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Year 2: MLC II > Test 1 > Flashcards

Test 1 Flashcards

1
Q

important elements of reporting and sharing results

A

many stakeholders

therapists should adhere to standards by APTA Physical Therapy Practice

results need to be easily understood

age equivalents should not be used due to limits/possible misunderstanding

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2
Q

factors important for how data is interpreted/reported

A

test purpose (screen/determining difference/evaluating change)

types of data collected

how data was gathered

reporting/sharing results

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3
Q

what is a norm referenced test/when to use

A

% or Z score

identifies kids with delays in SPECIFIC SKILL SET

scores always compared back to “normal developing” peers (AGE MATCHED)

senstive to knowledge, skills, and abilities

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4
Q

what is a criterion referenced test/when to use

A

% or raw score

measurement RESPONSIVE TO CHANGE (sensitive to intervention effects)

use to DETERMINE ELIGIBILITY and measure CHANGE over time

items used for criterion are well representative of domain being measured

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5
Q

benefit of using objective measures/why it is important

A

clinical decisions should be guided by standardized tests

reliable data can guide eligibility for intervention, goals, duration of therapy, etc

helps determine intervention effectiveness

determine prognosis

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6
Q

what is standard error

A

estimates how repeated measures of person on same instrument tend to be distributed around true score

large standard of error = neg impact on reliability

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7
Q

what is a confidence interval

A

range within a persons true score can be found

i.e. true score of that person is found 80% of the times it has been tested

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8
Q

z score

A

how far away your value is from mean, measured in standard deviations

Z = (child score-mean score)/test standard deviation

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9
Q

t score

A

used when you dont know population standard deviation

i.e. when comparing bone density of a population a t score would compare to a normal healthy person while a z score would compare to peers of same age, sex, condition, etc

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10
Q

percentile score

A

% of children that score below the child being tested

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11
Q

age equivalent score

A

average age at which a normal child reaches milestone/skill

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12
Q

developmental index

A

how well a child performs on a set of standard skills compared to a normative sample

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13
Q

raw score

A

unaltered data

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14
Q

developmental quotient

A

ratio statistic reflecting child’s overall development in relation to criteria logged in authentic social context

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15
Q

evaluative measure

A

measure of change over time/after treatment

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16
Q

predictive measure

A

classifies people based on future statis

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17
Q

discriminitive measure

A

distinguishes those who have a particular problem from those who dont

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18
Q

framework/philosophy components of pediatric evaluation

A

family centered

evolution since Edu for All Handicapped Children Act

start with hx/systems review/tests/measures

develop problem list

determine dx, outcomes, prognosis (top down or bottom up approach)

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19
Q

purpose of APTA guide to exam and eval

A

gather info

consider all factors

collaborate

sound clinical reasoning/decision making = desired outcome

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20
Q

intrarater reliability

A

stability within one test admin

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21
Q

interrater reliability

A

stability across multiple admin

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22
Q

validity

A

ability of measure to accurately capture/measure domain of interest

how similar are test subjects/method of administration to original research

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23
Q

sensitivity vs specificity

A

sensitivity = SnOUT
-high sensitivity rules out dx

specificity = SpIN
-high specificity means a + test will rule in

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24
Q

positive and neg predictive values

A

estimate test feasibility in actually identifying a child who tests + or - actually does or doesnt have condition

PPV = probability person with + has disease

NPV = probability a person with a negative truly doesnt have disease

25
Q

positive and negative likelihood ratio

A

+ LR = true + rate/false + rate

  • LR = test - with disease/test - without disease
26
Q

when does refinement of posture control occur

A

mature by 10-12 years

adult levels occur at different times for different aspects of posture control

body morphology affects until about 7 years old
-kids are more top heavy
-kid COM = T12
-adult COM = L5/S1

27
Q

how does head control develop in a newborn into infancy

A

not present at birth; poor coordination/muscle strength

can start developing for reactive control as early as 1 month

stage 1=hold head w/ trunk support

stage 2 = propping arms in sitting for brief periods

stage 3 = sit independent w/o falling

stage 4 = stand with perturbation

28
Q

stages of sitting development

A
  1. steady state
    -6-8 months w/ spontaneous sway
    - supports posture development
  2. reactive
    -early as 1 month
    -early synergies appear then reappear
  3. anticipatory
    -reaching while sitting
    -trunk control = limiting factor for reacting
29
Q

requirements for independent stance

A

balance with reduced stability limits

control to reduce degrees of freedom as leg and thigh segments are added

recalibration of sensory system to include thigh, shank, and foot balance

30
Q

importance of touch for motor control

A

used when manipulating objects
involves pain/temp/movement

helps with movement:
-accuracy
-consistency
-timing
-force
-distance

31
Q

receptors used with tactile sensation

A

meissner’s corpuscle = fast adapting mechanoreceptor; touch/pressure

merkel’s corpuscle = slow adapting mechanoreceptor; touch/pressure

free neuron ending = slow adapting; nociceptors, itch, thermoreceptors, and mechanoreceptors

pacinian corpuscles = rapid mechanoreceptor; vibration/deep pressure

ruffini corpuscle = slow adapting; skin stretch

32
Q

importance of proprioception in motor control

A

perception of body in space w/ movement

sends CNS info about direction, speed, and location

used in closed loop movements

receptors in muscles, tendons, ligaments, joints

33
Q

importance of vision in motor control

A

important, especially early on

enables us to coordinate movements

34
Q

cognitive/attentional contributions to motor control

A

attention directly affects posture control

older kids/adults = perform cognitive tasks while maintaining posture stability

sensory adaptation occurs when 1 or more of senses report inaccurate information

35
Q

describe the reflex hierarchial theory of postural control

A

posture control = dependent on appearance and integration of reflexes

as CNS matures inhibition and integration of reflexes enable increases posture control

posture control allows voluntary motor responses

36
Q

describe the systems theory of postural control

A

results from interaction of child’s maturing nervous system and MSK systems with environment

child develops in areas of strength, coordination, sensory processing, and cognition

child develops internal representation of body (body schema)

37
Q

posture control vs balance definitions

A

posture = controlling body’s position in stance for dual purpose of stability and orientation

balance = ability to control COM in relation to BOS

38
Q

characteristics of static balance

A

develops around 6-8 months

gradual process of infant learning to control degrees of freedom

develops in top down manner

39
Q

characteristics of dynamic/reactive balance

A

innate components of dymanic balance are available at birth but skill is refined over time

1 month = posture response synergies present

3-4 months = decline in synergies; less frequent

child learns to sit independently = reappear with greater frequency and refinement

40
Q

7 phases of erect locomotion

A

1 = stepping relfex

2 = disappearance of step reflex

3 = reappearance of step reflex

4 = assisted locomotion

5 = erect independent walking with hands in high guard position

6 = erect independent walking with hands down by side

7 = erect independent walking with trunk and head more erect

41
Q

describe the characteristics associated with the initial stages of walking

A

difficulty maintaining upright posture

unpredectable loss of balance

rigid, halting leg action

short steps

flat foot contact

toss/turn outward

wide BOS

flexed knee at contact followed by quick leg ext

42
Q

characteristics associated with elementary age stage of walking

A

gradual smoothing

increase in step length

heel-toe contact

arms down to side

BOS w/i lateral dimensions of trunk

outtoeing reduced/gone

increased pelvic tilt

apparent vertical lift

43
Q

characteristics of mature stage of walking

A

reflex arm swing

narrow BOS

relaxed/elongated gait

minimal vertical lift

define heel/toe contact

44
Q

describe the vestibular input for stabilizing the head/trunk while learning to walk and how it changes as children develop

A

start of walking to ~ 6 years
-locomotion in bottom up manner
-use support surface as reference
-head control en bloc (stiff neck/limited deg of freedom)

7 years+
-more incorporated use of vestibular system and VOR
-mastery of head control

45
Q

requirements for developing normal gait

A
  1. rhythmic stepping pattern (progression)
  2. control of balance (stability)
  3. ability to modify gait (adaptation)
46
Q

describe the “expanding repertoire” of steady state gait, running, skipping, etc

A

Run develops 1st
-need increase in strength/balance from walking

gallop next
-requires asymmetrical gait with unusual timing and varying force production
-more balance needed

hop next
-balance on 1 limb
-additional force needed to lift body off ground after landing

skip is last
-one locomotor pattern embedded in another
-requires more coordination

47
Q

describe the initial stages of gentiles stages of motor learning

A

develop an understanding of task dynamics

get an idea of requirements of movements

understand goal

develop strategies for movement

understand environmetnal features critical to organization of movement

learn to distinguish relevant or regulatory features of the environment from those that are nonregulatory

48
Q

describe the later stages of gentiles stages of motor learning

A

capability of adapting movement pattern to specific demands of any situation

consistency in achieving goal of skill at each attempt

efficiency of performance in terms of reduced energy costs

49
Q

practice considerations for learning a motor skill

A

generalization of motor skills

presentation of instructions (verbal vs demonstrate)

presentation of feedback during instruction

practice structure

50
Q

explicit vs implicit

A

explicit = knowledge that can be consciously recalled; requires attention, awareness, and reflection

implicit = learning w/o intention; reflexive/autonomic/habitual; nervous system learns characteristics of a certain stimulus

51
Q

2 year old motor skills

A

kick ball
tip toe
jump with both feet
some running
push/steer toy

52
Q

3 year old motor skills

A

hop on one foot
alternate stairs
dress themself
hop on one foot

53
Q

4 year old motor skills

A

walk down stairs
catch with hands only
climb
buttons
self care

54
Q

decribe the development of rolling

A

important part of mobility

introduces trunk RT that will be involved in subsequent motor skills

patterns of rolling change as infant matures

55
Q

describe prone progression 9 phases

A

1 = LE flexed posture
2 = extension of LE + head control
3 = increase in spinal EXT
4/5 = arms support chest; propulsion w/ arms/legs
6 = creeping
7 = disorganized progression
8/9 = organized progression of creeping

56
Q

typical development as defined in relation to accepted learning theories

A

no primary driver/influence

overlap in theories

theories direct research/intervention

development is not linear

57
Q

core concepts of early motor development

A
  1. biological environment interaction impacts health and development
  2. brain development grows in definied continuous steps
  3. major physiological systems develop rapidly during pregnancy and ealry childhood
  4. early caregiving environment is crucial for long term development
  5. developing child play important role in interactions and developmetn
  6. development of executive function is key aspect of early childhood development
  7. trajectories are unchanging (good or bad)
  8. variability in individual and group developemnt
  9. experiences across environmental concepts plays a role in early development
  10. discrepancy in access to resources matter
  11. health outcomes are the results of life experiences
  12. early interventions matter more and are more cost effective than later ones
58
Q
A

Year 2: MLC II (2 decks)

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