can explain alot, that is what I have found but I may be bouncing off my own theory.
    For example, if you get a 13 year old boy in for any complaint, say shin splints, just say to the mother/father "I expect that he has grown a few inches or so it seems in the past few months" They will instantly agree and because you have made a true statement, in their eyes, appear to be know what your on about and they will trust your judgement and also put you at ease. With you at ease and mummy and daddy now happy that your the right person for the job you'll perform better and things will start popping outta your head that you never knew were there ;)...by that I mean clincial examination tests, not what your having for dinner tonight :)
     
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