Exam 2 Flashcards
1
Q
distributed vs massed has to do with
A
intensity
2
Q
Blocked vs random has to do with
A
sequence
3
Q
explain constant vs variable
A
has to do with variability. consistant performance of the same task, vs varying char of the task
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
5
Q
KR vs KP
A
knowledge of results vs knowledge of performance (KR better)
6
Q
Serial, continuous and discrete
A
serial - multiple discrete tasks in a row
continuous-no beginning or end
discrete- has beginning and end
7
Q
4 main factors contributing to postural control
A
MSK sx
neuro sx - sensation
Neuromusular sx - control and coordination
enviroment
8
Q
postural control develops cephalo caudel, meaning
A
head to toe
9
Q
reflexes that effect the tone of the entire body
A
attitudinal/postural
10
Q
3 main types of reflexes
A
attitudinal/postural
righting
balance/protective
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)
12
Q
List the 3 attitudinal/postural reflexes
A
asymmetrical tonic neck reflex
symmetrical tonic neck reflex
tonic labyrinthine
13
Q
explain asymmetrical tonic neck reflex
A
fencer pose
14
Q
asymmetrical tonic age range
A
birth - 6 mos
15
Q
explain symmetrical tonic neck reflex
A
whatever neck does, UE follow, and LE do opp
16
Q
explain tonic labyrinthine reflex
A
when placed prone, babies will flex their bodies inward
when placed supine, they will extend outward
17
Q
age range of tonic labyrinthine reflex
A
up to 6 mos
18
Q
5 righting rxns
A
labyrinthine righting optical righting body on head righting body on body righting neck on body righting
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)
20
Q
what is optical righting
A
same as labyrinthine, but without loss of vision
21
Q
how long do we have labyrinthine and optical righting
A
over the lifespan
22
Q
what is body on head righting
A
when the body is placed prone, the head will want to be upright
23
Q
how long do we have body on head righting
A
up to 5 yrs
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
25
what is neck on body righting
as you rotate their head, the body will follow suit
26
___________ are innate reactions that align the body for proper alignment
righting reactions
27
List the balance/protective reactions
equilibrium (tilting)
| Postural fixation
28
List the time frames of when we start to see balance/protective reactions for prone, supine, sitting, quadruped, standing
```
Months
prone 6
supine 7-8
sitting 7-8
quad 9-2
wallking 12-21
```
29
protective reactions occur when
COG is outside of the normal limits or when there is a LOS
30
which balance/prot rxn is when the baby curves the trunk and uses extremities to try and correct/straighten the tilting
equilibrium
31
which balance/protection rxn occurs as baby is reaching, displacing COG and the baby curves the trunk towards the external force
postural fixation
32
as the dev of reflexes become integrated they reinforce what
muscle tone
33
typical age of starting to crawl
8-10 mos
34
typical age of sitting upright
6-7 mos
35
typical age of leaning against something as they stand
9-10 mos
36
typical age of independent stance
12 mos
37
what is a key component to dx dev delay in babies, what are we looking at very early
head control
38
normal posture control depends on
COM
| BOS
39
reflex hierarchial theory states that reflexes are all____ to balance
reactive
40
according to hierarchial theory, list the tiers or levels of what babies achieve in regards to balance/posture
1st - attitudinal reflexes
2nd -righting reflexes
3rd - balance/protective reflexes
then postural control
41
what is systems theory
states that anticipatory responses act when we are aware of the need to change our position/posture. anticipatory responses develop parallel to reactive
42
4 stages of motor control
```
initial mobility
stability
controlled mobility
skill
(I S C S)
```
43
explain initial mobility stage
AROM is required for posture (ex: baby prone on elbows)
44
explain stability stage
baby can hold the posture (maintains it)
45
explain controlled mobility stage
baby can control or shift wt
46
explain skill stage
baby can reach out in front
47
prominent sensory system used at birth-few days (newborn)
visual
48
prominent sensory sx used around 1 yr
somatosensory (proprio)
49
prominent sensory sx used at 7 yrs
vestibular
50
1st postural reflex developed
postural support reflex (you hold a baby upright over the floor and have their feet touch, they will try to support their wt)
51
explain landau reflex
prone baby, they will kind of stiffen up and extend
52
components to include when looking at the INDIVIDUAL in a posture/balance assessment
body structure
body function
cognition
53
babies begin to extend neck fully at what age
2 mos
54
motor control relates to ___ and ____ function
brain and spinal cord
55
motor performance is influenced by what body systems
all
56
what were the 4 components of motor learning
retention
generalizability
quality of movement
resistance to contextual change
57
postural control is the ability to maintain equilibrium both ___ and ___
statically and dynamically
58
what is posture orientation
maintaining appropriate relationship btwn body segments
59
how to measure static control
how controlled are they for a certain amt of TIME
60
what is meant by limits of stability
your movement is contigent on your BOS, if your BOS is small and narrow, your movement will be too
61
how to improve limits of stability
make your BOS larger
62
4 strategies of postural control
sensory
motor (the mvmt)
sensory motor (the coordination involved)
attentional (degree of attention required)
63
3 factors contributing to quiet stance
muscle stiffness
tone
antigravity contractions
64
3 main antigravity synergy sxs
abs and erectors
hip flexors and gluts
plantar/dorsiflexors
65
3 ways to objectively measure posture control
EM (electromyography)
kinematic analysis
kinetic analysis
66
which way to measure postural control involves videos with markers on the pt to check symmetry, includes forces velocity
kinematic
67
which way to measure postural control involves use of internal and external forces with plates and gages
kinetic
68
in general, forward sway, causing ankle strategy inacts what muscles
ALL post leg (plantar flexors and hams), and paraspinals
69
Hip strategy: backward sway inacts what muscles
abs, quads
70
forward pert (hip strategy) enacts what muscles
hams, paraspinals
71
high velocity pert. use what strategy
hip
72
velocity of pert. that causes loss of control
stepping
73
lateral pelvic mvmt or mediolateral, when you shift your wt, the leg you are loading the wt on is ADD or ABD
load bearing leg is ADD
| other leg is ABD
74
antigravity support muscles are provided by ____(mono articulating or biarticulating) muscles
mono
75
horizontal stability muscles in hip
quads (biarticulate)
76
when training a pt with a new LE prosthetic, its important to teach them to
bear wt on new prosthetic side to avoid hip hike/imbalance
77
sensory components of postural control (main contributors)
vision
vestibular
somatosensory
touch
78
Postural control depends on 5 important aspects of the INDIVIDUAL
```
COM
BOS
LOS
motor strategies
sensory strategies
```
79
As we age we lose ___muscle fibers
fast twitch
80
postural responses in older adults are ____ and___
delayed and weaker
81
what is foam and dome
clinical test for sensory integration/balance
82
goal writing strategy (saying)
FSMART
| functional, specific, measurable, attainable, relevant, time
83
How does the infant’s BOS and COM change through the developmental stages?
goes from flat and big to smaller and narrow (belly on floor to feet on floor)
84
COM for a child goes from
low to high
85
independent stance for babies comes at what age
12 mos
86
what muscles are activated for quiet stance
Erector Spinae, Iliopsoas, Glute med, Abs, TFL, Gastroc, Soleus, Tibialis anterior (A E I G G T T S)
87
What factors (intrinsic and extrinsic) affect postural control?
stiffness, tone, antigravity muscles contracting body systems, proprioception all are intrinsic examples
floor, environment, shoeware are examples of extrinsic
88
at hip, mediolaterally, what is going on with the muscles in regards to strategies for muscle control
hip flexors unload
| hip extensors load
89
list muscles in quiet stance
AEI GG ST (abs, erectors, iliopsoas, gastroc, gluts, soleus tibialis ant
90
muscles inacted with backward ankle strategy (pushed back)
ant tib, quads abs
91
overall, list some deformities that can occur from most of the reflexes if they continued
spine abnormalities, contracted vs lengthened imbalances, weak muscles
92
postural asymmetry could lead to
scoliosis
93
if the optical righting isn't working, what could this lead to
torticolis or kyphosis or altered perception dt altered vision
94
how could protective extension imbalance (child extending arm when falling to the ground) somehow lead to an issue
if they favor one side the other is inhibited
95
optical righting happens at what age
2 mos
96
prone to elbows what age
2 mos
97
log rolling what age
4 mos
98
age of walking
14 mos
99
How does sensory input for postural control changes across the lifespan
mostly decreases, vision, proprioception, tactile sensation, all decline
100
list some extrinsic reasons that elderly pts fall
lighting, stairs, pets, assistive devices, weather.
101
list some intrinsic reasons why elderly pts fall
type II fibers decrease, vision, proprioception, age, gender, meds, any psychosocial or physical
102
What types of therapeutic interventions are appropriate for balance problems, based upon risk factors leading to increased fall risk
```
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
15. How would a physical therapist progress a treatment plan based upon cephalo-caudal development and the development of postural control?
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
which reflexes contribute to the dev of postural control
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
what are some reflexes that contribute to head control early on
the righting ones that try to keep vision horizontal (optical righting, labyrinthine)
106
What reflex contributes to prone on elbows
body on head
107
body on head righting reflex starts/ends when
starts birth ends 5 yrs
108
labyrinthine and optical righting lasts
lifetime
109
neck on on body and body onn body start/end when
6 mos -5 yrs
110
the ability of a baby to control its head increases with
sensory input
111
in regards to fall assessment, what are 3 first things to ask
have you fallen, how manytimes, was there a specific cause
112
what are specific goals to focus on for fall intervention/prevention
speed (TUG), strength of muscles involved in strategies, education, proprioception
113
with aging, postural sway (inc or dec)
increases, their perception or feelings are decreasing
114
most falls occur when
walking lifting or carrying, this stuff should be incorprated late in balance training
115
dont forget to include the pts ___ in your plans/goals
env (bath mat, rug, dog, grab bars)
116
what 2 righting reflexes should be present at birth
lab, optical
117
postural stability
COM over BOS = equilibrium
118
plumb line
mastoid, ant shoulder, behind hip, ant knee, ant ankle
