Week 06 - Neuromuscular control

Question 1

What are the four elements of assessment/prescription to include?

Answer 1

1. Sensation (position and force detection)
2. Dynamic stability
3. Anticipatory and compensatory postural adjustments
4. Functional motor patterns

Question 2

Resistance exercise increases the responsiveness and size of response of the __________ pathways

Answer 2

primary afferent

Question 3

Resistance training increases the responsiveness of the ___________ to stimulation

Answer 3

alpha-motor neurons

Question 4

Static Balance: Rhombergs test, useful within _______________ (cap as 30s)

Answer 4

subject comparisons (no use to compare to population)

Question 5

If differences in static balance on each limb, don’t generalise to the affected joint only (ankle, knee, etc) but consider the entire _____, kinetic chain or system (fault in the system)

Answer 5

body

Question 6

Repositioning and force sensation tests are better in experimental set up and in _______ clinical scenarios rather than our field

Answer 6

therapeutic

Question 7

Results for balance control in Acta physiological 2007: Spinal reflexes measured at the long-latency response - thought that inhibition of spinal reflexes is good for balance because….??

Answer 7

reflex mediated joint oscillations will be reduced (sometimes you want to reduce unnecessary muscle activation)

Question 8

Results for balance control in Acta physiological 2007: Showed that the response to cortical stimulation (TMS) went down at the LLR too… saying that

Answer 8

System was already active

Question 9

What seems to happen with balance training (static balance context here)?

Answer 9

Humans upregulate ‘cortical’ activity in early phases of skill acquisition (e.g. after first session), but this decreases with progressive training (maintenance of balance becomes more automatic - CNS has increased degrees of freedom to response to a pertubation)
- MUST PROGRESS training

Question 10

In sensation prescription, compare ___ more than you compare ___

Answer 10

limbs, people

Question 11

Ways to assess sensation training?

Answer 11

• Rhombergs

- Performance in compound movements

Question 12

Prescription for sensation?

Answer 12

• Whole body resistance exercise!
• Biofeedback (mirrors are useful at first)
• Addition of balance work without overly complicating the movement (static focus with instability works—> balance board hold)

Question 13

Dynamic stability requires integration of _____ and ____ postural adjustments

Answer 13

anticipatory, compensatory

Question 14

Anticipatory postural adjustments (APAs) are the ….

Answer 14

involuntary and automatic adjustments in muscles activation that occur PRIOR to a predictable perturbation

Question 15

Compensatory postural adjustments (CPAs) are ….

Answer 15

Initiated by sensory feedback signals, and serve as a mechanism for restoration of body position AFTER the perturbation has occurred

Question 16

Errors in clinical practice occur when we ignore that the problem is always a ________ and reduce a problem down to one muscle for an easy prescription solution

Answer 16

system fault (part in the chain, whole body)

Question 17

For chronic back pain, adherence to ____________ appears to facilitate dynamic stability

Answer 17

ANY exercise program

Question 18

Back pain patients often exhibit excess ‘stiffness’ of the trunk in loaded perturbation type tasks, and delayed muscle onsets prior to ________ tasks

Answer 18

unexpected

Question 19

Targeting a single muscle when the system has multiple components is often a _____ approach to exercise prescription

Answer 19

faulty

Question 20

Jump landings of soleus muscle: The short latencyresponse was….

Answer 20

regulated at spinal cord level

Question 21

Jump landings of soleus muscle: The long latency response was….

Answer 21

corticol involvement

Question 22

Can latency responses be both?

Answer 22

No, either corticol involvement or spinal cord regulation (not both)

Question 23

Factors that contribute to long-term ankle instability (2)?

Answer 23

• Ankle strength

- Dynamic balance (control of a landing task)

Question 24

Someone with a lot of ankle issues tends to exhibit a lot of ______ issues -> indicator that it is a systemic issue

Answer 24

proximal (other issues)

Question 25

In chronic ankle instability related to (3):

Answer 25

• delayed gluteal and hip flexor recruitment during walking
• reduced hip abduction and external rotation strength
• delayed trunk postural responses to perturbation

Question 26

How to fix proximal issues ???

Answer 26

Train the proximal muscles (which you do as part of balanced whole body prescription template)
– Integrate isolation training with functional motor patterns (landing tasks and compound lower limb movement)

Question 27

Dynamic stability; assessment/prescription….

Answer 27

• compound movements for assessment, compare limbs
• Be mindful that ‘links in the chain’ can fault at multiple points (common problem with ankle and knees is lack of training hips)
• Jump landing tasks
• Throwing tasks
• Choose dynamic movements relevant for your client

Question 28

How to bring elements (sensation, force detection, dynamic stability) of neuromuscular control together?

Answer 28

= Functional motor patterns (should always be primary goal)

Question 29

Hip hinge benefits:

Answer 29

• Not be initiating movement from the lumbar/thoracic spine
• Keep thorax and hip together during movement to avoid counter-rotation movements thus shear stresses on the spinal discs