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PT663 > Postural Control > Flashcards

Postural Control Flashcards

1
Q

Why is postural control important in physical therapy?

A

Postural control is essential for movement and activities of daily living such as standing, walking, and climbing stairs.

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2
Q

How does postural control relate to skilled movements?

A

Good posture and balance are necessary for executing finer skilled movements, such as painting, where core stability is important.

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3
Q

What types of patients do physical therapists work with regarding balance?

A

Physical therapists treat patients with varying levels of balance abilities, from those with extremely poor balance to athletes with excellent balance.

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4
Q

Why is understanding the science of postural control crucial for physical therapists?

A

It allows therapists to apply evidence-based practices, understand the neural basis of balance, and assess and treat balance disorders effectively.

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5
Q

What is the significance of evidence-based practice in physical therapy?

A

Evidence-based practice relies on research findings to inform clinical decision-making and treatment strategies for balance and postural control.

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6
Q

What foundational knowledge do physical therapists need for assessing balance?

A

Therapists need to understand the tests and measures necessary to evaluate balance control and the factors contributing to imbalance.

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7
Q

What are the key components of this part of the lecture on postural control?

A

The basic science of motor control, the biomechanical basis of posture, systems involved in postural control, and principles of assessment and treatment based on the movement system framework.

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8
Q

How does postural control relate to the movement system framework?

A

Postural control is a crucial aspect of the movement system framework that informs assessment and treatment strategies for patients.

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9
Q

What are the two main parts of postural control?

A

Postural orientation and postural stability.

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10
Q

Define postural orientation.

A

The ability to maintain a favorable relationship between different body segments and between the body and the environment.

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11
Q

What is the purpose of postural control?

A

To control the body’s position in space for stability and orientation.

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12
Q

What does postural stability refer to?

A

The ability to control the center of mass in relation to the base of support.

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13
Q

How does postural orientation relate to task performance?

A

Good postural orientation is task-dependent; the alignment of body segments must be appropriate for the specific task being performed.

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14
Q

What is the difference between static and dynamic balance?

A

Static balance refers to maintaining a steady posture, while dynamic balance involves maintaining stability while the center of gravity and base of support are moving.

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15
Q

What is functional balance?

A

The ability to perform daily movement tasks that require balance, involving both static and dynamic balance.

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16
Q

How are postural orientation and postural stability interrelated?

A

Changes in postural orientation can affect postural stability, as alignment influences the control of the center of mass relative to the base of support.

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17
Q

What happens to postural orientation during a task that requires maintaining stability?

A

The focus shifts to maintaining stability, which may alter the postural orientation to achieve that goal.

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18
Q

Describe the impact of a forward bent posture on stability.

A

A forward bent posture shifts the line of gravity anteriorly within the base of support, compromising stability and increasing the risk of falls.

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19
Q

How can postural stability be regained if it is compromised?

A

By changing postural orientation, such as adjusting body segments to bring the center of mass back over the base of support.

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20
Q

Why is it important to consider task requirements when assessing postural control?

A

Task requirements influence both postural orientation and stability, making it crucial for evaluating and developing effective treatment strategies.

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21
Q

What are the key biomechanical constructs related to postural control?

A

Base of support, center of gravity, center of pressure, and stability limits.

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22
Q

Define base of support.

A

The area of the body in contact with the support surface; larger base of support equals more stability.

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23
Q

How does base of support change when moving from sitting to standing?

A

The base of support reduces significantly, leading to potential balance issues.

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24
Q

What is the center of mass?

A

The point at which the total body mass is concentrated, typically around the L2 vertebral level in standing humans.

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25
Q

Differentiate between center of mass and center of gravity.

A

Center of mass is a three-dimensional point in space, while center of gravity is the vertical projection of the center of mass onto a two-dimensional plane (ground).

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26
Q

How does the height of the center of mass affect stability?

A

A higher center of mass reduces stability, while a lower center of mass increases stability due to the moment arm effect.

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27
Q

What is center of pressure?

A

The point of application of the ground reaction force vector, reflecting the net distribution of forces applied to the support surface.

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28
Q

What is the relationship between center of gravity and base of support?

A

When the center of gravity is within the base of support, stability is greater; when it is outside, stability is compromised.

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29
Q

Define stability limits.

A

The boundaries within which the body can maintain stability without changing the base of support.

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30
Q

How do position and velocity of the center of mass influence stability limits?

A

Stability limits are determined by both the position and velocity of the center of mass; if either exceeds certain thresholds, a step may be necessary to maintain balance.

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31
Q

Why might patients with poor balance move slowly?

A

They may slow their movement to minimize center of mass velocity, thereby enhancing stability.

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32
Q

What clinical implication arises from understanding center of mass velocity?

A

Testing and assessing balance should be conducted at different speeds to accurately gauge a patient’s balance abilities.

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33
Q

What model is being used to discuss postural control?

A

The dynamical systems model.

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34
Q

What is the primary goal of the postural control system?

A

To ensure postural orientation and stability.

35
Q

How does the dynamical systems model view the nervous system?

A

As an interactive system that recognizes the importance of other systems contributing to movement control.

36
Q

What are the key components considered in the control of posture and balance?

A

The nervous system, biomechanical system, task, and environment.

37
Q

How is postural control achieved during motor tasks?

A

By controlling the center of pressure through active muscle control during self-initiated movements and unexpected perturbations.

38
Q

What is an example of a self-initiated motor task?

A

A sit-to-stand movement.

39
Q

What defines an unexpected perturbation?

A

An unanticipated event that affects balance, such as a sudden stop of a subway or being pushed.

40
Q

What are the outstanding questions in motor control of posture?

A

How the nervous system controls variables affecting posture and balance, factors influencing control, and systems that enable postural control.

41
Q

What is the purpose of research in understanding postural control?

A

To create a framework for assessing balance and treating postural control issues.

42
Q

How can research findings be utilized in clinical practice?

A

By organizing them into an easily translatable framework for clinicians.

43
Q

What does postural control emerge from?

A

The interaction of the individual within an environment while trying to accomplish a specific task.

44
Q

What three systems contribute to an individual’s control of balance?

A

Motor, sensory, and cognitive systems.

45
Q

What factors affect the motor system in postural control?

A

Musculoskeletal linkages, muscle strength, and muscle synergies.

46
Q

Why is muscle strength important for postural control?

A

Muscles need to contract to maintain the center of pressure over the center of mass

47
Q
A
48
Q

What are the three types of postural tasks?

A

Steady state tasks, reactive tasks, and proactive tasks.

49
Q

What defines a steady state task?

A

A task where the base of support remains unchanged and the control of the center of mass is predictable, such as sitting or standing.

50
Q

What is a reactive task?

A

A task requiring the ability to recover stability following an unexpected perturbation, like slipping on ice while walking.

51
Q

How does the nervous system respond to unexpected perturbations?

A

It activates reactive strategies to prevent falls and restore stability.

52
Q

What distinguishes a proactive task from a reactive task?

A

Proactive tasks involve muscle activation in anticipation of potential destabilizing movements, while reactive tasks respond to unexpected disturbances.

53
Q

What is an example of a proactive strategy?

A

Planting your foot flat on the ground while walking on slippery pavement to prevent a fall.

54
Q

What is the concept of feedback versus feedforward in postural control?

A

Feedforward processes are proactive and rely on anticipation, while feedback processes respond to perturbations.

55
Q

How does feedforward control work in postural tasks?

A

It involves making anticipatory adjustments to prevent postural disturbances before they occur.

56
Q

How does feedback control function?

A

It triggers postural responses based on sensory feedback from unexpected perturbations.

57
Q

What are the two main modes of postural control?

A

Feedback control (reactive) and feedforward control (anticipatory).

58
Q

How is feedforward control studied in scientific literature?

A

Through measurements of EMG muscle activity during tasks that involve sudden movements, such as shoulder flexions.

59
Q

What muscles might be involved in studying feedforward control during shoulder flexion?

A

Deltoid, external oblique, transverse abdominis, and internal oblique.

60
Q

What happens to the center of mass during sudden shoulder flexion?

A

The center of mass moves forward, creating a potential destabilizing moment.

61
Q

What does EMG timing reveal about anticipatory postural control?

A

The transverse abdominis activates before the deltoid during shoulder flexion, indicating the CNS anticipates the movement’s effect on the center of mass.

62
Q

How is feedforward control measured in the clinic?

A

By observing patients performing voluntary actions like sitting, standing, or reaching, and assessing their speed and efficiency.

63
Q

What characterizes feedback strategies in postural control?

A

They involve maintaining stability in response to external perturbations while in a steady state.

64
Q

How is feedback control studied in research?

A

By applying unexpected perturbations to a person standing on a movable surface and observing muscle activation patterns to regain balance.

65
Q

What is the order of muscle activation in response to an external perturbation?

A

First, the gastrocnemius, then the hamstrings, followed by the paraspinal muscles.

66
Q

What is an “ankle synergy”?

A

A coordinated muscle response activated in sequence to regain balance after a perturbation.

67
Q

How do environmental constraints affect postural control?

A

Factors like surface type (concrete vs. uneven), lighting, and clutter can influence a patient’s balance and movement.

68
Q

Why might a patient’s progress in therapy not translate to home?

A

Differences in the home environment, such as clutter, can affect their ability to maintain balance outside the clinic.

69
Q

What role do sensory systems play in postural control?

A

They provide crucial information about body position and movement, enabling effective postural adjustments.

70
Q

How does closing one’s eyes affect balance?

A

It reduces input from the visual system, increasing postural sway and potentially destabilizing balance.

71
Q

What cognitive factors influence postural control?

A

Motivation, fear of falling, and the ability to multitask can significantly affect balance performance.

72
Q

What is the BESTest?

A

The Balance Evaluation Systems Test assesses various aspects of balance and postural control, helping identify specific deficits in patients.

73
Q

What is the movement system framework for assessment?

A

It includes the activity, environment, and factors such as motion, force, energy, and motor control to evaluate postural control.

74
Q

What is the first principle of balance training?

A

Enhance the individual’s capacity regarding force, range of motion, and energy based on a movement system assessment.

75
Q

How can you improve motor control in balance training?

A

Through high-intensity challenging practice that focuses on the specific task needing improvement.

76
Q

Why is challenge crucial in balance training?

A

Challenge is essential because it pushes patients to work at their stability limits, making tasks feel challenging and promoting improvement.

77
Q

What should patients feel during balance training?

A

Patients should feel a sense of instability during treatment, indicating that they are being adequately challenged.

78
Q

How should therapists ensure patient safety while challenging their balance?

A

Therapists should guard patients closely and provide support, ensuring they do not fall while facing challenges.

79
Q

How can environments be modified to increase challenge in balance training?

A

Change environments frequently, use different surfaces, and adjust lighting or noise levels to enhance the challenge.

80
Q

What role do cognitive loads play in balance training?

A

Adding cognitive tasks, such as walking while talking or solving puzzles, increases the challenge and helps improve balance.

81
Q

Why is varying sensory input important in balance training?

A

Modifying sensory input, such as reducing vision or using different surfaces, creates additional challenges that enhance postural control.

82
Q

How does increasing speed affect balance training?

A

Adding speed to tasks is an effective way to challenge balance and encourage stability limits.

83
Q

What is a key takeaway regarding challenge in patient treatment?

A

If a patient is not feeling challenged or unstable during treatment, the therapist is not effectively promoting improvement.

PT663 (22 decks)

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