GREYS HOSPITAL

ORTHOPAEDIC DEPARTMENT
CEREBRAL PALSY ASSESSMENT
____________________________________________
DATE OF ASSESSMENT __________________

NAME OF PATIENT __________________ GENDER: M____ F_____

DATE OF BIRTH ___________________ AGE: ____YRS____MTHS
MOTHER/ C/GIVERS NAME __________________ CONTACT NO:__________
ADDRESS:________________________________________________________

__________________________________________________________________
MEDICAL HISTORY
1. PREGNANCY: Measles___ Jaundice___Diabetes___Hypertension___Smoking___Alcohol___
Others:

2. BIRTH HISTORY: Natural___C-Section___, Preterm____Admitted to Hospital___

Others:
3.FAMILYHISTORY:_______________________________________________________________
_____________________________________________________________________________
4. PREVIOUS TREATMENT:________________________________________________________
_______________________________________________________________________________

DIAGNOSIS
1. GMFCS(GROSS MOTOR FUNCTION CLASSIFICATION SYSTEM) 1 ______________________

II_______________________

III_______________________

IV______________________

V_______________________
2. What can the child do?

_____________________________________________________________________________
_____________________________________________________________________________

3. What can the child ALMOST do?

_____________________________________________________________________________
_____________________________________________________________________________
4. What can the child not do?
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
5. What is interfering?

Cognitive impairment

Poor head control

Asymmetry

Floppy trunk

Increased tone

DETAILED ASSESSMENT

1. JOINT RANGE OF MOTION (NEUTRAL- NULL METHOD) + (TANDIEV TEST)

LOWER LIMBS
JOINT MOVEMENT RANGE NEUTRAL-N-M TARDIEV

ANKLE JOINT Dorsiflex/plantar 30/0/60

flex( flexed knee)
20/0/60
Dorsiflex/plantar
flex(extended knee)

KNEE JOINT Flexion/Extension 160/0/5

Popliteal angle <-20

(Hip flexed to 90;
difference to full
knee extension.

HIP JOINT Flexion/Extension 130/0/0

Int/Ext rotation 60/0/40

(hip extended, knee
flexed to 90)
Abd/Add 45/0/30
(Hip and knee ext.)
 2. HIP FLEXION CONTRACTURE:

2.1 Thomas Test ( assessing shortening and increase in muscle tone of the iliopsoas)

2.2 Duncan- Ely test ( assess rectus femoris)

Slow fast

2.3 Adductor spasticity: - knee – distance test

- phelps gracilis test

- gracilis test

- pendulum test

2.4. Hip joint Rotation: Neutral-null method ( full int-ext rotation)

3. KNEE FLEXION SPASCITY

( to assess shortening and increase in muscle tone of medial hamstring)

- Sitting with feet in front test slow fast

- Tardiev test: Popliteal angle

To differentiate bet. fixed cont.

and increased muscle tone

4. SPASTIC EQUINUS : Assessing muscle length on passive dorsiflexion

Tardiev test: Triceps surae “catch”
Silfverskiold test
Selective motor control of the foot
Pendulum test
 UPPER LIMBS

JOINT MOVEMENT

SHOULDER FLEXION/EXTENSION
ABDUCT/ADDUCT
INT/EXT ROTATION

ELBOW FLEXION/EXTENSION

WRIST FLEXION/EXTENSION
PRONATION/SUPINATION

MODIFIED TARDIEV SCALE (Resistance to fast passive stretch)

GRADE:
1 Slight resistance throughout passive movement with no clear “catch” at any specific
angle.
2 Passive movement is interrupted at a specific angle by a clear “catch” followed by
release.
3 Fatigable clonus(less than 10 sec) when maintaining the pressure, appearing at a specific
angle.
4 Indefatigable clonus(more than 10 sec) when maintaining the pressure, appearing at a
specific angle.
5 Joint is rigid.

MODIFIED ASHWORTH SCALE

( Assess spastic muscle hyperactivity (muscle tone) with the modified Ashworth scale to
determine local efficacy of BTA treatment)

GRADE DESCRIPTION
O No increase in muscle tone

1 Slight increase in muscle tone, evident as “catch” and release, or as minimal

resistance at the end of the ROM when the examined joint is flexed or extended

1+ Slight increase in muscle tone, evident as “catch” followed by minimal resistance

throughout the remainder ( less than half) range of motion.

2 More marked increase in muscle tone through most of ROM but joint is still easily
moved.

3 Considerable increase in muscle tone, passive movement is difficult.

4 Joint is rigid in flexion or extension.