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Motor Control and Learning > Development of postural control > Flashcards

Development of postural control Flashcards

1
Q

Development in General

A
  • Combination of experience and maturation of systems
  • Sensorimotor mapping (motor learning) over time as systems change (cerebellum)
  • Seqeuntial order of motor tasks with wide variability and some progression/regression (spiraling)
  • Born with some hard-wired movement capabilities (reflexes; spinal cord); Starting point for movement, starts mappping the motor activity in the cerebellum eventually leading to voluntary control.
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2
Q

Normal vs Abnormal infant movement

A
  • Healthy: fidgety, complex patterns; movements are variable in intensity and velocity, shows coordination and fluidity
  • Abnormal: less fidgety - atypical monotonous or hypokinetic movements (indicate impaired nervous system)

We want lots of movement for sensorimotor mapping!

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3
Q

Development rate limiting factprs

A
  • CNS maturity (Matures into teenage years)
  • Musculoskeletal strength
  • Anthrpometrics (Height and mass distribution)
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4
Q

CNS Maturation

A

Newborn
* Brain is BIG - 25% of adult weight
* Midbrain and spinal cord are myelinated allowing for vital functions, sleep and primative reflexes)
* Touch/Somatosensory tracts myelination has started (Ends at 2 years)
* Trillions of synapses at birth; Synaptogenesis begins at 2 months (primitive reflexes fade and purposeful movement begins)

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5
Q

At what age do babies start to become vision dominant? Why?

A
  • At 3 months!
  • Synaptic formation increase in the visual cortex! Start of visually directed movement
  • Example: Assymetric Neck Reflex; As the head turns toward the right side, the right arm extends and left arm bends.
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6
Q

At what age does pruning begin and why?

A
  • 10 years old
  • Brain eliminates connections to refine, become more efficent and increase speed.

This is why children start to forget childhood memories around 10

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7
Q

Musculoskeletal Strength

A
  • Greatest increase in the number of muscle fibers occurs prenatally (before birth)
  • Increase in size and differentiation of muscle fibers postnatally
  • Strength increases linearly until 12 years old.
  • At 6 months can produce force greater than body weight
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8
Q

Why can children not stand at 6 months if they are strong enough?

A

They don’t have the coordination and balance systems/connections made yet.

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9
Q

Infant Anthropometrics

A
  • Top heavy!
  • Head is 25% of body length
  • Head width is close to shoulders and hip width
  • Biomechanical challenge (balance due to COM)
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10
Q

Anthropometrics - After 1 Year

A
  • Infant doubles weight
  • Length increases by 50%
  • Head circumference increases by 30%
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11
Q

Anthropometrics - Birth to adulthood

A
  • Head size doubles
  • Trunk length triples
  • UE quadruple
  • LE quintuple
  • Body proportions change and COM lowers as maturation occurs
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12
Q

What do we need to think about with maturation from birth to adulthood?

A
  • The maturation effects coordination.
  • This results in progressions/regressions to move toward the next milestone (spiraling)
  • Completely normal!
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13
Q

Pattern of Development occurs in what directions? Why?

A
  • Head to foot
  • Proximal to distal within segments
  • Allows for the child to gain control centrally before moving distal; if we don’t have this we don’t have a proper base of support with movements.
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14
Q

Major Milestones of Development - Sequential

A
  • Crawling (Belly/Army Crawl)
  • Sitting
  • Creeping (Quadruped motion, what you thought crawling was)
  • Pull to Stand
  • Independent Stance
  • Walking
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15
Q

Windows of achievement for six gross motor milestones

A
  • Wide variability
  • 95% Ranges
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16
Q

Specific motor tasks requiring postural control

A
  • Head Control
  • Independent Sitting
  • Transition to independent stance

Need each of these to accomplish the next, which then leads to mobility.

All precursors to walking

17
Q

Development of Head Control

A
  • Lack of head control in newborns results from lack of strength and lack of organized (coordinated) muscle activity.
  • They lack strength due to being in the womb which does not have the same gravitational impact.
  • They don’t have the ability to coordinate extension of the neck extensors.
18
Q

Development of Head Control - Sensory Contributions

A

Vision
* Visual and motor connection via optical righting reaction)
* Experience and self produced movment are necessary to refine vision and muscle activity

Vestibular
* Aids in orienting the head vertical (labyrinthine righting)

Somatosensory System
* Proprioceptive/tactile information is used to orient the head and body (body on head righting)

19
Q

What is optical righting?

A

Eyes move toward stimulus, head will orient with them in space to align vertically

20
Q

What is important for parents to do with infants?

A
  • positioning and handling to promote refined control of head movements
21
Q

Development of Independent Sitting - Stages

A
  • Neck control “spreads” to shoulders/trunk

4 Stages:
* Stage 1: 4-5.5 months: Head and trunk control are present, but not sitting independently; Highly variable COP fluctutations; child exploring what works what doesn’t
* Stage 2: 5-6.5 months: upright breifly, less variable, found one strategy and using it.
* Stage 3: 6-8 months: independent sitting, large sway, more (variable) responses responses to different directions
* Stage 4: 8-9 months: stable sitting with minimal sway, strategy refined

22
Q

Development of Independent Sitting - Balance

A

Balance reaction strategies to pertibations
* Available before sitting develops to a limited extent
* 1-4 months: Onset times, directions and response rates are all variable (neural struture refinement)
* 5-9 months (over time or with specific practice) practice improves probability of response, amplitude and consistency of response; synergies are refined

23
Q

Development of independent sitting - Sensory

A

Vision
* Infants rely heavily to control sway
* Overrides proprioception and somatosensory
* With experience, reliance diminishes

Somatosensory
* Dominant factor in reacting to seated pertibations (fastest)

24
Q

Trunk control ____ to legs

A

“spreads”

25
Q

As a child gets close to standing, ____ often gets worse

A

sitting performance

26
Q

Common regressions in children represent a process of…

A

recalibrating sensorimotor maps for new skill

27
Q

The rate limiting factor to independent stance is…

A

neural coordination required to maintain the center of mass within the base of support.

28
Q

Development of independent standing - pull to stand to standing

A
  • 2-6 months: early pull to stand - no coordinated response; fall right back down.
  • 7-9 months: directionallly appropriate response starts at the ankles
  • 9-11 months: independent stance distal to proximal sequence emerges (ankle strategy)

Demonstrates the process of neural refinement to synergies to control COM

Only have AP strategy not ML

29
Q

Timeline for ankle and hip strategy development

A

9-11 months: Ankle strategy
7-10 years (up to 13-15): Hip strategy; Multidirectional strategy

30
Q

What is the rate limiting factor for development of postural strategies? How can we aid in promoting strategies?

A
  • Neural maturation!
  • Practice increases the probability of getting postural response but response changes do not change so neural maturation is large factor
31
Q

How does sensory contributions to stance change as humans age?

A
  • Visual dominance early! Seen at 3 months with assymetric neck reflex.
  • Followed by refined ability to integrate multi-modal sensory information. Seen starting at age 3 and into adolescence as speed of processing increases. Requires myelination and experience.
  • Somatosensory contributions finish myelination development at 2 years
  • Vestibular contributions begin at age 7.
32
Q

Body morphology and postural sway - children

A
  • Children are shorter and top heavy
  • Children sway at a faster rate than adults (static balance is more difficult); more likely to have to use stepping stategy
  • After age 7 sway during normal quiet stance is not related to height or mass (vestibular)
33
Q

Postural Control is essentially “adult like” by age ____

A

age 7-10 (up to 15) years

34
Q

Young children’s postural sway is characterized by an increase in…

A
  • Amplitude
  • Velocity
  • Random variations

Decrease with age into adolescence

35
Q

Adaptability - Timeline

Response to pertibations

A

1.5 to 3 years
* Well organized muscle responses
* Large amplitude & slower response latency
* Longer response durations
* More stretch reflex activation is observed; takes time to develop so they rely more on stretch reflexes

4-6 years
Some studies show even slower and more variable than 1.5 - 3 yrs and 7-10 yrs
Regression due to reorganization?

7-10 (15) years
* “Adult like” – ankle, hip, and multi-directional strategies are observable

36
Q

Development of anticipatory control

A
  • Related to devellopment of reaching and important for walking
  • Sitting:
    – Activation of trunk in advance of reach at 9 months
  • Standing:
    – 10 Months: inconsistent anticipatory action prior to reaching
    – 13 months: consistent anticipatory actions (associated with walking)
    – 4-6 years: anticipatory adjustments preceding arm movement while standing are mature
  • Need practice to develop anticipatory control
37
Q

Children can’t do multiple things at once well but they can….

A

as they age and develop postural control

38
Q

____ is one of the hallmarks of development

A

Variability!

Motor Control and Learning (13 decks)

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