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PHTH 450 > proprioception > Flashcards

proprioception Flashcards

1
Q

what is balance

A

the proces by which the body’s COG is controlled with respect to the base of support, whether that base is stationnary or moving

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2
Q

what are the systems that contribute to balance

A

visual, vestibular and somatosensory system

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3
Q

what is the visual system’s role in balance

A

measures the orientation of the head and the eyes in relation to its surrounding onjects thus allows to maintain balance

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4
Q

what info is supplied by the vestibular system

A

info that measures gravitational, linear, angular accelerations of the head in relation to inertial space

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5
Q

what type of information is not provided by the vestibular system?

A

orientation information in relation to external objects

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6
Q

does the vestibular system play a major or minor role in balance when the visual and somatosensory systems provide accurte info

A

minor role

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7
Q

what is proprioception

A

overall awareness of body position which is independent of vision and essential in preventing injury

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8
Q

how does proprioception function

A

the nervous system communicated w/ muscles, tendons, joints through different proprioceptirs to sens and alter body position

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9
Q

where are muscle spindles located

A

parallel to skeletal muscle fibers

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10
Q

what activated muscle spindles and how do they repsond.

A

any rapid or excessive muscle lengthening (monitor change in tissue length) will cause spindles to provoke a muscle contraction in order to prevent excessive stretch of the muscle

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11
Q

what type of nerves monitor the rate and magnitude of stretch for whuch the muscle spindles respond to

A

sensory nerves

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12
Q

what happens if the tissue undergoes a strong or fast enough stretch

A

potential tissue damahe hence the a-MN prompts the surrounding extrafusal fibers to contrct and shorten the muscle thus protecting it

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13
Q

what response is provoked by muscle spindles

A

myotatic reflex

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14
Q

where are GTO located

A

woven within the CT of the tendon

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15
Q

what triggers GTO and how does it respond

A

excessive muscle contraction or passive stretch (change in muscle tension) will provoke GTO and cause inhibition of target muscle along with contraction of antagonist muscle

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16
Q

what happens when a ms generates sufficent tension either through contraction or passive stretch

A

GTO activate and inhibit ms contraction and prompt ms to relax along with antagonist contraction thus decreasing muscle tension

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17
Q

what reflex is associated with the action of the GTO

A

inverse myotatic reflex

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18
Q

what is reciprocal inhibition

A

contraction of one muscle, relaxation of the other.
both GTO and muscles spindles are cqpable of this and allows the body to move and not fight against itself this allows for smooth and coordinated mvmt to take place if the appropriate give and take occurs

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19
Q

what are mechanoreceptors

A

specialized nerve endings that deform in response to pressure by registering the speed and amount of deformation and indicate the position and mvmt of their associated structures

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20
Q

where are pacinian corpuscle located

A

skin, CT, muscles and tendons

21
Q

what triggers pacinian corpuscle and how does it respond

A

vibration and deep pressure thus allowing to indicate the direction and speed of the body mvmt

22
Q

where are rufini corpuscle loacted

A

in the joint capsule

23
Q

what triggers ruffini corpuscle and how does it respond to the trigger

A

distortion of joint capsule will allow to indicate the position of the joint in space even w/ eyes closed

24
Q

what is included in the maintenance of postural equilibrium

A

sensory detection of body motions
integration of sensorimotor info w/in the CNS
execution of appropriate MSK responses (inhibit or contract)

25
Q

why is balance important in the rehab proces

A

because it dictates mvmt strategies w/in the CKC

26
Q

provide examples of activities that require balance

A

joint position sense
kinesthesia
proprioception

27
Q

what happens after an injury to the recruitment pattern and timing of muscular contractions

A

alterations

28
Q

what are the 2 main reasons from a clinical stand point why a person may have impaired balance

A
  1. position of COG relative to the base of support is not accurately sensed
  2. the automatic mvmts required to bring the COG to a balanced position are not timely of effectively coordinated
29
Q

what may cause for automatic mvmts to be done in an uncoordinated or untimely manner?

A

alteration in the ratio of muscle spindles to GTO activity or disruption in the proprioceptive pathway

30
Q

what may happen to due to decreased proprioception after injury

A

-impaired balance and decreased coordination
decreased joint position sense
-tendency of joints to give way
-altered reflexes when performing specific mvmts

31
Q

what happens in the event that there is a delay in the body’s response time to an unexpected load on dynamic restraints

A

the static restrain structres undergo excessive forces thus increasing their risk for injury such as a ligament tear or sprain w/ inversion/eversion of the ankle

32
Q

what is tomberg position

A

feet together w/ a narrow base of support

33
Q

what is semi-tendem

A

stride position (one foot ahead of the other)

34
Q

what is tandem stande

A

heel directly in front of toes

35
Q

what is soleo/solec

A

standing on 1 leg eyes open/closed

36
Q

what are the different static standing balance positions done when standing on foam

A
  • eyes open
  • eye clsoed
  • feet togeter, eyes open
  • feet together, eyes closed
37
Q

why is it important for proprioceptive retraining to be started as early as possible

A

reduce the risk of injurt reoccurence

38
Q

what types of exercises are provided in proprioceptive retraining

A

non-stressful to healing tissue

aims to enhance overall coordination and ease the effectiveness fo strngth and endurance exercises

39
Q

what is the goal of proprioceptive retraining

A

restore proximal stability
muscle control
flexibility

40
Q

what happens during the first phase of proprioceptive retraining

A

production of static stabilization exercises w/ CKC and unloading (weight shifting)

41
Q

what type of exercises are implemented in the 1st phase of proprioceptive retraining

A

isometric exercises of involved joint on even and uneve surfaces
may involve balance retraining and joint reposition exercises

42
Q

what tools can be used in the first phase to help pt as he/she progresses
how can they be made even more challenging

A 
trampoline
balance board
swissball 
wobble board
made more challenging by progressing from double limb support to single limb and all while performing sports specific tasks
43
Q

what happens during the 2nd phase of proprioceptive retrraininhg

A

concious control of the motion w/o impact and substitue isometric exercises w/ concentric and eccentric exercises through a larger ROM

44
Q

whhat do we want to stimulate during the 2nd phase of proprioceptive retraining

A

dynamic postural response and increase muscle stiffness to resist and absorb joint loads

45
Q

what happens during the 3rd phase of proprioceptive retraining

A

unconcious control and loading of the joint and introduce both ballistic and impact exercises such as running and jumping

46
Q

what should the exercises prescribed in proprioceptive retraining involve

A

sudden alterations in joint positionning that necessitate reflex muscular stabilization and axial loading
rythmic stabilization in both OKC and CKC
use of stable and unstable bases to encourage co-contraction of agonist-antagonists

47
Q

provide examples of weight shifting exercises for the UE

A
  • stand and lean on treatment table
  • 4 point knee position; rock forwards and back and then progress onto unstable objects
  • 3 point position
  • 2 point position (superman)
  • weight shifting on fitter while in a kneeling position
  • slide board exercises in quadruped position moving hands forwards and backwards
48
Q

provide example of LE progression for proprioceptive rehab

A

-partial WB: walking w/ support and ensuring proper heel-toe mvmt. sitting w/ feet on rocker board and rocking both legs forward and back, then progress to one
-full WB
on floor: feet together, eyes closed, then one leg, add mvmt of the other leg, bouce or throw/catch a ball
mutiaxial rocker using both legs will use a similar progression as above
-minitrampoline: same as above, add hop and land, rythmic hopping
jumping, skipping, running drills

PHTH 450 (14 decks)

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