Presentations
- Ataxia
- Dyskinesia, such as:
- athetosis
- chorea
- dystonia
- Movement or posture disorders
- Spasticity
Conditions
- Acquired brain injuries
- Cerebral palsy
- Hereditary spastic paraplegia
- Spinal cord injury
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, prevalence, pathophysiology, and clinical science
- take a comprehensive clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients and their quality of life when developing a management plan
Manage
- provide evidence-based management
- prescribe therapies tailored to patients’ needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
Conditions
- Genetic conditions, such as:
- Aicardi–Goutières syndrome
- Genetic dystonias
- Leucodystrophies
- Metabolic conditions
- Multiple sclerosis (MS)
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, prevalence, pathophysiology, and clinical science
- take a comprehensive clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients and their quality of life when developing a management plan
Manage
- provide evidence-based management
- prescribe therapies tailored to patients’ needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
- Epidemiology of conditions leading to hypertonicity and movement disorders in children (tamariki) and young people, such as:
- incidence
- morbidity
- mortality
- prevalence
- Neuromuscular impairments, such as:
- contracture
- dystonia
- muscle weakness
- spasticity
- tremor
- Neurophysiology of hypertonicity and movement disorders
- Pharmacological treatments for dystonia, movement disorders, and spasticity, such as:
- alpha-2 (α2) adrenergic agonists, such as clonidine
- baclofen
- benzodiazepines, such as diazepam
- botulinum toxin A
- gabapentin / pregabalin
- tetrabenazine
- trihexyphenidyl HCL (Artane)
Clinical assessment tools
- Goal setting and outcome measurement tools
- Hypertonicity and dystonia assessment tools
- Muscle strength
- Musculoskeletal examination
- Specific assessment for activity, impairment, participation, and quality of life
- Specific spasticity scale measures, such as:
- Australian Spasticity Assessment Scale (ASAS)
- Modified Ashworth Scale (MAS)
- Tardieu Scale
Investigations
- Biochemical tests, such as neurotransmitters in cerebrospinal fluid (CSF)
- Genetic tests
- Hip surveillance
- Medical imaging, such as:
- Scoliosis monitoring
Procedures
- Botulinum toxin type A, including:
- dosing
- rvidence for use
- mechanism of action
- risks
- Deep brain stimulation, intrathecal baclofen, and selective dorsal rhizotomy, and their:
- benefits
- evidence for use
- mMechanisms of action
- risks
- Muscle anatomy and function, and injection guidance techniques, including:
- muscle stimulation
- surface anatomy
- use of ultrasound
- Neurosurgical procedures used in movement disorder management, such as:
- Orthopaedic procedures for musculoskeletal complications of hypertonicity and movement disorders, such as:
- bone surgery
- spine surgery
- tendon surgery
Physical therapy modalities
- Electrical stimulation, such as functional electrical stimulation (FES)
- Muscle strengthening
- Stretch and positioning, such as:
- casting
- orthoses
- seating
- splints
- standing
- Task-specific training
Prevention / Reduction of noxious stimuli
- Bladder infections
- Bowel constipation
- Fatigue
- Fractures
- GORD
- Hip dislocation / subluxation
- Oral health
- Pain
- Scoliosis
- Skin problems, such as:
- infections
- pressure wounds
