Scenario: A 5-year-old is referred to physical therapy following removal of a cast for a femur fracture and subsequent diagnosis of osteogenesis imperfecta (OI). The child has decreased active and passive knee range of motion (ROM). The child presents with a leg-length difference and decreased strength in the hip, knee, and ankle on the involved side.
Question: What are some other impairments that are likely to be seen with this patient?
A. Delays in eating habits and fine motor skills only.
B. Hyperflexibility in uninvolved joints and pain during AROM.
C. Delays in gross motor skills development and higher than normal dependency for transfers and ADLs.
D. Pain during PROM and delays in eating habits.
Answer with rationale: C. Delays in gross motor skills development and higher than normal dependency for transfers and ADLs. Delays in gross motor skills comes from potential immobility from fractures, decreased strength, and decreased ROM. Higher than normal dependency comes from a combination of decreased strength and a common lack of ambulatory development.
For more information see Chapter 247: Osteogenesis Imperfecta in The Color Atlas of Physical Therapy