4 Sitting APA RPA

Question 1

What is dynamic sitting APA?

Answer 1

• Preserve balance with expected perturbation
• postural muscle activation occurs before the prime mover for the activity
• Task = forward reach
• APA: neck extension to stabilze head in perparation an anterior displacemtn of the COM
• Once neck extensors are activated then the reach begins with shoulder flexion and then trunk flexion

Question 2

What are the APA impairments for the motor system?

Answer 2

Timing and sequencing of erector spunae and lateral trunk muscle firing are disrupted on hemiplegic side during arm and leg lift

Onset of firing is delayed in the APA muscles

Question 3

What are the sensory impairments related to APAs?

Answer 3

problems with eyes open and closed for 30 seconds

sitting on compliant surface EO EC for 30 seconds

lateral stabilty was poor especially during reaching

Similar results for inreased sway

Question 4

What are the APA trunk proprioception impairments?

Answer 4

EC forward lean

EC lateral shift

Question 5

What are the 3 main focus to APA intervention

Answer 5

Smooth coordination motion of trunk and arm to get hand to object

Appropriate loaoding of the affected foot

Preventing the use of maladaptive strageties (widening BOS)

Question 6

What are supine exercises in hooklying?

Answer 6

Selective AP movements of pelvis (tilts)

Extension of the hips (bridging)

Rotation of the trunk initiated from the upper and lower part of the trunk

Question 7

What are APA internvetions in a sitting position?

Answer 7

Flexion/Ext of trunk, lumbar spine, hips

Lateral flexion of trunk

rotation from the upper and lower part of the trunk

Shuffling forwards and backwards on an exercise table

Question 8

What is dynmanic postural control RPA?

Answer 8

• muscle activity in respose to a threat of a loss of balance
• movement occurs at hip
  
  • somatosensory system
  • head and shoulders move together followed by trunk then LE
• Modulation of response is multisensory

Question 9

What occurs when the patient falls or uses UE for support in response to external perturbation?

Answer 9

Slow activation of posutral muscles

Question 10

What is the intervention for slow activation of postural muscles?

Answer 10

Manual perturbations in sitting

platform perturbations in sitting

weighted ball activities (only a few attempts then becomes an APA)