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This chapter applies principles of musculoskeletal development to common pediatric conditions and discusses intervention strategies. For educational purposes, this book is divided into systems. The human body, however, operates through an interaction of all of the systems. Individuals with neurological impairment are affected by the musculoskeletal system, and in contrast, individuals with musculoskeletal impairment can make improvements through refinements in the nervous system. For example, someone who repeatedly injures a joint may alleviate the problem by educating the nervous system to move in a new pattern. Likewise, functional abilities of an individual with neurological impairment can be enhanced through improvements in ROM or force production. In this chapter, only the musculoskeletal aspects of disease will be addressed. For information on the neurological components, please refer to Chapters 7 and 8. The end of the chapter provides more in-depth information and intervention suggestions for two common pediatric conditions with significant musculoskeletal concerns: cerebral palsy and Down syndrome.


Musculoskeletal Pathologies of Connective Tissue


The first diseases to be discussed are those that affect a child's connective tissue, which includes ligaments, tendons, and cartilage (Table 6.1). Ehlers-Danlos syndrome, juvenile idiopathic arthritis (JIA), and hemophilia are the three pediatric connective tissue disorders that will be discussed in this chapter. Osteogenesis imperfecta is also a collagen disorder but will be discussed in the section on bone due to the significant bone pathology that accompanies it. Lupus erythematosus is another condition affecting the connective tissue, primarily of women between the ages of 15 and 45. Although less common, pediatric systematic and neonatal lupus erythematosus affect children. Detailed information about lupus is not discussed in this text, but some general information is presented in Table 6.1.

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Table 6.1

Pediatric Diseases Affecting Connective Tissue

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