Concepts of Adult Motor Control

Question 1

Describe the Progression of anti-gravity extensor control before the development of anti-gravity flexor control

Answer 1

When the baby is in utero, they are all flexed in a forward position, which causes the extensor muscles to be elongated.
4mo - some indication of antigravity flexor control
6mo - flexors catch up w/ extensors; balanced responses

Question 2

Describe the 5 characteristic patterns of movement which develop sequentially

Answer 2

1. random, spontaneous, non purposeful movements
2. bilateral symmetrical movements
3. alternate reciprocal movements
4. unilateral symmetrical movements
5. diagonal reciprocal movements

Question 3

random, spontaneous, non purposeful movements

Answer 3

Random kicking and movement of arms in supine and a little in prone
Want to make sure they are moving both arms, both legs, and their head

Question 4

bilateral symmetrical movements

Answer 4

muscles on both sides of the body work together to move

3mo - lift head in prone

Question 5

alternate reciprocal movements

Answer 5

3.5mo - lift head in prone and turns to one side

Question 6

developmental planes in order

Answer 6

occurs first in sagittal, then coronal, then transverse

Question 7

unilateral symmetrical movements

Answer 7

Flexor and extensor muscles on the same side of the body work together and in a balanced manner to produce lateral movement of the head and or trunk
- ability to tilt head (4mo) or lateral side-bending

Question 8

diagonal reciprocal movements

Answer 8

7-9mo
most advanced pattern of movement
trunk displays rotation, equilibrium, loading/unloading

Question 9

describe a loading response and explain what occurs during a typical weight shift

Answer 9

Loading response—helps move center of gravity while moving on base
In a normal weight shift, the vertebral bodies will rotate, and the trunk will elongate on the loaded side with shortening of the unloaded side

Question 10

define mobility and describe how movement is initiated

Answer 10

• Mobility is the ability to move and to assume a desired posture
• We move before we stabilize
• Move in gross movements first
• ## As movement occurs, the agonist moves through its range of motion from lengthened range to shortened range, and antagonist is elongated from its shortened range to its lengthened range

Question 11

define stability and describe how muscle movements are stabilized

Answer 11

• Stability is the ability to maintain a posture once it has been assumed
• Result of co-contraction of agonists and antagonists around the joint
• The deeper muscle sand more proximal muscles tend to function more as stabilizes than as mobilizers

Question 12

structural stability

Answer 12

• provided by the environment or caregiver
• Results from tissue tightness due to the in-utero positioning
  When a newborn is placed in prone, they are able to maintain a flexed position because of tightness in flexor muscles

Question 13

positional stability

Answer 13

• 1-7 mo
• Achieved by using the body or body parts to create a large base of support
• Standing with legs wide apart, sitting with legs abducted and with support on arms
• high guard: holding arms out for positional stability

Question 14

internal stability

Answer 14

• 9mo-1yr
• Internal control mechanism that allows it to maintain position or posture without the need for positional control
• righting reactions, protective extension, and equilibrium reactions
• As this increase, the size of base of support will decreases, ease, freedom, and ROM will increase

Question 15

3 normal combinations of rolling

Answer 15

1. Extension of the head and neck with rotation, extension rotation of upper trunk-flexion rotation of the lower trunk, flexion, adduction of the upper extremity, flexion adduction of the lower extremity
2. Extension of the head and neck with rotation, extension of the trunk, flexion, adduction of the upper extremity, extension, abduction of the lower extremity
3. Flexion with rotation of the head and neck, flexion of trunk, extension with adduction of upper extremity, flexion with adduction of lower extremity

Question 16

center of gravity (COG)

Answer 16

Infants COG is at nipple level (T4)
As the child grows, the COG descends until it is about navel level (lower lumbar)
The COG shifts as movement within a posture occurs and must be controlled to keep it within the base of support or to bring it back within the base of support

Question 17

point of stability (POS)

Answer 17

• that point in a posture toward which the weight is shifted
• It represents the “anchor” of the posture around which the movement occurs
• least moveable point in the posture and as we move away from the point of stability greater ranges of movement are possible

Question 18

base of support (BOS)

Answer 18

• Any part of the body that is touching the environment

- POS and BOS are the same when there is NO weight shift

Question 19

structures of the jaw

Answer 19

the mandible and the maxilla are not in the appropriate relationship with each other at birth, but as baby uses the oral motor musculature the relationship of the mandible to maxilla will adjust.
If the appropriate relationship is not achieved, leads to under/over/crossbite
baby: soft palate and epiglottis touch and tongue fills oral cavity (pressure to suck)

Question 20

rib cage

Answer 20

An infant’s ribs are boxy and don’t have the appropriate slope
As the infant works in prone, supine, and side lying (first 6 months), the rib cage will be shaped, and normal adult thoracic contours will be achieved
If the rib cage does not develop normally, it can result in a variety of problems including impaired patterns of respiration, sound production, and speech

Question 21

femur to acetabulum alignment

Answer 21

In an infant, there is about 60 degrees of femoral ante-version, that is the femoral head is rotated forward and out from the acetabulum

As weight bearing and exertion of muscle pull across the bone occurs, the femur will realign itself with the acetabulum and the internal torsion will unwind, giving them 8 degrees of anteversion (like an adult)

Failure to do this could cause excessive toeing or in toeing out, and an unstable hip and impaired stability of the trunk

genu varus - bow legged

Question 22

hypertonus and hypotonus

Answer 22

too much tone

floppy or placid

Question 23

spasticity

Answer 23

resistance is dependent on speed of movement

The faster the passive movement, the greater the resistance offered

Question 24

rigidity

Answer 24

resistance is constant regardless of speed of movement

Question 25

tissue compliance

Answer 25

whether the tissues allow you to move

Question 26

progression of normal antigravity posture through 4 stages

Answer 26

1. mobility
2. stability
3. controlled mobility
4. skill

Question 27

static-dynamic work

Answer 27

Ability to shift weight onto one extremity and maintain control while the opposite extremity is freed to move in space
(ex. walking)

Question 28

weight shift

Answer 28

lengthening on weighted side and shortening on non-weighted side

Question 29

muscle tone

Answer 29

resistance to passive stretch

degree of “stiffness” of the muscle

Question 30

EOLQ: What is the importance of physiologic flexion to the progression of normal anti-gravity movement in a typical newborn?

Answer 30

We have antigravity extension first because extensors are lengthened due to in utero positioning

Question 31

EOLQ: What are factors which may limit normal anti-gravity movement?

Answer 31

Low tone, disability that causes change in muscle tone, musculoskeletal misalignment, tissue compliance (edema)

Question 32

Cranial nerves associated with rooting and sucking

Answer 32

Trigeminal (V)
Facial (VII)
Glossopharyngeal (IX)
Vagus (X)
Spinal Accessory (XI)
Hypoglossal (XII)