Atypical Postural Control Flashcards
Abnormal postural control results from probs in what 3 main areas
motor
sensory/perceptual
cognitive
What are the subcategories under problems in motor systems
steady-state balance
reactive balance
anticipatory postural control
Steady state balance includes:
alignment
postural sway
functional stability limits
steady-state balance in sitting
reactive balance includes:
impaired in-place strategies
reactive balance in sitting
impaired change in support strategies
impaired in place strategies (reactive balance) include:
sequencing probs
coactivation
delayed onset of postural responses
probs modifying postural strategies
impaired central set
what are 2 categories in which there are probs in sensory/perceptual systems
- sensory probs
- perceptual probs
sensory probs affect:
steady state balance
reactive balance
anticipatory balance
what are 2 probs with organization that sensory issues lead to?
input deficits
inflexibility
perceptual probs affecting postural control alter perceptions of _______-
verticality
what are 2 factors concerning perceptions of verticality
- subjective visual vertical (SVV)
- subjective postural vertical (SPV)
probs in cognitive systems include:
- balance and falls-self efficacy
- impaired postural stability and DT interference
impaired stability causes
- loss of functional independence
- reduces or restricted participation in ADLs
- increased risk for falls
Falls are associated with what 3 mobility tasks
- walking
- transfers
- stairs
alignment
- weight baring asymmetry in people with stroke
- stooped posture in those with PD
postural sway in those with PD
- increase sway area
- increase sway velocity
- increase M/L sway
What are 4 factors that affect functional stability limits
- biomechanics of the body
- subjective perceptions
- postural control abilities
- environmental factos
what pops are reduced limits of stability found in
MS
PD
Stroke
steady state balance in sitting
- good prognostic indicator of outcome after stroke
impaired in-place strategy: sequencing probs
normal is distal to prox but those with CP, DS, or cerebellum disorders may response prox to distal
impaired in place strategies: coactivation
people with PD coactivate antagonistic muscle around the hip and knee while control group does not
impaired in-place strategies: delay activation of postural responses
delays in the onset of postural responses can contribute instability in persons with neurological defect
impaired in place strategies: delayed onset of postural responses
the subject who fell had slower onset latencies in the paretic TA and slower responses in both the paretic and nonparetic RF, suggesting poor intralimb coupling
impaired in place strategies: probs modifying postural strategies
muscle responses of the person with cerebellar degeneration are hypermetric (larger in amplitude and longer in duration)
impaired in place strategies: impaired central set
- inability to change movement strategies quickly to adapt to changes in support surface
- similar muscle activation patterns are seen regardless of the changes in balance task
impaired change in support strategies
- people with PD showed a lack of anticipatory lateral weight shift and delayed onset reduces the effectiveness of the lateral stepping strategy
- people with PD took several small steps to recover from the perturbation
reactive balance in sitting
- see top down instead of bottom up recruitment order of postural muscles in children wth CP and other types of developmental disorders
- people with stroke may need to reach for support to recover from an unexpected perturbation
motor system probs: impaired anticipatory postural control
- control is dependent on previous experience and learning
- inability to activate postural muscles in anticipation of voluntary arm movements has been described in those with neurological pathology
normal postural control requires what from sensory/perceptual systems?
sensory integration from visual, SS, and vestibular inputs
coordination of sensory inputs with motor actions
what is sensory inflexibility
inability to appropriately select a sense for postural control in environment
people with stroke showed a greater dependency on visual inputs for postural control
balance and falls self-efficacy
reflect how confident people are in their ability to do ADLs w/o losing their balance
poor balance and falls self-efficacy are reported in people with stroke
impaired postural stability and DT interference
increased RT in people with stroke
reduced ability to maintain balance in people with PD and DCD
T or F: postural control deficits have been observed in active pops with MSK injuries
True! Examples:
- ankle injury
- Patellafemoral pain
- LE injury in runners
- after LE joint surgery
- low back pain
- scoliosis
