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Developmental Concepts > Week 1- Postural Control > Flashcards

Week 1- Postural Control Flashcards

1
Q

What is the age range for infancy?

A

It is birth to 1 year

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2
Q

What are the parts of infancy?

A

Neonatal and infant are part of infancy

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3
Q

What is the age range for neonatal?

A

It is birth to 2 weeks of age

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4
Q

What is the age range for infant?

A

It is 3 weeks to 12 months of age

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5
Q

What is the age range for toddlerhood?

A

It is 13 months to 2 years (includes 2 yrs, 11 months)

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6
Q

What are the parts of early childhood?

A

Preschool and elementary school are part of early childhood

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7
Q

What is the age range for preschool?

A

It is 3 yrs to 5 yrs

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8
Q

What is the age range for elementary school?

A

It is 5 yrs to 10 yrs (includes 10 yrs, 11 months)

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9
Q

What is the age range for adolescence?

A

It is 11 yrs to 18 yrs

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10
Q

What is the age range for young adulthood?

A

It is 18+ yrs

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11
Q

True or False: Pediatric PT’s are often involved in the care of children through early adulthood

A

True

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12
Q

What is the age range for adulthood?

A

It is 22-40 yrs

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13
Q

What is the age range for middle age?

A

It is 40-65 yrs

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14
Q

What is the age range for late adulthood?

A

It is 65+ yrs

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15
Q

What does Advanced Maternal Age (AMA) describe?

A

It describes a pregnancy where the mother is older than 35

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16
Q

Who developed the eight stages of development?

A

Erik Erikson developed the eight stages of development

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17
Q

What does the eight stages of development theorize?

A

There is a specific psychological struggle that takes place through the eight stages of a person’s life. These struggles contribute to one’s personality throughout their development.

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18
Q

What is postural control?

A

It involves controlling the body’s position in space for the dual purposes of stability and orientation

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19
Q

What is postural orientation?

A

It is the ability to maintain an appropriate relationship between the body segments and between the body and the environment for a task

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20
Q

What is postural stability?

A

It is the ability to control the center of mass in relationship to the base of support

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21
Q

What is center of mass (COM)?

A

It is the point that is at the center of the total body mass

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22
Q

Where is the center of mass (COM)?

A

It is anterior to S-2 in the upright position

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23
Q

What is the center of mass (COM) controlled by?

A

It is controlled by the postural system

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24
Q

What is center of gravity?

A

It is the vertical projection of the center of mass (COM)

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25
Q

What is the center of gravity dependent on?

A

It is dependent on the weight and distribution of weight within the body

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26
Q

What is the center of pressure (COP)?

A

It is the center of the distribution of the total force applied to the supporting surface

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27
Q

Why does the center of pressure (COP) move continuously around the COM?

A

It keeps the COM within the support base

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28
Q

What is the base of support (BOS)?

A

It is the area of the body that is in contact with the support surface

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29
Q

What is quiet stance?

A

It is the small amount of spontaneous postural sway as the body moves continuously within its BOS

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30
Q

Where does the vertical line of gravity fall in the midline between?

A

It falls in the midline between:
-mastoid process
-anterior to shoulder joints
-hip joints
-anterior to knee joints
-anterior to ankle joints

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31
Q

What are the the tones for body alignment in quiet stance?

A

They are muscle tone and postural tone

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32
Q

What is muscle tone?

A

It is the force to which a muscle resists being lengthened (stiffness)

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33
Q

What happens when we stand upright?

A

Activity increases in antigravity postural muscles to counteract the force of gravity

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34
Q

What is critical to postural tone?

A

Sensory inputs from multiple systems

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35
Q

True or False: Postural control, stability, and orientation requirements will not vary with the task and environment

A

False

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36
Q

What are the three types of postural control?

A

-Steady state control
-Reactive control
-Proactive or anticipatory control

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37
Q

What is steady-state control?

A

It is the ability to control the COM relative to the BOS in fairly predictable and nonchanging conditions (ex: sitting, standing quietly)

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38
Q

What is reactive control?

A

It occurs in response to outside forces, such as perturbations, displacing the COG or moving the BOS (ex: being bumped in a crowd)

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39
Q

What is proactive or anticipatory control?

A

It occurs in anticipation of internally generated, destabilizing forces, such as the intent to move (ex: stepping onto a curb)

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40
Q

Which postural control provides a supportive framework for skilled movements?

A

Proactive/anticipatory control

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41
Q

True or False: Most functional tasks require all three aspects of balance control at some point or another

A

True

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42
Q

What does reactive balance rely on?

A

It relies on feedback mechanisms

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43
Q

How does reactive balance rely on feedback mechanisms?

A

Postural control that occurs in response to sensory feedback from an external perturbation

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44
Q

What does proactive/anticipatory balance rely on?

A

It relies on feedforward mechanisms

45
Q

How does proactive/anticipatory balance rely on feedforward mechanisms?

A

Anticipatory postural adjustments that are made in anticipation of a voluntary movement that is
potentially destabilizing in order to maintain stability during the movement

46
Q

What kind of perturbation is the ankle strategy?

A

This postural strategy has a smaller, slower perturbation

47
Q

What kind of perturbation is the hip strategy?

A

This postural strategy has a larger, faster perturbation

48
Q

What kind of perturbation is the stepping strategy?

A

This postural strategy has the largest, fastest perturbation

49
Q

What strategy is more frequent with aging?

A

The stepping postural strategy is more frequent with age

50
Q

What kind of perturbation is the reach strategy?

A

This postural strategy is elicited by a similar perturbation as the stepping strategy

51
Q

What are the primary curvatures?

A

Thoracic and sacral are these curvatures

52
Q

What are the secondary curvatures?

A

Cervical and lumbar are these curvatures

53
Q

What does anterior protective extension look like?

A

Arms extend forward to prevent falling

54
Q

What does lateral protective extension look like?

A

Arms extend to the side to prevent from falling

55
Q

What does posterior protective extension look like?

A

The child extends head and arms forward to recover balance

56
Q

What does upper extremity parachute look like?

A

The child, in prone horizontal suspension, is moved towards the surface head first. There is symmetrical arm extension and abduction

57
Q

How old does a child show anterior and lateral protective extensions?

A

These reflexes appear around 6-9 months

58
Q

How old does a child show the upper extremity parachute reflex?

A

This reflex emerges around 6-7 months

59
Q

How old does a child show the posterior protective extension?

A

This reflex emerges around 9 months

60
Q

When can children independently sit?

A

7-9 months

61
Q

What systems is balance composed of?

A

Vision, vestibular, and proprioception are three systems that compose balance

62
Q

When is adult-like postural control fully developed?

A

7 yrs

63
Q

These reflexes are at the newborn to 2 months mark

A

Primary standing/positive support and automatic walking

64
Q

What is primary standing/positive walking?

A

The baby, in supportive standing, first accepts weight on legs for 20-30 sec, then collapses

65
Q

What is automatic walking?

A

The baby steps reciprocally when inclined forward

66
Q

These reflexes are at the newborn to six months mark

A

Asymmetric tonic neck reflex (ATNR) and tonic labyrinthine reflex (TLR)

67
Q

What is ATNR?

A

In supine, head rotation elicits chin side arm/leg extension and skull side arm/leg flexion

68
Q

What is TLR?

A

Neck extends: increased extensor tone and extension of all limbs
Neck flexes: increased flexor tone and flexion of all limbs

69
Q

Developmental changes of prenatal (25-27 weeks)

A

-Somersaults
-Axial rotations
-Flexing
-Kicking
-Stretching
-Punching

70
Q

Developmental changes of newborn (at birth)

A

-Proportionately large head, relatively shorter legs than trunk and arms, C-curve throughout spine
-Flexion is the predominate posture in all limbs

71
Q

What are some developmental changes in infancy during the first 3 months?

A

-Flexed posture dominates (head tipped forward in supported seating)
-Limb symmetry at first, progressing to asymmetry
-Increased extension of spine
-Midline orientation (ex: holding a toy at midline)

72
Q

When does limb symmetry progress to asymmetry?

A

Begins at 2 months

73
Q

When does a baby begin to lift their head in prone?

A

By 2 months

74
Q

When does a baby show midline orientation?

A

By 3 months

75
Q

What are some developmental changes in infancy during 4-6 months?

A

-On elbows on on hands posture
-Spinal extension includes lumbar region
-Head held upright
-Begins hand knees position from prone
-Becomes more independent in sitting, once positioned
-Begins to take weight on legs again in supported stance

76
Q

When does a baby become more independent in sitting once positioned?

A

By 6 months

77
Q

What are some developmental changes in infancy during 7-9 months?

A

-continues rolling and achieves quadrupled position
-belly crawling to creeping
-independent, though wobbly, achievement of sitting posture
-sitting becomes the preferred position for the 8 month old
-improve body-weight shifting skills
-transitions between postures are readily practiced

78
Q

How old is a baby when sitting becomes the preferred position?

A

8 months

79
Q

What are some developmental changes in infancy during 10-12 months?

A

-vertical postures now preferred by child
-lumbar lordosis and protruding abdomen
-pulls to standing at first, then begins to stand up without pulling
-walking: early steps with wide base of support, arms in “high guard”

80
Q

How old is a baby when exaggerated lordosis and protruding abdomen begin to disappear?

A

2-6 years old

81
Q

Around 2-6 years old, the % of body fat steadily decreases from ____% at age one year to about _____ at age five years

A

-22%
-12.5%-15%

82
Q

Increased ___________ and decreased ___________ five the child appearance of being more lean and muscular at 2-6 years old.

A

-muscle tone
-body fat

83
Q

What are some developmental changes in middle childhood around 7-12 years?

A

-Improved transitional movements and improved symmetry
-By age 10, adult skills are being refined and mastered
-Standing postural patterns emerge (ectomorphs and mesomorphs)

84
Q

This body type is described as:
-passive stance, slouched posture
-small bone structure
-thin (hard to gain weight)
-lean muscle mass and flat chest

A

Ectomorph

85
Q

This body type is described as:
-active, more military posture
-strong, athletic, hard body with defined muscles
-gain muscle easily and gain fat more easily than ectomorphs

A

Mesomorph

86
Q

Adult skills are being refined at mastered at this age.

A

10 years old

87
Q

Static balance (stance control in childhood)

A

-more difficult for children
-higher center of mass (T12)
-faster sway rate (reaches adult levels from 9-16 years)

88
Q

Describe the postural responses to perturbations at ages 2-3 years old.

A

Well organized by amplitudes and latencies are longer than adults

89
Q

Describe the postural responses to perturbations at ages 4-6 years old.

A

Responses become slower and more variable

90
Q

Describe the postural responses to perturbations at ages 7-10 years old.

A

Essentially like those of an adult

91
Q

Describe the sensory adaptation for 4-6 years old

A

Larger sway, very little reliance on vestibular system and more on somatosensory system

92
Q

Describe the anticipatory control for 12-15 months old

A

-Able to activate postural muscles prior to arm movements
-Adult like postural control not fully developed until age 7

93
Q

When does the ideal posture develop?

A

Adolescence

94
Q

What characterizes the ideal posture?

A

-Less abdominal protrusion
-Less knee hyperextension
-Head and shoulders well aligned

95
Q

When are transitional movements most symmetrical?

A

Adolescence

96
Q

At what age does a child have peak control of transitional movements?

A

15 years old

97
Q

SLIDE 33

A
98
Q

Postural changes in older adulthood

A

-widened base of support
-slightly flexed knees and hips
-trunk forward lean, or protuberant abdomen
-reduced lumbar lordosis –> increased thoracic kyphosis (decreased strength of spinal extensor muscles, impaired balance, slower walking and stair climbing, shorter functional reach)
-loss of spinal flexibility and decreased ROM

99
Q

In older adulthood, patients revert to more _____ postures

A

asymmetric

100
Q

In older adulthood, the time during transitional movements _______ between positions

A

increase

101
Q

What are contributing factors to impaired transitional movements?

A

-decreased balance, strength, flexibility, and confidence
-decreased activity

102
Q

What systems make up balance?

A

Vision, vestibular, proprioception

103
Q

What types of musculoskeletal changes occur in older adulthood?

A

-decreased strength, endurance, and muscle mass
-decreased number of type I and type II muscle fibers
-decreased number of motor units
-muscles fatigue more rapidly
-decreased spine and ankle joint ROM, as well as postural shift back onto heels

104
Q

What are some balance and postural changes in older adulthood?

A

-increased sway in quiet stance
-reduced functional stability limits
-increased use of hip movements as opposed to ankle movements to regain balance
-altered anticipatory posture abilities due to delayed muscle onset times
-altered response strategy due to muscle weakness, reduced ankle-joint sensation, and joint stiffness

105
Q

What are some cognitive changes in older adulthood?

A

Decreased attentional capacity, especially during multitasking

106
Q

_____________ tends to increase with age and risk of injury is a major concern.

A

Falling

107
Q

______________ is better than treatment of injury.

A

Prevention

108
Q

True or false: Power training my be more effective than strength training in older adults with muscle weakness

A

True

Developmental Concepts (12 decks)

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