Gait and Posture Flashcards

1
Q

Factors that impact movement

A
  • Individual
  • Task/action
  • Environment
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2
Q

Center of Mass (COM)

A

Point in space where there is equal distribution of mass

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3
Q

Center of Pressure (COP)

A

The center of distribution of total force applied to the supporting surface

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4
Q

Postural Control

A

Controlling the body’s position in space

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5
Q

Postural Orientation

A

Ability to maintain:

  • Appropriate relationship between body segments AND
  • Appropriate relationship between the body and environment for a task
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6
Q

Postural Stability

A

Ability to control COM in relationship to the base of support (BOS)

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7
Q

Where does neural control of posture take place?

A
  • Postural stability is not organized at the spinal level

- Controlled at higher centers, such as the brainstem and cerebellum

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8
Q

Factors impacting motor control of the quiet stance

A
  • Alignment
  • Muscle tone
  • Postural tone
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9
Q

Alignment

A

Putting the body segments in a place that minimizes the effects of gravity

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10
Q

Muscle tone

A

Keeps the body from collapsing under the force of gravity

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11
Q

Postural tone

A
  • An extension of muscle tone
  • Focus is on the muscles designed to provide posture
  • Antigravity muscle activation during quiet stance
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12
Q

Muscles involved in postural control

A
  • Erector spinae
  • Iliopsoas
  • Abdominals
  • Gluteus medius
  • Tensor fascia latae
  • Biceps femoris
  • Quads (?)
  • Calves (gastroc/soleus)
  • Tibialis anterior
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13
Q

Perturbation

A

Displacement of the supporting surface

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14
Q

Strategies to deal with pertubations

A
  • Ankle
  • Hip
  • Step
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15
Q

Ankle Strategy

A
  • Used when perturbation is slow and low amplitude

- Head is in phase with the hips

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16
Q

Muscles activated for ankle strategy in a forward sway

A

1) Gastrocnemius
2) Hamstrings
3) Paraspinals (erectors)

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17
Q

Muscles activated for ankle strategy in a backward sway

A

1) Tibialis anterior
2) Quads
3) Abdominals

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18
Q

Hip Strategy

A
  • Restores balance in response to larger and faster perturbations or when BOS is restricted
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19
Q

Muscles activated for hip strategy in a forward sway

A

1) Quads

2) Abdominals

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20
Q

Muscles activated for hip strategy in a backward sway

A

1) Hamstrings

2) Paraspinals (erectors)

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21
Q

Stepping Strategy

A
  • Used when either the ankle or hip strategy is insufficient

- Alters the BOS

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22
Q

Lifespan Posture

A

Emergence of skills requires development of postural activity to support the primary movement

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23
Q

Types of Reflexes

A
  • Primitive
  • Postural
  • Locomotor
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24
Q

Primitive Reflexes

A

Survival and protection

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25
Q

Postural Reflexes

A

Reaction to gravity and changes in the equilibrium

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26
Q

Locomotor Reflexes

A

Resemble later voluntary locomotion movements

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27
Q

Postural Reflexes List

A
  • Head and body righting
  • Labyrinthine righting
  • Pull-up
  • Parachute
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28
Q

Head and Body Righting Reflex

A

-

- Starting Date: ~ 2 months

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29
Q

Labyrinthine Righting Reflex

A

-

- Starting Date: ~ 2 months

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30
Q

Pull-up Reflex

A

-

- Starting Date: ~ 3 months

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31
Q

Parachute Reflex

A

-

- Starting Date: ~ 4 months

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32
Q

Sequence of postural control development

A

Postural control development follows a cephalocaudal (head to foot) and proximodistal (midline to extremity) sequence

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33
Q

What causes lack of head control in infants?

A
  • Lack of strength

- Lack of organized muscle activity

34
Q

-

A

-

35
Q

-

A

-

36
Q

Cognitive Systems in Postural Development

A
  • Postural demands of younger children tax attentional resources more than for older children
  • This may affect both postural and cognitive performance in dual-task situations
37
Q

Why is balance so important in older populations?

A

Falls are a leading cause of injury death in older adults

38
Q

Fall (clinical definition)

A

A situation in which the older adult falls to the ground or is found lying on the ground

39
Q

Fall (research definition)

A

Movement of the center of mass outside the limits of the base of support

40
Q

Spontaneous sway during quiet stance

A
  • Acts as an indicator for assessing balance function
  • Individuals at both ends of the age spectrum (6-14 & 58-80) have the most difficulty with sway during quiet standing
41
Q

Sway Amplitude

A

The amount of displacement occurring during the quiet stance

42
Q

Sway Velocity

A

The speed of displacement occurring during the quiet stance

43
Q

Impact of Sway Amplitude vs Sway Velocity in Older Adults

A
  • Sway velocity is significantly greater than sway amplitude for older adults with previous falls and those older than 80
  • Measure the velocity of sway in a certain population may be a more sensitive measure of balance problems than amplitude of sway
44
Q

Factors Impacting Instability in Association with Voluntary Movement

A
  • Delayed onset of muscle responses
  • Inability to activate postural muscles ahead of prime movers
  • Inability to shut off muscle activity once activity completed
45
Q

How to changes in the sensory systems contribute to declining stability as people age?

A

Vestibular System
- Peripheral organ and nuclear degeneration
Deep Tendon Reflexes/Postural Muscle Strength
- Reflexes are reduced
- Postural muscles get weaker

46
Q

Sensory Depravation and Sway

A

-

47
Q

Positional relationship of the COM and BOS during gait

A

The COM must be projected outside the BOS to generate forward progression

48
Q

Gait Analysis Considerations

A
  • Human gait is the most common of all human movements
  • Clinical investigators tend to look at output measures (stride length, cadence, etc)
  • Neurological researchers focus on EMG
  • Biomechanists analyze kinematics, reaction forces, moments of force, powers, energies, etc
49
Q

Variables that describe the CAUSE of the gait pattern

A
  • EMG
  • Moments of force
  • Power
50
Q

Variables that describe the EFFECT of the gait pattern

A
  • Kinematics
  • Momentum
  • Stride length
  • Cadence
  • Reaction forces
51
Q

Phases of the Gait Cycle

A
  • Stance

- Swing

52
Q

Components of the Stance Phase

A
  • Initial contact (heel strike)
  • Loading response (foot flat)
  • Midstance
  • Terminal stance (heel off)
  • Preswing (toe off)
53
Q

Components of the Swing Phase

A
  • Initial swing
  • Midswing
  • Terminal swing
54
Q

Relative Duration of Each Phase

A
  • Stance Phase –> 60%

- Swing Phase –> 40%

55
Q

Double vs Single Support

A
  • Initial contact (DOUBLE)
  • Loading response (SINGLE)
  • Midstance (SINGLE)
  • Terminal stance (SINGLE)
  • Preswing (DOUBLE)
  • Initial swing (SINGLE)
  • Midswing (SINGLE)
  • Terminal swing (SINGLE)
56
Q

When does push-off occur?

A

Terminal stance –> Preswing

57
Q

Velocity

A

Distance traveled/unit of time

58
Q

Step Length

A

Distance b/t heel of one foot and heel of the opposite foot

59
Q

Step Width

A

Distance b/t center of heel on one foot and the other foot

60
Q

Step Frequency

A
  • AKA cadence

- Number of steps/unit of time

61
Q

Stride Length

A

Distance b/t heel of one foot and heel mark of same foot on next successive step

62
Q

Relationship between stride length and cadence

A

Stride length and cadence are dependent on each other

63
Q

Net Extensor Moment During Stance Phase

A

Various combinations of the extensor muscles can be used to prevent collapse

64
Q

Balance during gait

A
  • The body is in a continuous state of imbalance

- HAT (head, arms, trunk) need to be controlled

65
Q

Walking Speed and Gait

A
  • Speed affects COM displacement

- Slow speeds increase COM ML (medial-lateral?) deviation in healthy young adults

66
Q

What is the goal of the swing phase?

A

Reposition the limb

67
Q

What happens during swing phase?

A
  • Hip flexion starts the swing
  • Momentum sustains the swing once initiated
  • Knee motions are constrained during swing
  • Dorsiflexion occurs to prepare for heel contact
  • Less variable than stance control
68
Q

Cerebellum and Gait

A
  • Regulation of the stepping pattern based on sensory information
  • Spinocerebellar tracts: dorsal (muscle sensory afferents) and ventral (spinal motor neurons of CPG) are active
69
Q

Role of cortical areas of the brain

A

“Perception and action” pathways

70
Q

Contributions to Emergence of Locomotion

A
  • Limited locomotor pattern generator at birth
  • Optic flow modulations for head control at birth
  • Modulation of stance at 5-6 months
  • Voluntary control
  • Motivation increases at onset of creeping
71
Q

Sequence of Rudimentary Locomotor Abilities

A
  • Crawling
  • Creeping
  • Walking
72
Q

Crawling

A

Body drag (6-8 months)

73
Q

Creeping

A

Abdomen clears the ground (8-10 months)

74
Q

Walking

A
With support (9-10 months)
Alone (well) (12-14 months)
Backward (14-18 months)
Stairs (up and down) (2-4 years)
Perfected (5 years)
75
Q

Change in arm position while walking over time

A
  • Base of support narrows
  • Foot contact changes (flat-foot and toes out)
  • Foot angle changes (plantar to dorsi)
  • Double knee-lock variation is acquired
76
Q

Gait in the 1st year

A
  • High step frequency
  • Absence of reciprocal arm swinging between upper and lower limbs, flexed knee in stance
  • Increased hip flexion, pelvic tilt and hip abduction, relative foot drop in swing
  • Plantar flexion during foot strike
77
Q

Gait at 2 years

A
  • Reciprocal arm swing in 75% of children
  • Pelvic tilt, abduction, and ER of hip decreased
  • Ankle dorsiflexion increases
78
Q

Gait after 2 years

A

Push-off begins at the end of stance

79
Q

Gait during years 2-7

A

Muscle amplitudes and durations reduce, becoming similar to adults

80
Q

Gait after 7 years

A

Walking very similar to adults

81
Q

Normal gait in older adults

A

No defined standards to conclude “normal” gait in older adults

82
Q

Changes in gait for older adults

A
  • 10-20% reduction in gait velocity and stride length
  • Increased stance width
  • Increased time spent in double support phase
  • Bent posture