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Peds Midterm > Development of Mobility Control > Flashcards

Development of Mobility Control Flashcards

1
Q

T/F: most of the skeletal muscle has developed at birth

A

True

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2
Q

Type I and II fibers are present by about ____ weeks GA. Denervation effects type ___ fibers first.

A

30

II

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3
Q

Number of muscle fibers increases through the first _____ of life.

A

year

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4
Q

Diaphyses are almost __________ at birth. Epiphyses are ____________ at birth. Epiphyseal plate ossification happens for most bones by age ____.

A

ossified
cartilaginous
20

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5
Q

T/F: at birth, the acetabulum covers more than 1/2 of the femoral head

A

False, it covers less than 1/2

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6
Q

Acetabulum depth increases around age ___.

A

8

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7
Q

Rolling:

  • ___ to ___ months: roll sidelying to supine
  • ___ months: prone to supine
  • ___ to ___ months: supine to sidelying
  • ___ to ___ months: supine to prone
  • ___ months: development of segmental rotation rather than log-rolling
A
  • 1 to 2
  • 4
  • 4 to 5
  • 6 to 8
  • 9
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8
Q

Name the 3 elements/characteristics of normative sit to stand.

A

progression
stability
adaptation

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9
Q

Most children walk between ___ and ___ months of age. 50% of children walk independently by ____ months of age. Gait is fully mature by age ___.

A

9 and 15
11.5
7

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10
Q

Walking is the __________ activity, gait is more ___________.

A

functional

biomechanical

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11
Q

5 Attributes of Mature Gait:

  1. Stability in _________
  2. Sufficient foot _________ in swing
  3. Appropriate pre-positioning of the foot for _________ contact
  4. Adequate ______ length
  5. _________ conservation
A
  1. stance
  2. clearance
  3. initial
  4. step
  5. energy
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12
Q

Prerequisites for Gait

  • Adequate motor control and _____ maturation
  • Muscle activation patterns for ________ stabilization
  • Adequate _____ and strength
  • Appropriate _____ structure/composition
  • Intact __________
A
  • CNS
  • pelvic
  • ROM
  • bone
  • sensation
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13
Q
  1. Stepping reflex: birth to ___ months
  2. Stepping reflex disappearance: 3 to 4 months
  3. Stepping reflex reappearance: ___ to ___ months
  4. Assisted walking
    5-7. Independent walking: 9 to 15 months
A
  1. 3

3. 8 to 10

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14
Q

Getting Ready (birth to 9 months)
- Supported Walking
- Cephalocaudal development of postural control and extensor muscle strength
- _______ helps develop antigravity strength of hip flexors
_ Hip _________ are strengthened in prone, creeping and kneeling
- ________ develops hip abductor strength

A
  • Kicking
  • extensors
  • cruising
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15
Q

Onset of Walking (9-15 months)

  • Hip ________ strength is critical
  • Wide BOS
  • Hip abduction, flexion and ____
  • Internal _________ torsion
  • Tibiofemoral varus
  • ___________ heels
  • Increased hip and knee __________
  • Full foot initial contact
  • Short stride with increased __________
  • Relative foot drop during swing
  • COM at lower _________ level
  • The head must be controlled in the limits of stability/ BOS
  • Hip strength is inadequate to control _____________ forces during gait
  • Coactivation for stability
A
  • extensor
  • ER
  • tibial
  • Everted
  • flexion
  • cadence
  • thoracic
  • gravitational
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16
Q

Age 18-24 Months

  • Straightened ____________ angle
  • BOS has decreased
  • Hip _________ ROM is no longer excessive
  • Increased ant/post movement over planted foot, heel strike by ____ months
  • COM descends
  • Stability improves
  • Decreased contraction across antagonistic muscle groups
A
  • tibiofemoral
  • abduction
  • 24
17
Q

Age 3 to 3.5 Years

  • Joint angles mature into adult patterns
  • Tibiofemoral ________
  • Consistent heel ______
  • ____ lowers
  • Walking velocity normalized for height is similar to adults
A
  • valgus
  • strike
  • COM
18
Q

Age 6-7 Years

  • Gait patterns are fully mature
  • Femoral __________ is largely resolved
  • Heel position is __________
  • Tibiofemoral angle has returned to neutral
  • COM is at ______ (still a bit higher than in the adult)
A
  • anteversion
  • neutral
  • L3
19
Q

Stage of Gait: unpredictable and off balanced, rigid leg action, more hip and knee flexion, shorter steps, wide BOS, flat foot surface contact

A

Initial stage

20
Q

Stage of Gait: gradually smoothing pattern, increased step length, heel contact during walking, arm swing while walking, increased pelvic tilt, BOS diminishes more toward adult level

A

Elementary stage

21
Q

Stage of Gait: reflexive arm swing while walking, narrow BOS, more relaxed/elongated gait, good heel contact

A

Mature stage

22
Q

Determinants of “Mature” Walking:

  • Duration of _______ limb stance
  • Walking ________
  • Cadence
  • _______ length
  • Radio of _______ span: ankle spread
A
  • single
  • velocity
  • Step
  • pelvic
23
Q

Gait Parameters for 1 Year Old:
Step Length-
Cadence-
Velocity-

A

Step Length- 22 cm
Cadence- 176 steps/min
Velocity- .64 m/s

24
Q

Gait Parameters for 7 Year Old:
Step Length-
Cadence-
Velocity-

A

Step Length- 48 cm
Cadence- 144 steps/min
Velocity- 1.14 m/s

25
Q

Does bone increase in size of strength first?

A

size, therefore weight bearing activities are important during the first years of life

26
Q

Femoral anteversion is ____ degrees at birth and decreases with normal development. Excessive ante version results in an in-toed posture and increased ___ sitting.

A

30

W

27
Q

Abnormal Gait Deviation: reduce stance on affected side, osteomyelitis, injury to the bottom of the foot

A

Antalgic gait

28
Q

Abnormal Gait Deviation: excessive hip abduction, leg length differences, CP

A

Circumduction gait

29
Q

Abnormal Gait Deviation: CP, stroke

A

Spastic gait

30
Q

Abnormal Gait Deviation: instability with an alternating narrow to wide gait, ataxic CP, cerebellar ataxia

A

Ataxic gait

31
Q

Abnormal Gait Deviation: contralateral hip drop, abductor muscle weakness, myopathies, hip dysplasia, spina bifida, CP

A

Trendelenberg gait

32
Q

Abnormal Gait Deviation: CP, not a red flag unless they have neuro S&S

A

Toe-walking gait (“equines”) with absent heel contact

33
Q

Abnormal Gait Deviation: the entire leg is lifted at the hip to assist in ground clearance, spina bifida

A

Stepping gait

34
Q

Abnormal Gait Deviation: a general term for lack of motor coordination, CP, arthritis

A

“Clumsy” gait

Peds Midterm (8 decks)

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