NPTE Practice Test 15

Scenario: school-based PT, spastic diplegic cerebral palsy

¹A 6-year-old girl with spastic diplegic cerebral palsy, born at 29 weeks gestation, receives school-based physical therapy under her individualized education program (IEP). She is classified at Gross Motor Function Classification System (GMFCS) level III.

²At school she walks short distances in the classroom with a posterior (reverse) walker and bilateral hinged AFOs, and uses a manual wheelchair, pushed by an aide, for longer distances such as the playground and field trips. She can self-propel for short distances on smooth floors.

³Current findings: Modified Ashworth Scale grade 2 in the hamstrings and plantarflexors bilaterally; popliteal angle 60° bilaterally; hip abduction 20° bilaterally; she walks with a crouch pattern of hip and knee flexion.

⁴Her wheelchair has been outgrown and a new chair is being ordered. In her current chair she sits with a posterior pelvic tilt and slides forward on the seat. The team also plans a 12-week block of intensive gross motor training and wants to measure its effect.