Pos3

Question 1

Toddler walking(6)

Answer 1

• wide base of support
• excessive hip and knee flexion
• anterior tilt of pelvis
• ankle joint pronation - foot flat
• toe curling
• upper limb abduction an elbow flexion

Question 2

3 components to gait development (3)

Answer 2

• neurophysiological
• motor learning
• biomechanical

Question 3

Neurophysiological component of gait development (7)

Answer 3

myelination of cns
Increased vascularity to brain 
Primitive reflexes
-neonatal placing response
-positive supporting reflex
-spontaneous stepping reflex 
Eg blind child centre of gravity in base of support

Question 4

Motor learning component of gait development (6)

Answer 4

Stored sets of motor demands innate an learned
-closed and open loop therapies
Closed
-peripheral and sensorimotor feedback
Open
-central control and monitoring mechanism

Question 5

Normal developmental milestones (5)

Answer 5

Independent standing
-9.5 months (6-12months) 
Crusing
Independent walking
-13 months (10-22months)

Question 6

Biomechanical component of gait development (7)

Answer 6

Normal anatomical alignment for age
Weight bearing pattern 
Ground reaction force
Effect on growing
-centre of gravity lowers
-limb length increases
-limb stability increases

Question 7

Tibial torsion with age (5)

Answer 7

• a pattern of gradually increasing external rotation with age
• at 1 year = 4 degrees
• by 1 1/2 years = 6 degrees
• by 7 years = 10 degrees
• mean adult transmalleolar axis 10degrees

Question 8

Femoral/tibial alignment in kids (8)

Answer 8

Median alignment 1 year = neutral
-distribution shows both varus and valgus
Mean time for transition from
-varus to valgus = 22 months
Valgus maximal at 3 years
-salenius et al 1975
Valgus then decreases till about 6 years

Knee varum at birth > adult valgum = 7 degrees

Question 9

Osteogenesis imperfecta (4)

Answer 9

• brittle bone diseaae
• genetic bone disorder characterise by bones that break easily
• composition of collagen bone is not correct
• 3 types

Question 10

Osteogenesis imperfecta type I (8)

Answer 10

• mildest form
• hypermobility common
• spinal issues > regular monitoring beeded
• possible hearing problems (early 20s)
• possibly dentinogenesis imperfecta > brittle teeth and crumble
• adults generally appear physically in good health
• children may be clumsy >hypermobility > increased chance of falling/tripping
• more frequent fractures with age

Question 11

Osteogenesis imperfecta type 3 (6)

Answer 11

• severe form
• fractures may occur in women > baby often born with fractures
• short height, bent/short legs and arms
• respiratory problems common as rib cage may not be properly developed
• bending of long bones may be an issue
• spinal curvature to be monitored

Question 12

Type 2 osteogenesis imperfecta (2)

Answer 12

• more severe

- babies do not normally survive beyond first few months