presented by Kathy Martin
In order to understand how to appropriately plan interventions for children with gross motor delays, physical therapists must first understand typical development. In this course, the typical development of the lower extremity (muscle, bone and cartilage) will be reviewed. This will include a discussion of developmental stages in which genu valgum or genu varum and in-toeing are considered developmentally appropriate. Screening tests for femoral torsion and tibial torsion will be demonstrated. Normative data for lower extremity alignment will be reviewed with an emphasis on when to refer to an orthopedic physician.
Dr. Martin received a BA in Athletic Training from Purdue University in 1987, an MS in Physical Therapy from the University of Indianapolis in 1990, and a Doctor of Health Science from the University of Indianapolis in 2003. She joined the faculty of the Krannert School of Physical Therapy at the University of Indianapolis in 2000, and is currently a Professor. Her clinical background includes early intervention and inpatient pediatric general acute care. Dr. Martin teaches the pediatric portion of the DPT curriculum, and her research efforts have been focused on orthotic effectiveness, and children with Down syndrome. Dr. Martin is currently the Chair of the Education Committee for the Academy of Pediatric Physical Therapy and has been actively involved in identifying best practices in pediatric physical therapy professional education. She is also the 2008 winner of the Indiana Chapter of the APTA Frances Ekstam Award for outstanding contribution to the physical therapy profession.
This chapter will review the typical changes in the femur and the tibia/fibula that occur with growth. This will include a review of femoral and tibial torsion along with the time frames when hip antetorsion, genu valgum or varum, and in-toeing is developmentally appropriate.
This chapter will demonstrate simple screening techniques to evaluate for rotational abnormalities in young children. Normative values will be presented for each screening technique along with suggestions for criteria for referral to a pediatric orthopedic surgeon.