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S4- Motor Development and Behavior > Week 5- Reach, Grasp, and Manipulation/ Developmental Assessment/MSK Development > Flashcards

Week 5- Reach, Grasp, and Manipulation/ Developmental Assessment/MSK Development Flashcards

1
Q

PART 1: REACH, GRASP, AND MANIPULATION

A

PART 1: REACH, GRASP, AND MANIPULATION

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2
Q

What are the 4 key components of UE control?

A
  1. ) Locating the object (visual regard or perhaps auditory regard)
  2. ) Transportation of arm in space (reaching and the necessary postural control to support reaching)
  3. ) Grasp and release
  4. ) In-hand manipulation
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3
Q

What is the difference between feedback and feedforward control?

A
  • Feedback – input from sensory systems is compared to a reference signal (the movement that was intended) – the difference is used to update the output of the system.
  • Feedforward – or anticipatory control – relies on previous experience to predict the consequences of sensory information that is received.
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4
Q

Locating a Target:

  • Normally ________ is used to locate object and guide UE movements – requires coordination of eyes (central visual field) and head (peripheral visual field)
  • Kinematic studies – eyes reach object before head movement occurs but EMG studies – neck muscles are activated first.
  • Reaching to objects in the far visual field will also involve _______ movements.
  • Hand movements are more accurate if _____ movements are involved.
A
  • vision
  • trunk
  • eye
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5
Q

Kinematics of Reach and Grasp:

  • The control of arm movements depends on the _______ of the task.
  • During pointing – all segments of the arm are controlled as a unit.
  • During reach and grasp – the hand is controlled ____________ of the other arm units.
  • Velocity profiles and movement durations vary dependent on _______.
A
  • goal
  • independently
  • task
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6
Q

Grasping:

  • Patterns vary depending on________, ______, and _______ of object.
  • ________ vs. ________ (eye liner versus hammering).
  • Posture of thumb and fingers will vary.
A
  • location, size, and shape

- power vs precision

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7
Q
  • ______ grasp – handle of a suitcase
  • _________ grasp – softball
  • _________ grasp - bottle
A
  • Hook
  • Spherical
  • Cylindrical
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8
Q
  • ________ Grip – the finger and thumb pads are directed toward the palm to transmit a force to the object.
  • ________ Grip – the forces are directed between the thumb and fingers – allows movement of the object relative to the hand and within the hand.
A
  • Power

- Precision

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9
Q

What are the requirements for successful grasp? (2)

A
  • The hand must be adapted to the shape, size, and use of the object.
  • The finger movements must be timed appropriately in relation to transport so that they close on the object just at the appropriate moment.
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10
Q

Shaping of the hand for grasp occurs during the ___________ phase of the reach and is affected by:

  1. ) the ________ properties of the object such as size, shape, and texture.
  2. ) the ________ properties such as orientation, distance from the body, and location with respect to the body.
A

Transition Phase

  • intrinsic
  • extrinsic
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11
Q

What are the 4 phases of Grasp and Lift tasks?

A
  1. ) Contact between fingers and object.
  2. ) Grip force and load force (load on fingers) increase.
  3. ) Load force overcomes weight of object – movement starts.
  4. ) End of task – decrease in grip and load force shortly after object makes contact with table.
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12
Q

Grasp and Lift Tasks:

  • This scheme allows great flexibility in lifting objects of different weights.
  • Duration of loading depends on objects ________.
  • Grip and load force ratios have to be above a certain level otherwise _________ will occur.
  • Previous experience and afferent information assist in determining these ratios.
  • If there is a mismatch – receptors in finger pads are activated – pacinian corpuscles.
  • Role of cerebellum – predictive control of grip forces.
  • ________ lesion – poor predictive control of grip forces.
  • ________ lesions – normal timing of predictive grip forces but reduced response amplitudes.
A
  • weight
  • slipping
  • cerebellar
  • cortical
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13
Q
  • Although reach and grasp are controlled by different systems, the timing of each is _________.
  • In a patient with dysfunction, do we train them seperately or together?
A
  • coupled

- both separately and together

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14
Q
  • What do we develop at 4-5m of age?
  • What do we develop at 9-13m of age?
  • At what age do higher cognitive aspects begin?
A
  • more accurate reaching and grasp components
  • pincer grasp
  • 12m
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15
Q

Eye Head Coordination:

  • Control of saccadic eye movements develops _______ smooth pursuit.
  • Initial tracking is performed with ________ eye movements.
  • Limited ______ ________ present in the infant.
  • Quickly improves around __ weeks of age.
  • __ months – eyes stay on object most of time.
  • __ months – predictive abilities.
  • Head movements in smooth pursuits – present in 1 month olds and increases with age through at least 5.
A
  • before
  • saccadic
  • smooth pursuit
  • 6w
  • 3m
  • 5m
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16
Q

Eye Hand Coordination:

  • At __ months – head-arm movements become coupled very strongly and then become uncoupled to allow more flexibility.
  • At __ months – beginning postural stability – stable base for moving.
A
  • 2m

- 4m

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17
Q

Motor Components of Reach and Grasp:

  • __-__ months –extension of arm – opening of hand – difficulty to grasp object.
  • __ months – reaching becomes more refined – approach path straightens, number of segments of the reach decreases.
  • __ months – visually guided reaching.
  • Reaction time reducing with age up to 16-17 years.
A
  • 0-2m
  • 4m
  • 5m
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18
Q

Changes in Adults:

  • ____-______ changes such as slowing of onset latencies for postural response or decreased movement speed.
  • Coordination factors related to changes in movement or muscle activation patterns.
  • Changes in the use of ________ and _________ control of both postural and mobility skills.
A
  • time-related

- feedback and feedforward

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19
Q

Reaching Changes with Age:
-Discrete reaching slows __-__% in velocity – depending on task.
Hypothesized to be due to changes in information processing.
Changes in reaching coordination with more time spend in the deceleration phase.
More complex tasks – more age related changes.

A

30-90%

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20
Q

Grasping Changes with Age:

  • Decrease in manual ________.
  • Time required to manipulate small objects increased __-__% by age 70.
  • Older adults use larger grasp forces and take longer to adapt the force.
  • Most age-related decrements in reaching performance can be improved with training. Training effects remain high for at least a month after training has ended and also transfer to other reaching tasks.
A
  • dexterity

- 20-45%

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21
Q

PART 2: DEVELOPMENTAL ASSESSMENT

A

PART 2: DEVELOPMENTAL ASSESSMENT

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22
Q

What are the purposes of developmental testing? (4)

A
  • Diagnosis/Prognosis
  • Eligibility for various programs
  • Evaluation of outcomes
  • Treatment planning
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23
Q

What are the basic methods of the assessment? (4)

A
  • Interview
  • History
  • Clinical Observation
  • Assessment Tools
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24
Q
  • What is age equivalent score?
  • What is percentile score?
  • What is raw score?
A
  • Age equivalent score: mean chronologic age represented by a certain test score.
  • Percentile score: indicates the number of children of the same age or grade level who would be expected to score lower that the child tested.
  • Raw score: total number of items that are passed or correct on a particular test.
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25
Q
  • ______ = lowest score

- ______ = highest score

A
  • Basal

- Ceiling

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26
Q
  • What is interobserver reliability?

- What is test-retest relaibility?

A
  • Interobserver = The reliability of 2 people performing a test and getting the same thing.
  • Test-retest = Closeness of the agreement between the results of successive measurements.
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27
Q
  • _________________________ gives an estimate of the margin of error associated with a particular test score.
  • _________ scores are expressed as deviations or variations from the mean score for a group – expressed in units of standard deviation.
A
  • Standard Error of Measurement

- Standard Scores

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28
Q

What are the 5 types of validity?

A
  • Content
  • Construct
  • Face
  • Concurrent
  • Predictive
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29
Q
  • ___________ validity means the test measures appropriate content.
  • __________ validity means the test measures the skills/abilities that should be measured.
  • _______ validity is simply whether the test appears (at face value) to measure what it claims to.
  • _________ validity is a type of evidence that can be gathered to defend the use of a test for predicting other outcomes.
  • _________ validity is one approach of criterion validity that predicts individual performance on some measure scores administered at a later date.
A
  • Content
  • Construct
  • Face
  • Concurrent
  • Predictive
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30
Q

What are the criteria for evaluating a standardized test? (9)

A
  1. ) Purpose
  2. ) Age Range
  3. ) Areas Tested
  4. ) Time Required
  5. ) Administration
  6. ) Appropriateness
  7. ) Cost
  8. ) Reliability
  9. ) Validity
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31
Q

What is the difference between norm-referenced and criterion-referenced test?

A
  • Norm-referenced test is a comparison between a specific child and an “average” child.
  • Criterion-referenced test is a comparison to specific criteria rather than comparison to a “normal” group.
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32
Q

When are norm-referenced tests most appropriate?

A

Most appropriate when the purpose is to determine whether an infant has a motor delay or to determine eligibility for early intervention.

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33
Q

When are criterion-references tests most appropriate?

A

Are most appropriate for evaluation of the effects of physical therapy and treatment planning.

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34
Q

For many infants, is a norm- or criterion-referenced test recommended?

A

For many infants, the use of both a norm-referenced and criterion referenced assessment is recommended.

35
Q

What are standardized screening tests intended to do?

A

differentiate between those persons who are normal and healthy in a particular respect from those who are not.

36
Q

Standardized Screening:

  • To identify the risk for dysfunction in specific __________ of children.
  • To detect the risk for dysfunction in an _________ child.
  • To formulate a register or monitoring system for children identified at risk.
  • Usually done at regular intervals (i.e., yearly).
A
  • categories

- individual

37
Q

Standardized Evaluation:

  • To help team determine a _________.
  • To identify _________ development.
  • To obtain ___________ information on child’s performance or status.
  • To determine eligibility for service.
  • Usually ______-referenced and/or formal.
  • Usually done once or infrequently.
A
  • diagnosis
  • atypical
  • baseline
  • norm-referenced
38
Q

Standardized Assessment:

  • To plan an __________ program.
  • To delineate strengths, weaknesses, and needs across domains and environments.
  • Often are __________-referenced and/or informal.
  • Done on an on-going basis (i.e., within treatment).
A
  • intervention

- criterion-referenced

39
Q
  • Standardized Evaluation = _____-referenced

- Standardized Assessment = ______-referenced

A
  • Standardized Evaluation = norm-referenced

- Standardized Assessment = criterion-referenced

40
Q

Is the Alberta Infant Motor Scale (AIMS) a standardized assessment, evaluation, or screen?

A

screen

41
Q

What is the bottom line for standardized tests?

A

Norm-referenced assessments enable the physical therapist to document the infants’ level of development and to monitor general progress; while the criterion-referenced assessment serves as a measure of direct effects of physical therapy.

42
Q

How do we choose an appropriate standardized test? (8)

A
  • Purpose of test
  • Type of test
  • Age Range
  • Domains tested
  • Psychometric characteristics
  • Administration
  • Time required
  • Price
43
Q

What are some screening tests used?

A
  • Harris Infant Neuromotor Test (HINT)
  • Miller First Step Screening Test for Evaluating Preschoolers
  • Milani-Comparetti Motor Development Screening Test
  • Denver II (DDST)
44
Q

Harris Infant Neuromotor Test:

  • Age range?
  • Purpose?
A
  • 3-12m

- Purpose is to identify developmental delay.

45
Q

Miller First Step Screening Test for Evaluating Preschoolers:

  • Age range?
  • Purpose?
A
  • 2y9m to 6y2m

- Assesses cognitive, communicative, physical, social-emotional, and adaptive function.

46
Q

Milani-Comparetti Motor Development Screening Test:

  • Age range?
  • Purpose?
A
  • 0-2 years
  • Evaluates motor development on the basis of a correlation between the functional motor achievement of the child and the underlying reflex structure.
47
Q

Denver II (DDST):

  • Age range?
  • Purpose?
A

-0-6y
-Screens 4 areas of development
(Personal-social, Fine motor, Language, Gross motor)

48
Q

What are some tests of motor function?

A
  • Movement Assessment of Infants
  • Test of Infant Motor Performance
  • Peabody Developmental Motor Scales-2 (PDMS-2)
  • Alberta Infant Motor Scale (AIMS)
  • Bruininks-Oseretsky Test of Motor Proficiency (BOT)
49
Q

Movement Assessment of Infants:

  • Evaluates muscle tone, primitive reflexes, automatic reactions, and volitional movements in the _________ of life.
  • _________-referenced
  • 65 items
  • Requires extensive handling of the infant
  • ___ minutes for testing and scoring
A
  • first year
  • criterion-referenced
  • 90 minutes
50
Q

Test of Infant Motor Performance:

  • Purpose: capture the components of _________ and _________ control of movement that are important for function in early infancy.
  • 32 weeks gestational age – 3.5 months after full term delivery
  • ________-referenced
  • 27 observed items, 25 elicited items
A
  • postural and selective

- criterion-referenced

51
Q

Peabody Developmental Motor Scales-2 (PDMS-2):

  • Purpose?
  • Age Range: Birth-__ months
  • Areas Tested: _____ and _____ motor
  • ______-referenced
  • Time Required: __-__ minutes
  • Approx. Price: $______
A
  • Determine level of motor skill acquisition, detect small changes in motor development in children w/ known delays or disabilities and assist in programming for children with disabilities.
  • 71 months
  • gross and fine motor
  • norm-referenced
  • 45-60 minutes
  • $400
52
Q 
Alberta Infant Motor Scale (AIMS):
-Purpose?
-Age Range: Birth-\_\_ months
-Type: \_\_\_\_\_\_\_ or \_\_\_\_\_\_\_\_\_\_\_
-Areas Tested: 58 \_\_\_\_\_\_ motor skills divided amongst 4 positions (prone, supine, sitting, and standing)
-\_\_\_\_\_\_\_-referenced
Time required: \_\_-\_\_ minutes.
Approx Price:  $\_\_\_\_\_\_
A
  • Identify infants and toddlers with gross motor delay and to evaluate gross motor skill maturation over time.
  • Screen or evaluation
  • gross motor skills
  • norm-referenced
  • 20-30 minutes
  • $100
53
Q

Bruininks-Oseretsky Test of Motor Proficiency (BOT):

  • Assesses ______ and _____ motor functioning.
  • Age Range: __-__ years
  • ____-referenced
A
  • gross and fine motor
  • 4-14 years
  • norm-referenced
54
Q

What are some comprehensive developmental scales?

A
  • Hawaii Early Learning Profile (HELP)

- Bayley II

55
Q

Hawaii Early Learning Profile (HELP):

  • Purpose?
  • Age Range: __-__ years
  • What areas are tested?
  • ________-referenced
  • Time required: __-__ minutes
A
  • Determine the level of motor skill acquisitions, detect small changes in motor development in children with known delays or disabilities and assist in programming for children w/ disabilities.
  • 0-6 years
  • gross motor, fine motor, cognitive, social, self help, language
  • 20-30 minutes
56
Q

Bayley II:

  • ______-referenced
  • Three parts including _____, _____, and ______ scale.
A
  • norm-referenced

- mental, motor, and behavior scale

57
Q

Early Intervention Developmental Profile (EIDP):

  • 6 scales?
  • Age Range: birth-__ months
  • ________-referenced
A
  • perceptual fine motor, gross motor, cognition, language, social or emotional, self care
  • 36 months
  • criterion-referenced
58
Q

PART 3: MUSCULOSKELETAL DEVELOPMENT

A

PART 3: MUSCULOSKELETAL DEVELOPMENT

59
Q

“The effects of forces on the musculoskeletal system during the entire life span.”

A

Developmental Biomechanics

60
Q

General Principles of Growth:

  • Biological tissue is created, shaped, and remodeled through __________ or _________ forces.
  • Type, direction and magnitude of force influence body size.
  • As does genetics, nutrition, drugs, hormones.
A

internal or external

61
Q

Effects of Loading on Tissue Type:

  • The _______ and __________ of loading influences the type of tissue or articulation being formed.
  • Forces are important in determining the type of tissue formation.
  • ____________ – intermittent loading
  • ___________ – continuous loading
A
  • type and duration
  • Chondrogenesis
  • Osteogenesis
62
Q

Bone Formation:

  • Bone, cartilage, and muscle are all developed from the ___________.
  • Bone formation occurs through either __________ or ___________ ossification.
  • All bones, except the clavicle, mandible, and skull, are formed by ____________ ossification.
A
  • mesoderm
  • endochondral or intramembranous ossification
  • endochondral
63
Q

Bone Formation:

  • Primary ossification centers are typically located in the center of the ___________ or body of bone. By birth, diaphysis are almost ossified.
  • _________, or distal ends of bone, remain cartilaginous at birth.
A
  • diaphysis

- epiphysis

64
Q

Premies have _____ calcified bones, calcification of fetal bone increases as the fetus gains weight.

A

less

65
Q

Bone Formation:

  • Secondary ossification centers appear in early childhood in the __________.
  • Timing of ossification varies with each bone, most ossified by 20 years.
  • After birth, long bones grow in length at the epiphyseal plate.
A

epiphysis

66
Q

Bone Formation:

  • Bone also increases in size through ________ growth which is the accumulation of new bone in the bone surface, thus increasing bone density and thickness.
  • What are the most rapid periods of bone growth?
A
  • appositional growth

- prenatal, 7 years old, adolescence

67
Q

Joint Formation:

  • Begins with the formation of the cartilaginous models.
  • Basic structures formed during __-__ weeks of gestation.
  • Final shape develops throughout early childhood.
A

6-8 weeks

68
Q

Bone and Mechanical Forces:
-Early on, the role of mechanical forces is ________. As fetus grows and space becomes confined, mechanical influences become more important.
-Uterine crowding can result in ______ foot and abnormal facies.
Decreased joint movement can result in _______, _________ bones.

A
  • minimal
  • club foot
  • fragile, misshapen
69
Q

Modeling:

  • After initial development, bone shape can be changed through a process called modeling, which involves bone _________ and _________.
  • What is Wolff’s Law?
A
  • formation and resorption

- Bones develop a particular internal trabecular structure in response to the mechanical forces that are place on them.

70
Q

Modeling:

  • ____________ loading, parallel to the direction of growth, results in either compression or tension,
  • If applied intermittently with appropriate force (weight bearing or muscle pull) it will stimulate _______.
  • Intermittent compression appears to stimulate _____ growth than tension.
A
  • Longitudinal
  • growth
  • more
71
Q

Modeling:

  • Constant or excessive static loading causes bone material to _________.
  • _________-_______ Principle of bone growth regulation: growth plates produce increased growth in response to tension and decreased growth in response to excessive compression. (unequal forces due to malalignment = more malalignment)
A
  • decrease

- Hueter-Volkmann

72
Q

Modeling:

  • What would stapling the epiphyseal plate do?
  • _____ growth is commonly used with leg length discrepancies in children.
  • The ______ technique for limb lengthening.
A
  • Produce constant compressive slowing down one side.
  • Slow growth
  • Ilizarod
73
Q

Modeling:

  • Shear forces which run parallel to the epiphyseal plate can lead to ________ _______ changes, it occurs with normal muscle pull.
  • This could result in genu ______/________, scoliosis.
  • Asymetrical growth can also occur secondary to a fracture
  • HOWEVER, ________ drift (Bone is able to straighten some degree of malalignment)
A
  • torsion twisting
  • varum/valgum
  • flexure drift
74
Q

Flexure Drift:

  • Strain on a curved bone wall applied by repeated loading tends to move the bone surface in the direction of the concavity to straighten the bone.
  • Bone is resorbed from the ________ side and laid down on the ________ side.
  • Seen in the femur as the child loses the initial genu _______ posture.
A
  • convex, concave

- varum

75
Q
  • Newborns generally have genu ______.
  • At 1-2 years the legs _________.
  • At 2-4 years, they generally have genu ______.
A
  • varum
  • straighten
  • valgum
76
Q

Alignment:

  • Neonatal ___________ or “physiological limitations in motion”
  • Hip, knee, and elbow _______ (hip 30 degrees)
  • Spine ________
  • Hips _________ and _________
A
  • contractures
  • flexion
  • kyphotic
  • shallow and unstable
77
Q

Alignment:

  • Hip – excessive _________ (69-76 degrees) decreases to a mean of 60 by 2 years of age.
  • Extreme abduction appears to decrease along with the development of ________ postures.
  • More _________ rotation – this relationship changes during the first two years.
  • Decreased lateral rotation related to increased hip ________.
A
  • abduction
  • upright
  • lateral
  • extension
78
Q

Alignment:
-Coxa _______ – increased angle of inclination or neck-shaft angle (135-145).
Angle decreases to adult values (125) by adolescence due to compression and tension forces that occur with weight bearing and muscle pull.

A

valga

79
Q

Alignment:

  • Torsion – normal amount of rotation present in a long bone (Femoral torsion)
  • _________ occurs when the head and neck of the femur are rotated forward in the sagittal plane relative to the axis through the femoral condyles
  • _________ occurs when the head and neck of the femur are rotated backwards.
A
  • Antetorsion

- Retrotorsion

80
Q

Alignment:

  • Knee flexion contracture of __-__ degrees
  • Apparent physiological bowing – tibia appears outwardly bowed in the frontal plane ( the entire tibia is rotated slightly forward – this places the lateral head of the gastroc in a more forward position.
A

-20-30 degrees

81
Q

Alignment:

  • The forward position of the tibia is due to the contracture of the medial knee structures due to intrauterine positioning.
  • Tibiofemoral angle – ______ in the newborn.
  • May be as high as 15 degrees but decreases to 5 during first year.
  • __-__ yrs it shifts to genu valgum. (10-15 degree)
A
  • varus

- 3-4 years

82
Q

Alignment When to Treat:

  • Bleck and McDade – If varus position of the knees is not decreasing by 18 months to 2 years – need to investigate particularly if beyond 25 degrees
  • Genu valgum – If it does not reduce to __-__degrees.
A

-5-7 degrees

83
Q

Alignment

  • Tibial torsion
  • Neonate – sight external torsion (5 degrees)
  • Increases to ___ degrees by age 14 and 23-25 degrees by skeletal maturity.
A

-18

84
Q

Alignment Ankle and Foot:

  • Newborn – very flexible – but may have a _________ limitation.
  • Talus and calcaneus are inclined medially – forefoot slightly inverted in nonweightbearing.
  • Foot should have straight lateral border
  • If the lateral border is a “C” – metatarsus adductus
A

plantarflexor

S4- Motor Development and Behavior (9 decks)

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