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Lifespan > Posture, Balance, and Gait Changes > Flashcards

Posture, Balance, and Gait Changes Flashcards

1
Q

Reactive postural control

A

Governs unexpected movements of COM within or outside BOS

Perturbations

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2
Q

Anticipatory postural control

A

Postural adjustments made before a movement

Tossing a ball

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3
Q

Adaptive postural control

A

Modification of a motor response due to a change in environmental conditions or task demands

Incline

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4
Q

Younger input from…

A

Visual input birth-3

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5
Q

Adult input

A

Somatosensory

If impaired, vestibular system kicks in

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6
Q

Eye-head stabilization

A

Eyes and labyrinths (establish difference btwn egocentric and exocentric motion)

Provide orientation of head in space

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7
Q

Egocentric motion

A

Body moves

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8
Q

Exocentric motion

A

Environment moves

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9
Q

MSK system

A

Regulated by viscoelastic properties of mm, GTO, and DESCENDING motor control

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10
Q

Motor coordination

A

Ability to coordinate mm activity to control performance

Requires appropriate mm tone and anti-gravity strength

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11
Q

Ankle strategy

A

Distal to proximal activation for ant/post stability

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12
Q

Hip strategy

A

Proximal to distal activation for ant/post stabilization

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13
Q

Step strategy

A

All planes

If ankle and hip strategy aren’t enough to re-establish COM within BOS

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14
Q

Predictive central set

A

Postural readiness

3 purposes for anticipatory postural adjustments

  1. Keep postural disturbance to a minimum
  2. Prepare for movement
  3. Assist in development of force or velocity
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15
Q

Righting rxns

A

Orienting head with horizon

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16
Q

Equilibrium rxns

A

Balancing over a point

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17
Q

Nashner Model of Postural Control and Stance

A

Less BOS? More use of hip strategy

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18
Q

Eyes open v eyes closed balance testing in children

A

Vision should not be occluded during first three years due to relying on this input

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19
Q

Fxl reach test

A

Self-perturbed balance and fall risk

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20
Q

Clinical test of sensory integration and balance

A

Foam and dome

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21
Q

Posture and movement changes with age

A

Older adults more variable

Floor to stand more asymmetrical

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22
Q

Posture and balance decline because…

A 
Change in static posture
Loss of flexibility, mm strength, mm tone
Vestibular impairments
Sensory input and integration
Visual changes
Medications and poly-meds

***Many changes due to inactivity and lack of practice

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23
Q

Postural changes with age

A

Increased kyphosis

24
Q

Loss of flexibility and decreased postural rxn leads to…

A

Less organized motor patterns

Diminished motor coordination

25
Q

When to use hip strategy

A

Unstable surface
Smaller BOS
Fast moving environment

26
Q

Visual changes with age

A

Less ability to pick up contours and depth cues

27
Q

Vestibular changes with age

A

Loss of hair cells that sense direction of endolymph in semicircular canals

28
Q

Vestibular nerve (VIII) changes with age

A

Reduction in number of fibers

29
Q

Vibratory sense changes with age

A

Declines in LE

30
Q

Tripping over your own feet

A

While ankle and hip were most important, there are studies showing that stepping strategies are more important in recovering balance

Training stepping pattern is more important

Older adults tend to cross-over or collide limbs when utilizing stepping strategies

31
Q

Anticipatory postural adjustments stabilize…

A

PRIOR to voluntary movement

32
Q

Rxn time in adults

A

Negatively affected

33
Q

Longer onset latencies in postural mm…

A

LE > UE

34
Q

Torque generating capacity

A

Decreases with age

Example: hip ABD

35
Q

Static postural control

A

Ensures stability by maintaining COM within BOS

36
Q

Independent ambulation by…

A

11.5 mos (50% of infants)

37
Q

Critical variable in development of independent ambulation

A

Extensor mm strength

38
Q

Initial gait pattern

A 
Wide BOS
Arms in high guard px
Short swing phase
Lack of heel strike and push-off
ER of hips
39
Q

2-3 years old and ambulation patterns

A

Reciprocal arm swing

Heels strike

40
Q

3-4 years of age and ambulation

A

Narrowing of BOS

Increased time in single limb stance

41
Q

Children ambulation

A

Mature gait pattern kinematics by 4 years

Consistent heel strike and knee flexion in early stance

42
Q

7 years old and ambulation

A

COM at L3
Adult kinematic pattern more refined

May see further refinement of spatial and temporal aspects of gait up to 15 years of age

43
Q

4-7 years ambulation

A

You can pick out normal adult gait cycle

44
Q

Key parameters that show change as gait matures to an adult level (4)

A
  1. SLS duration increases with age and maturation
  2. Walking velocity increases with age and limb length
  3. Cadence decreases with age and limb length
  4. Step length increases with age and limb length
45
Q

Normal aging gait changes

A 
Decreased gait velocity
Decreased stride length
Decreased peak knee extension ROM
Decreases knee flexion in swing
Slightly increases ankle dorsiflexion
Decreased ankle PF power
46
Q

Decreased strength and ambulation

A

Increased pelvic tilt (weak abs)
Decreased vertical displacement of body during gait
Decreased gait velocity
Decreased cadence (decreased DF strength)

47
Q

Decreased balance and ambulation

A

Increased BOS
Decreased gait velocity
Increased time in double limb support
Increased use of visual scanning

48
Q

Fall

A

Unexpected event in which an individual comes to rest on the ground, floor, or lower level

49
Q

Older adult fallers gait characteristics

A

Comparison to NON-FALLERS

Decreased stride length
Decreased walking speed and cadence, especially with dual task
Increased double support time, especially with dual task
Conservative approach when negotiating an obstacle (smaller steps)
Mediolateral instability
Greater stride freq across various gait speeds
Inability to maintain peak gait speed
Increased stride to stride variability

50
Q

Sometimes adults have higher gait speed. Why?

A

They don’t like walking and want to get it over with
Decreased time on single limb
Use momentum so they don’t utilize as much energy

51
Q

Mediolateral instability

A

More predictive of falls

52
Q

Factors contributing to falls in older adults (9)

A

Difficulty corralling COM when perturbed
Greater mediolateral instability
Difficulty modulating step length to avoid obstacles
Decreased speed
Decreased step length
Slower rate of ankle torque development in trip response
Increased difficulty in performing another task while walking
Decreased hip ABD torque generating capacity
Decreased trunk axial rotation

53
Q

Fall Prevention Intervention Strategies (5)

A 
Reduce risk factors
Multifactorial fall risk assessment
PA and balance training
Higher risk? Home Hazard Assessment
Low heel and resistant-soled shoes should be worn inside and outside the home
54
Q

Fall Risk Factors

A 
Mm weakness
History of falls
Gait deficit
Balance deficit
Use of assistive device
Visual deficits
Neurological deficits
Arthritis
Impaired ADL's
Depression
Cognitive impairment
Age > 80 years
Medication
Cardiovascular deficits
55
Q

Therapeutic exercise + balance training =

A

Increased…

Balance
LE strength
Safety
Physical and functional capacity
Ability to perform IADL's and ADL's

Lifespan (18 decks)

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