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Human Movement > Balance & Posture > Flashcards

Balance & Posture Flashcards

1
Q

Define «center of gravity»

A

Point of application of the resultant of the gravitation forces

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2
Q

Where is Center of gravity located in anatomical stance ?

A

Anterior between S1 and S2

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3
Q

Define the Center of mass

A

The theorical point in which the mass of the body is uniformly distributed

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4
Q

Define «base of support»

A

The area beneath a person that include every point of contact that the person makes with the supporting surface. It can include body parts and also walking aids or furniture (ex: chair)

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5
Q

What are the disadvantages of bipedal posture ?

A
  • increase heart work
  • increase stress on vertebral column, pelvis and lower extremities
  • reduces stability
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6
Q

Define good posture

A

A stereotipycal alignement of body limb segment that requires the least effort to maintain and puts the least strain on ligaments, bones and joints.

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7
Q

Define static posture

A

The body and its segments are aligned and maintained in a certain posture.
How you hold yourself when you are not moving.

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8
Q

Dynamic posture

A

Posture in which the body and its segments are moving.

How you hold yourself when you are moving.

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9
Q

Describe the path of the line of gravity in a ideal posture along the sagittal plane

A
  • mastoid process of the temporal bone
  • anterior to S1
  • slightly posterior the the hip joint
  • anterior to the knee and ankle
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10
Q

Describe the path of the line of gravity in an ideal posture in the frontal plane

A
  • through the 2 feet
  • through the umbilicus
  • through the xiphoïde process
  • through the chin and noise
  • between the eyes
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11
Q

Name the «anti-gravity» muscles

A

Also called postural muscles

  • calf muscles + soleus
  • hamstrings
  • gluteus
  • erector spinae
  • neck muscles
  • cervical muscles
  • abdominal and deep hip muscles
  • knee extensors, quadriceps femoris
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12
Q

What are the types of standing posture

A
  • lordosis
  • kyphosis
  • flat back
  • sway back
  • scoliosis
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13
Q

Describe the body segments alignement in lordosis

A
  • pelvis is anteriorly twisted with an increased lumbar lordosis
  • knees are hyperextended
  • ankle joints are slightly plantar flexing
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14
Q

Which muscles are commonly elongated and weak in lordosis ?

A
  • anterior abdominals
  • lower and middle trapezius
  • hamstrings (compensate)
  • small muscles of lumbar spine like rotators or multifidus
  • upper thoracic and cervical erector spinae
  • rhomboids
  • hyoid muscles
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15
Q

Which muscles are short and strong in lordosis ?

A
  • lumbar erector spinae
  • hip flexors
  • sternocleomastoid
  • scalenes
  • upper trapezius
  • pectoralis major and minor
  • subocciptials
  • levatore scapulae
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16
Q

Describe the body segments alignement in kyphosis posture

A
  • head held forward with cervical spine hyperextended : it is the most anteriorly placed body segment
  • scapula may be protracted
  • inscreased thoracic kyphosis
  • hips flexed
  • knee hyper extended
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17
Q

Which muscles are elongated and weak in kyphosis ?

A
  • neck flexors
  • upper erector spinae
  • if shoulder protracted : middle and lower trapezius
  • external obliques
  • thoracic erector spinae
  • rhomboids
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18
Q

Which are the commonly short and strong muscles in kyphosis

A
  • neck extensors
  • hip flexors
  • if scapula protracted : serratus anterior, upper trapezius, pectoralis major and minor, levatore scapulae
  • upper abdominal muscles
  • intercostalis
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19
Q

Describe the body segments position in sway back

A
  • the pelvis is the most anterior body segment
  • lower lumbar area flattened
  • pelvis neutral or in posterior tilt
  • hip and knee joint hyperextended
  • subject can stand on one leg so the pelvis is tilted down to non-favor side
  • favored leg appears longer in stance
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20
Q

Name the muscles commonly weak and elongated in sway back

A
  • one joint hip flexors
  • external obliques
  • lower thoracic extensors
  • lower abdominals
  • neck flexors
  • where one leg is favored, gluteus medius, on the favored side
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21
Q

What are the muscles commonly short and strong in sway back ?

A
  • hamstrings
  • hip extensors
  • upper fibers of internal obliques
  • internal intercostals
  • low back musculature is short but not strong
  • where one leg is strong TFL and illiotibial tract
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22
Q

Describe the body segments in flat back posture

A
  • loss of lordosis in the low back with pelvis posterior tilt
  • hip and knee joints hyperextended
  • forward head posture with increased flexion of thoracic spine
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23
Q

Which muscles are elongated and weak in flat back posture ?

A
  • one joint hip flexor
  • lumbar extensors
  • local stabilizers (multifidus, rotatores)
  • anterior intercostals
  • scapular retractors (?)
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24
Q

What are the muscles commonly short and strong in flat back posture

A
  • hamstrings
  • abdominals
  • hip extensors
  • scapular retractors
  • thoracic erector spinae
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25
Q

Describe the body segments alignement in scoliosis

A
  • the spine is curved to left or right (one curve or several curves to left and right)
  • ribs protrude on one side and depress on the other side
  • pelvis is tilted laterally
  • on concavity side : leg looks longer and shoulder drops
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26
Q

Which muscles are elongated and weak in scoliosis ?

A
  • muscles on the convex side
  • hip abductors on concave side
  • foot pronator muslces on the «long side»
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27
Q

Which muscles are short and strong in scoliosis ?

A
  • muscles on the concave side
  • hip adductors on the convex side
  • foot supinator on short side
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28
Q

Define balance

A
  • happens when weight is equally spread so you don’t fall
  • the ability to move or to remain a position without loosing control or falling
  • postural control
  • variation of leg muscles length induced by rotation around the ankle joint
29
Q

Define equilibrium

A

When opposing forces or actions are balanced so that one is not stronger than the other

30
Q

According to the systems model of balance what coincides with stability ?

A

1) goal / task orientation
2) central set
3) environmental organization
4) sensory organization
5) motor coordination
6) musculoskeletal systems

31
Q

Explain goal/task orientation ?

A
  • what is the nature of the activity or task ?

- what are the goals or objectives ?

32
Q

Explain central set

A

The readiness of central nervous system for an upcoming event based on initial conditions, prior experiences and expectations.
Continuous adaptation to optimize the action to peculiar conditions.

33
Q

Define automatic postural responses

A

The postural strategies and postural synergies

34
Q

On which parameters are the automatic postural responses dependent ?

A
  • the goal of maintaining equilibrium (and not stereotyped reflex)
  • depend on the central set : so that they are specific to the conditions of support and adapt to prior experience
35
Q

Explain motor coordination

A

Precise behavioral and kinematics descriptions of equilibrium reactions exist for various conditions.
Typical responses of standing subjects to surface perturbations
—> postural strategies
—> postural synergies

36
Q

What are the broad categories of postural strategies to maintain/restore balance ?

A
  • ankle and hip strategies

- stepping and reaching strategies

37
Q

Explain the ankle and hip strategies

A
  • fixed support strategies that return the body center of over the base of support
38
Q

Explain the stepping and reaching strategies in broad

A
  • change in support strategies : strategies that change the base of support under the falling center of mass
39
Q

Describe the ankle strategy to maintain balance

A
  • the body moves as a flexible inverted pendulum
  • the muscles are recruited distal to proximal
  • head movement is in phase with the hips

It is used when there is a slow, low amplitude perturbation and when the contact surface is firm, wide and longer than the foot.

40
Q

Describe the hip strategy to maintain balance

A
  • the body exerts torque at the hips in order to quickly move its center of mass
  • muscles are recruited proximal to distal
  • head movement is out of phase with hips movement

Used when the perturbation is sudden or with a large amplitude and/or the surface is unstable or shorter than the feet

41
Q

Explain the gradual adaptation of strategy to maintain balance

A

Gradual adaptation from an ankle to a hip strategy (and vice a versa) due to change in surface between large and narrow

42
Q

Describe the stepping strategy to maintain balance

A
  • used to prevent fall
  • first attempt is to replace the body center of mass to initial position by exerting ankle torque
  • used when perturbations are sudden, with large amplitude or when other strategies fail
43
Q

Explain the reaching strategy to maintain balance

A
  • used to prevent a fall if a rail or a stable support is present
  • faster than stepping strategy
  • forward bend of the trunk with flexion of the ankle and hips which may progress to a squat
  • the center of gravity is lowered
44
Q

Describe musculoskeletal system (with regard to systems model stability)

A
  • range of motion of joints
  • strength / power
  • sensation (pain, reflexive inhibition)
  • abnormal muscle tone (ex : hypertonia, hypotonia)
45
Q

Explain sensory organization (systems model of balance)

A
  • visual
  • vestibular
  • somatosensory/proprioceptive

However it mainly relies on proprioceptive information followed by vestibular and visual information for stability while standing on a firm surface

46
Q

What are the 3 main roles of the vestibular system ?

A
  • engages a number of reflexes pathways that are responsible for making a compensatory movement
  • adjustments of the body position
  • engages pathways that project to the cortex to provide perception of gravity and movement
47
Q

Which structure of the inner hear respond to angular acceleration ?
How does it work ?

A

The ampullae
Semi circular ducts work in pairs to detect head movements : when the head turns, it excites the receptor of on ampullae and inhibits the receptors of the ampullae on the other side

48
Q

What are the receptors of inner hear

A

Macula : patches of hair topped by small calcium carbonate crystals called otoconia

49
Q

What is the role of utricule in inner hear ?

A

Utricule senses horizontal, linear acceleration (like in walking)

50
Q

What is the role of saccule in inner hear ?

A

Saccule senses the vertical acceleration (like in falling)

51
Q

What is the vestibulo ocular reflex ?

A

It controls eyes movement to stabilize the image when they move.
When the head moves in one direction, they eyes initially turn in the other direction !

52
Q

What is the role of vestibulocollic reflex ?

A

It stabilizes the head in space during active body movements (locomotion). It is canceled during voluntary head movement.

53
Q

What are the 2 main components of vestibulocollic reflex tract ?

A
  • medial vestibulospinal tract

- lateral vestibulospinal tract

54
Q

To which structure are the signals from semi circular ducts sent to ?

A

Neck motoneurons (with the intervention of one interneuron on the vestibulocollic neuron)

55
Q

Describe the inputs pathway along the vestibulocollic neuron

A
  • neck motoneurons receive bilateral excitatory input from the left and the right anterior canal of the vestibulocollic neuron
  • neck motoneurons receive bilateral inhibitory input from the left and the right posterior canal of the vestibulocollic neuron
56
Q

What is the purpose of cervico collic reflex ?

A

Keeps the head to body relation constant

57
Q

What is the main difference between the vestibulo collic reflex and the cervico collic reflex ?

A
  • The vestibulo collic reflex, stabilizes the head position in relation to the gravity vector
  • The cervico collic reflex, stabilizes the head position in relation to the trunk
58
Q

What shows the Romberg test ?

A

An increase in body sway can be observed with eyes closed compared to eyes open.

59
Q

Name the 5 distinct eye movement systems responsible for voluntary and reflex selection of a visual target

A
  • vestibular
  • optokinetic
  • smooth pursuit
  • saccadic
  • vergence
60
Q

What are the components of the somatosensory system

A
  • muscle spindles
  • golgi tendon organs
  • joint receptors
  • cutaneous receptors
61
Q

What are the 5 steps of the reflex arc and their roles ?

A
  • receptor : detects the stimulus
  • sensory neuron : convey the sensory info to the brain or the spinal cord
  • interneuron : relay neuron
  • motor neuron : conducts the motor information to the periphery
  • effector : muscle or gland
62
Q

Classify the sensory receptors by the type of stimulus they detect

A
  • mechanoreceptors
  • nociceptors
  • thermoreceptors
  • photoreceptors
  • chemoreceptors
63
Q

Classify the sensory receptors according to their body location

A
  • exteroreceptors
  • interoreceptors
  • proprioreceptors
64
Q

Classify the sensory receptors according to their complexity

A
  • complex receptors

- simple receptors

65
Q

Explain the environment organization of the systems model of balance

A
  • nature of the surface ? What is its texture ? Is it moving or stationary ?
  • nature of the surrounds = regulatory features of the environnement
66
Q

Define sensory reweightening

A

Important mechanism for changing the relative contributions made by the different sensory systems for postural control

67
Q

Describe the sensory reweightening on a firm surface

A 
Proprioceptive = 70%
Vestibular = 20%
Visual = 10%
68
Q

Describe the sensory reweightening on an unstable surface

A
  • increase in vision and vestibular weighting

- decrease dependance on proprioceptive inputs

Human Movement (11 decks)

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