Exam 2 Flashcards

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1
Q

distributed vs massed has to do with

A

intensity

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2
Q

Blocked vs random has to do with

A

sequence

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3
Q

explain constant vs variable

A

has to do with variability. consistant performance of the same task, vs varying char of the task

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4
Q

guidance vs discovery

A

how much you are involved, are you letting them discover most of the solutions themselves or are you primarily guiding them

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5
Q

KR vs KP

A

knowledge of results vs knowledge of performance (KR better)

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6
Q

Serial, continuous and discrete

A

serial - multiple discrete tasks in a row
continuous-no beginning or end
discrete- has beginning and end

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7
Q

4 main factors contributing to postural control

A

MSK sx
neuro sx - sensation
Neuromusular sx - control and coordination
enviroment

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8
Q

postural control develops cephalo caudel, meaning

A

head to toe

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9
Q

reflexes that effect the tone of the entire body

A

attitudinal/postural

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10
Q

3 main types of reflexes

A

attitudinal/postural
righting
balance/protective

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11
Q

in the hierarchial theory of development, what reflex type is the foundation

A

attitudinal/postural (lack of these often indicate dev delay or pathologies)

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12
Q

List the 3 attitudinal/postural reflexes

A

asymmetrical tonic neck reflex
symmetrical tonic neck reflex
tonic labyrinthine

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13
Q

explain asymmetrical tonic neck reflex

A

fencer pose

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14
Q

asymmetrical tonic age range

A

birth - 6 mos

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15
Q

explain symmetrical tonic neck reflex

A

whatever neck does, UE follow, and LE do opp

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16
Q

explain tonic labyrinthine reflex

A

when placed prone, babies will flex their bodies inward

when placed supine, they will extend outward

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17
Q

age range of tonic labyrinthine reflex

A

up to 6 mos

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18
Q

5 righting rxns

A
labyrinthine righting
optical righting
body on head righting
body on body righting
neck on body righting
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19
Q

what is labyrinthine righting

A

you do something to restrict/prevent their vision, and as you tilt the suspended body, they maintain upright head (horizontal gaze)

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20
Q

what is optical righting

A

same as labyrinthine, but without loss of vision

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21
Q

how long do we have labyrinthine and optical righting

A

over the lifespan

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22
Q

what is body on head righting

A

when the body is placed prone, the head will want to be upright

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23
Q

how long do we have body on head righting

A

up to 5 yrs

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24
Q

what is body on body righting

A

if you rotate a segment of the body (ex UE) the opposing segment (LE) will follow to align

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25
Q

what is neck on body righting

A

as you rotate their head, the body will follow suit

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26
Q

___________ are innate reactions that align the body for proper alignment

A

righting reactions

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27
Q

List the balance/protective reactions

A

equilibrium (tilting)

Postural fixation

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28
Q

List the time frames of when we start to see balance/protective reactions for prone, supine, sitting, quadruped, standing

A
Months
prone 6
supine 7-8
sitting 7-8
quad 9-2
wallking 12-21
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29
Q

protective reactions occur when

A

COG is outside of the normal limits or when there is a LOS

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30
Q

which balance/prot rxn is when the baby curves the trunk and uses extremities to try and correct/straighten the tilting

A

equilibrium

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31
Q

which balance/protection rxn occurs as baby is reaching, displacing COG and the baby curves the trunk towards the external force

A

postural fixation

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32
Q

as the dev of reflexes become integrated they reinforce what

A

muscle tone

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33
Q

typical age of starting to crawl

A

8-10 mos

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34
Q

typical age of sitting upright

A

6-7 mos

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35
Q

typical age of leaning against something as they stand

A

9-10 mos

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36
Q

typical age of independent stance

A

12 mos

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37
Q

what is a key component to dx dev delay in babies, what are we looking at very early

A

head control

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38
Q

normal posture control depends on

A

COM

BOS

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39
Q

reflex hierarchial theory states that reflexes are all____ to balance

A

reactive

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40
Q

according to hierarchial theory, list the tiers or levels of what babies achieve in regards to balance/posture

A

1st - attitudinal reflexes
2nd -righting reflexes
3rd - balance/protective reflexes
then postural control

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41
Q

what is systems theory

A

states that anticipatory responses act when we are aware of the need to change our position/posture. anticipatory responses develop parallel to reactive

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42
Q

4 stages of motor control

A
initial mobility
stability
controlled mobility
skill
(I S C S)
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43
Q

explain initial mobility stage

A

AROM is required for posture (ex: baby prone on elbows)

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44
Q

explain stability stage

A

baby can hold the posture (maintains it)

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45
Q

explain controlled mobility stage

A

baby can control or shift wt

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46
Q

explain skill stage

A

baby can reach out in front

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47
Q

prominent sensory system used at birth-few days (newborn)

A

visual

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48
Q

prominent sensory sx used around 1 yr

A

somatosensory (proprio)

49
Q

prominent sensory sx used at 7 yrs

A

vestibular

50
Q

1st postural reflex developed

A

postural support reflex (you hold a baby upright over the floor and have their feet touch, they will try to support their wt)

51
Q

explain landau reflex

A

prone baby, they will kind of stiffen up and extend

52
Q

components to include when looking at the INDIVIDUAL in a posture/balance assessment

A

body structure
body function
cognition

53
Q

babies begin to extend neck fully at what age

A

2 mos

54
Q

motor control relates to ___ and ____ function

A

brain and spinal cord

55
Q

motor performance is influenced by what body systems

A

all

56
Q

what were the 4 components of motor learning

A

retention
generalizability
quality of movement
resistance to contextual change

57
Q

postural control is the ability to maintain equilibrium both ___ and ___

A

statically and dynamically

58
Q

what is posture orientation

A

maintaining appropriate relationship btwn body segments

59
Q

how to measure static control

A

how controlled are they for a certain amt of TIME

60
Q

what is meant by limits of stability

A

your movement is contigent on your BOS, if your BOS is small and narrow, your movement will be too

61
Q

how to improve limits of stability

A

make your BOS larger

62
Q

4 strategies of postural control

A

sensory
motor (the mvmt)
sensory motor (the coordination involved)
attentional (degree of attention required)

63
Q

3 factors contributing to quiet stance

A

muscle stiffness
tone
antigravity contractions

64
Q

3 main antigravity synergy sxs

A

abs and erectors
hip flexors and gluts
plantar/dorsiflexors

65
Q

3 ways to objectively measure posture control

A

EM (electromyography)
kinematic analysis
kinetic analysis

66
Q

which way to measure postural control involves videos with markers on the pt to check symmetry, includes forces velocity

A

kinematic

67
Q

which way to measure postural control involves use of internal and external forces with plates and gages

A

kinetic

68
Q

in general, forward sway, causing ankle strategy inacts what muscles

A

ALL post leg (plantar flexors and hams), and paraspinals

69
Q

Hip strategy: backward sway inacts what muscles

A

abs, quads

70
Q

forward pert (hip strategy) enacts what muscles

A

hams, paraspinals

71
Q

high velocity pert. use what strategy

A

hip

72
Q

velocity of pert. that causes loss of control

A

stepping

73
Q

lateral pelvic mvmt or mediolateral, when you shift your wt, the leg you are loading the wt on is ADD or ABD

A

load bearing leg is ADD

other leg is ABD

74
Q

antigravity support muscles are provided by ____(mono articulating or biarticulating) muscles

A

mono

75
Q

horizontal stability muscles in hip

A

quads (biarticulate)

76
Q

when training a pt with a new LE prosthetic, its important to teach them to

A

bear wt on new prosthetic side to avoid hip hike/imbalance

77
Q

sensory components of postural control (main contributors)

A

vision
vestibular
somatosensory
touch

78
Q

Postural control depends on 5 important aspects of the INDIVIDUAL

A
COM
BOS
LOS
motor strategies
sensory strategies
79
Q

As we age we lose ___muscle fibers

A

fast twitch

80
Q

postural responses in older adults are ____ and___

A

delayed and weaker

81
Q

what is foam and dome

A

clinical test for sensory integration/balance

82
Q

goal writing strategy (saying)

A

FSMART

functional, specific, measurable, attainable, relevant, time

83
Q

How does the infant’s BOS and COM change through the developmental stages?

A

goes from flat and big to smaller and narrow (belly on floor to feet on floor)

84
Q

COM for a child goes from

A

low to high

85
Q

independent stance for babies comes at what age

A

12 mos

86
Q

what muscles are activated for quiet stance

A

Erector Spinae, Iliopsoas, Glute med, Abs, TFL, Gastroc, Soleus, Tibialis anterior (A E I G G T T S)

87
Q

What factors (intrinsic and extrinsic) affect postural control?

A

stiffness, tone, antigravity muscles contracting body systems, proprioception all are intrinsic examples

floor, environment, shoeware are examples of extrinsic

88
Q

at hip, mediolaterally, what is going on with the muscles in regards to strategies for muscle control

A

hip flexors unload

hip extensors load

89
Q

list muscles in quiet stance

A

AEI GG ST (abs, erectors, iliopsoas, gastroc, gluts, soleus tibialis ant

90
Q

muscles inacted with backward ankle strategy (pushed back)

A

ant tib, quads abs

91
Q

overall, list some deformities that can occur from most of the reflexes if they continued

A

spine abnormalities, contracted vs lengthened imbalances, weak muscles

92
Q

postural asymmetry could lead to

A

scoliosis

93
Q

if the optical righting isn’t working, what could this lead to

A

torticolis or kyphosis or altered perception dt altered vision

94
Q

how could protective extension imbalance (child extending arm when falling to the ground) somehow lead to an issue

A

if they favor one side the other is inhibited

95
Q

optical righting happens at what age

A

2 mos

96
Q

prone to elbows what age

A

2 mos

97
Q

log rolling what age

A

4 mos

98
Q

age of walking

A

14 mos

99
Q

How does sensory input for postural control changes across the lifespan

A

mostly decreases, vision, proprioception, tactile sensation, all decline

100
Q

list some extrinsic reasons that elderly pts fall

A

lighting, stairs, pets, assistive devices, weather.

101
Q

list some intrinsic reasons why elderly pts fall

A

type II fibers decrease, vision, proprioception, age, gender, meds, any psychosocial or physical

102
Q

What types of therapeutic interventions are appropriate for balance problems, based upon risk factors leading to increased fall risk

A
balance training: changing surfaces, obstacles, eyes open eyes closed
MSK - strengthen muscles involved in strategies, and endurance
NM - pertebations
Sensory -proprioceptive drills
Postural - increase anticipatory ability
Cognitive - mental practice
Education on risk factors
Referral if needed (glasses, devices)
103
Q
  1. How would a physical therapist progress a treatment plan based upon cephalo-caudal development and the development of postural control?
A

Gradually changing the COG by changing the base of support. For example, from a large BOS, prone head raising, to a smaller BOS, supported sitting, to changing the COG even more, sitting with movement, to standing supported, standing unsupported, standing and reaching, etc.

104
Q

which reflexes contribute to the dev of postural control

A

ALL
Attitudinal or Postural Reflexes (reflexes that influence the tone of the entire body)
Righting Reactions (reactions that right the body for proper alignment)
Balance and Protective reactions – Reactions that contribute to the maintenance of balance

105
Q

what are some reflexes that contribute to head control early on

A

the righting ones that try to keep vision horizontal (optical righting, labyrinthine)

106
Q

What reflex contributes to prone on elbows

A

body on head

107
Q

body on head righting reflex starts/ends when

A

starts birth ends 5 yrs

108
Q

labyrinthine and optical righting lasts

A

lifetime

109
Q

neck on on body and body onn body start/end when

A

6 mos -5 yrs

110
Q

the ability of a baby to control its head increases with

A

sensory input

111
Q

in regards to fall assessment, what are 3 first things to ask

A

have you fallen, how manytimes, was there a specific cause

112
Q

what are specific goals to focus on for fall intervention/prevention

A

speed (TUG), strength of muscles involved in strategies, education, proprioception

113
Q

with aging, postural sway (inc or dec)

A

increases, their perception or feelings are decreasing

114
Q

most falls occur when

A

walking lifting or carrying, this stuff should be incorprated late in balance training

115
Q

dont forget to include the pts ___ in your plans/goals

A

env (bath mat, rug, dog, grab bars)

116
Q

what 2 righting reflexes should be present at birth

A

lab, optical

117
Q

postural stability

A

COM over BOS = equilibrium

118
Q

plumb line

A

mastoid, ant shoulder, behind hip, ant knee, ant ankle