• Assessment of level of function. Can the patient sit independently? Is the patient ambulatory?
• Assessment of general health status. Is there a history of seizures, frequent pneumonia, or poor nutrition?
Figure 7-6. Severe spondylolisthesis associated with sagittal plane decompensation.
• Evaluation of head control, trunk control, and motor strength. Does the underlying neuromuscular problem result in a spastic, flaccid, or athetoid picture?
• Assessment of curve flexibility. Curve flexibility can be assessed by grasping the head in the area of the mastoid process and lifting the patient from the sitting or standing position.
• Is pelvic obliquity present? Is it correctable with traction and positioning?
• Evaluation of the hip joints for coexistent pathology, including contractures.
• Is the patient's underlying neuromuscular disorder associated with any other organ system problems? For example, Duchenne muscular dystrophy is associated with cardiomyopathy.
• Documentation of pressure sores and areas of skin breakdown.
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