Proprioception

Question 1

Define proprioception

Answer 1

Perception of position and mvmt of one’s own limbs and body w/o using vision; other half of somatosensation

Question 2

Names two pathways proprioception comes from

Answer 2

Spinocerebellar tract

Dorsal column- medial lemniscus

Question 3

Describe SCT

Answer 3

-Muscle spindles and tendon organs
-Golgi tendon organs= 1b (stretch)
-Muscle spindles= 1a
(change in length)

Question 4

Describe DCML

Answer 4

-Joint stretch receptor do dorsal column

Question 5

Describe methods of stimulus generation

Answer 5

• stretch= move parts of body into position
• Compression= WB +/- proximal pressure down towards support surface
• Approximation= child not WB but physio pushing back in toward body

Question 6

Describe Senses

Answer 6

Basic registration
[-] low tactile registration= doesn’t detect joint position or mvmt
[+] hypersensitivity= very alert to stimuli, pays too much attention to mvmt

Question 7

Describe Engages

Answer 7

[-] avoids/dislikes= decreased movement particularly involving compression, prefers quiet activities
[+] overseeks= seeks out approximation or compression (strong hugs), excessive movement (bouncing, pulling, pushing)

Question 8

Describe Nominated

Answer 8

Interpretation of spatial and temporal aspects of stim and gives meaning to sensory input–> how fast, weight, where

Question 9

Describe symmetry

Answer 9

[-] extinction, hemiparesis, hemiplegia= inability to register or perceive prop stim on one side more than other
[+] localised hypersensitivity= parts of body more sensitive than others

Question 10

Describes adjusts

Answer 10

[-] poor/delayed postural adjustments= look uncomfortable. Child doesn’t adjust body after passive movement
[+] excessive position adjustment= overcompensates with excessive movement, rigid body control

Rhombergs

Question 11

Describe tunes

Answer 11

[-] under responds to stim= poor attention to prop, does not correctly predict or perceive aspects like weight of object
[+] over responds to stim= over responds due to absence/poor perception, child unable to calibrate feedback from prop to adjust finger mvmt

Question 12

Describe integrates

Answer 12

[-] under responds= unable to combine prop perception with other senses to grade fine motor tasks eg presses too har with pencil

[+] over responds= child distracted by poor/lack of feedback, fidgety, wriggly as want together more stim

Question 13

Describe override

Answer 13

Instances of sensory conflict
[-] unresolved sensory conflict= unable to maintain mvmt, balance and posture when prop does not match other senses
[+] Detects sensory conflict appropriately= can cope with mvmt, perturbation

Question 14

Describe normal performance

Answer 14

[-] delayed/under responding= accidental injury, poor control, poor awareness for ages
-look awkward, more trips and falls

[+] over responding= too safe, fearful, avoidance, low experience
-hyper-sensitive prop so too sensitive to awkward positions, fearful of mvmt especially ext facil

Question 15

Automatic posture adjustment

Answer 15

Ability: Adjust posture + demo positional awareness. Can transition with mvmt and engage with environment
- Proprioceptive info from muscle spindles, golgi, joint receptors + cutaneous  postural adjustment

Typical performance
- Emerges at 1mo = response traction, primary standing, ATNR, STNR
- 8mo = automatic postural adjustment of trunk/limbs when moving between positions
- 12mo = child moves indep, crawling, pull to stand
Atypical Performance
- no/poor response, inability to transition
- Unawareness or lack of initiative to correct awkward position

Question 16

Joint position sense (hand)

Answer 16

Ability: copy wrist, hand, finger positions using visual or proprio input – motor planning component needed
Typical performance
- 4y = whole hand + wrist copy, use visual cueing
- 5y = whole hand copy, use prop cueing
- 6y = copy thumb to single fingers, mid-range and more complex patterns, 4 NSMDA patterns
- 7y = copy 2 finger positions

Question 17

Joint position sens (limb)

Answer 17

Ability: copy forearm, elbow, shoulder positions using visual cueing or proprio input – motor planning component required
Typical performance:
- 2.5-3y = imitation of gesture (2D position)
- 3-4y = can copy 3D positions; 4y = can copy asymmetric 3D mvmts of arms
- 5y = crossing midline and be able to copy midrange positions

Question 18

Static Hold- Arm extension test

Answer 18

Ability: maintain stsatic hold in standing with arm flexed to 90’
- Child stand on firm surface  stretch arms straight out in front of body with palms facing down  maintain for 10-20s

Typical performance = child can maintain position for 10-20s w/good control using an ankle strategy + no loss of arm position
Atypical = loss of position, inability to maintain arm position, involuntary movement