LOCOMOTOR DISABILITY

It is a person's inability to execute distinctive activities associated with moving,both personally and objects, from place to place, and such inability resulting from afflictions of musculo-skeletal and, or nervous system.

Some common conditions giving raise to locomotor disability as

• Poliomyelitis
• Locomotor Disability
• amputation
• injuries of spine/ head/ soft tissues
• fractures
• muscular dystrophies

Characteristics

Have problems associated with moving self

Have problems associated with moving objects

 Locomotor disability can be classified as:

 Congenital and acquired/ developmental.

• Congenital and Developmental

1. Locomotor Disability
2. Congenital Talipes Equinovarus (club-foot)
3. Meningocele, meningo-myelocele (Spina bifida)
4. Phocomelia (absence of extremities)
5. Congenital Dislocation of Hip

• Acquired Causes: Infective Causes

1. Tuberculosis – (i) Spine (ii) Other Joints
2. Chronic Osteomyelitis (severe, persistent, and sometimes incapacitating infection of bone and bone marrow)
3. Septic Arthritis (joint infection or infectious arthritis)
4. Acute Poliomyelitis
5. Guillain-Barré syndrome (G.B. Syndrome)
6. 6. Leprosy
7. Encephalitis
8. AIDS

TRAUMATIC CAUSES

1. Traffic/domestic Accidents
2. Fall from height
3. Bullet injuries, explosions
4. Violence
5. Sports injuries
6. Natural Catastrophies like earthquakes, floods etc.

METABOLIC CAUSES

1. Rickets
2. Diabetic Neuropathy
3. Vit. B12 deficiency
4. Gout

Degenerative Causes

1. Motor Neuron Disease
2. Parkinson’s disease
3. Multiple Sclerosis
4. Osteoarthritis, Spondylosis

Metabolic Causes

1. Rickets
2. Diabetic Neuropathy
3. Vit. B12 deficiency
4. Gout

OTHER CAUSES:

Vascular

Cerebrovascular disease (refers to a group of conditions, diseases, and disorders that affect the blood vessels and blood supply to the brain. Blockage, malformation, or hemorrhage prevents the brain cells from getting enough oxygen, brain damage can result)

Peripheral vascular disease (blood circulation disorder that causes the blood vessels outside of your heart and brain to narrow, block, or spasm.)

Perthes disease. ( rare childhood condition that affects the hip. It occurs when the blood supply to the rounded head of the femur (thighbone) is temporarily disrupted. Without an adequate blood supply, the bone cells die, a process called avascular necrosis.)

OTHER CAUSE OF LOCOMOTOR DISABILITY

• Amputation (removal of limb or a part of it)
• Paralysis is caused due to a large number of reasons. And then paralysis often becomes the cause of locomotor disability.
• Muscular dystrophy
• Short stature/ dwarfism
• Neurological conditions
• Cardiopulmonary diseases

CLINICAL FEATURES.

• Deviation or slowness in a child's developmental milestones.
• Excessive stiffness or floppiness of child.
• Use of limbs of only one side of the body.
• Difficulty or abnormality observed when asked to do the following:

      -Lift arm overhead

      -Pick a small object lying in front of him/her

      -Pick a stone from the ground

      -Walk a few steps

      -Run a short distance

• Difficulty in standing up from sitting position.
• Range of motion of joint decreased or excessively increased.
• Absence of limb in part or full.

Evaluation of Locomotor Disability and its management

• Functional impairment is measured for the estimation of locomotor disability.
• Impairment may cause functionallimitations which are partial or total inability to perform these activities necessary for motor, sensory or mental function within the range or manner of which a human being is normally capable,Intervention
• Modification and adaptation of school/educational environment.
• Modification and adaptation of school /educational curriculum
• Development of Enrichment programmers- like physical independence and self, reliance, self-awareness, vocational training etc.

1. a. Orthotics -Orthotics refers to the science of fabricating or fitting orthoses. The term orthotics encompasses the provision of splints and appliances which improve the function and appearance of a patient.

        The main purposes for which orthoses may be prescribed are:

1. Prevention and correction of deformity,
2. Relief of pain by limiting motion or weight bearing,
3. Immobilization and protection of weak, painful or healing musculo-skeletal segments,
4. Reduction of axial load (weight bearing),
5. Improvement of function.
6. Orthoses –

An orthosis is an appliance which is added to the patient, to enable better use of that part of the body to which it is fitted HKAFO(Hip Knee Ankle Foot Orthosis) provides improved standing balance in patients with weak hip muscles.

KAFO (Knee Ankle Foot Orthosis) provides stability at knee and ankle. A KAFO is used for weakness around the knee, ankle and foot.

AFO is used for patients having weakness around the ankle and foot only.

In the upper limb, mobility and function are more important than stability.

A common upper limb splint is dynamic metacarpophalangeal joint-hand and wrist hand orthosis (WHO)

Spinal orthoses are commonly used in spinal injury and tuberculosis. For example, Taylor’s brace (thoraco-lumbo-sacral orthosis) used to immobilize the thoraco lumbar spine. A cervical collar is commonly used to limit neck motion in cervical spondylosis, tuberculosis or injury.

1. Prosthetics

Any artificial substitute for lost part of the body is called prosthesis.

• It can be defined as an art which deals with prescription, design, fabrication and fitting of artificial limbs in a scientific manner. Prosthesis can be for external or internal use. The external prosthesis is used for upper and lower limbs. Internal prostheses are used as Joint replacements e.g. hip,knee and Heart valves.

Prosthetic rehabilitation

• The aim of prosthetic rehabilitation is to achieve maximum function out of the remaining stump

1. D) Walking aids- Crutches, wheel chairs etc

HOMOEOPATHIC MANAGEMENT :

• Conium Maculatum
• Alumen
• Gelsemium Sempervirens
• Plumbum Metallicum
• Causticum
• Gelsimium
• Calcarea phos
• Baryta carb