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PT 642 DDxI Adult Neuro > Coordination and Balance Assessment > Flashcards

Coordination and Balance Assessment Flashcards

1
Q

ability of CNS to control/direct the neuromotor system in purposeful movement/postural adjustment; accomplished by selective allocation of muscle tension across appropriate joint segments

A

motor control

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2
Q

ability to execute smooth, accurate, and controlled movement; involves multiple joints and muscles activated in the appropriate timing and sequence for efficient movement

A

coordination

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3
Q

all forces acting on the body are balanced such that the COM is within the bodys BOS

A

balance

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4
Q

measurement of how a person performs certain tasks and fulfills their various roles in life

A

functional assessment

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5
Q

compares and makes corrections between intended movement and actual movement, involved in feedforward and feedback control

A

cerebellum

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6
Q

what tracts control voluntary movement and which control involuntary movement

A

voluntary: corticospinal (pyramidal)
involuntary: extrapyramdial tracts (5)

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7
Q

how does the cerebellum act indirectly to contribute to coordination

A

connections with primary motor cortex and descending extrapyramidal tracts

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8
Q

compares and makes corrections between intended movements and actual movement; fine tuning movement; involved in feedforward and feedback control

A

cerebellum

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9
Q

what area of the brain is heavily involved in motor learning and motor programming via connects with memory centers in temporal lobe

A

cerebellum

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10
Q

list impairments associated with cerebellar pathology

A
  • ataxia
  • gait ataxia
  • asthenia/hypotonia
  • dysdiadochokinesia
  • dysmetria
  • dysarthria
  • dyssynergia
  • nystagmus
  • intention tremor
  • delayed reaction/movement time
  • rebound phenomenon
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11
Q

uncoordinated movement

A

ataxia

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12
Q

damage to where in cerebellum would cause ataxia in the limbs

A

hemispheres (more lateral)

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13
Q

damage where in cerebellum would cause ataxia in trunk

A

vermis (central)

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14
Q

presents with wide BOS, staggering, path deviations, flinging of limbs

A

gait ataxia

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15
Q

generalized muscle weakness

A

asthenia

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16
Q

low tone

A

hypotonia

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17
Q

inability to perform rapid alternating movements

A

dysdiadochokinesia

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18
Q

inability to judge distance between points (over or underestimation)

A

dysmetria

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19
Q

movement decomposition

A

dyssynergia

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20
Q

tremor that occurs with movement

A

intention tremor (cerebellum lesion)

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21
Q

involved in initiation and regulation of movement; planning and execution of complex motor patterns; provides input to regulate normal motor tone

A

basal ganglia

22
Q

helps with automatic movements (reciprocal arm swing, blinking) and postural adjustments; indirect and direct pathways allow for excitatory or inhibitory influences on motor thalamus and primary motor cortex

A

basal ganglia

23
Q

impairments associated with basal ganglia pathology

A
  • bradykinesia/akinesia
  • rigidity (cogwheel and leadpipe)
  • resting tremor
  • chorea/athetosis
  • dystonia
  • hemiballismus
24
Q

how does age effect coordination and balance

A
  • decreased strength due to sarcopenia (decreased fast twitch fibers and oxidative capacity of muscles, loss of antigravity mm)
  • slowed reaction time (impacts speed accuracy tradeoff, cognitive changes lead to decreased dual task performance)
  • decreased ROM
  • postural changes (FHF, FSP, altered lordotic curves, increased hip/knee flexion, wider BOS)
  • impaired postural control
25
Q

examples of CNS lesions that can produce changes in motor control that affect coordination and balance

A

stroke, parkinsons, MS, huntington’s, CP, cerebellar tumors, central vestibular pathology, TBI

26
Q

list the elements of coordination

A
  • agility: body
  • dexterity: hand
  • speed, distance, and direction of movement
  • timing of movement
  • muscle tension needed to produce coordinated/balanced motions
  • intralimb and interlimb coordination
  • eye-hand coordination
27
Q

what does Romberg EC test

A

somatosensation

28
Q

alternate or reciprocal movements, movement composition, movement accuracy, fixation or limb holding patters, UL/BL tasks, B/L asymmetrical tasks/ multilimb tasks

A

non-equilibrium tests

29
Q

ability to maintain equilibrium in both static and dynamic positions

A

postural control and balance testing

30
Q

postural control and balance assessment is the integration of what

A
  • sensory system input (visual, vestibular, proprioceptive)
  • motor system synergies - output
  • CNS control - input and output
31
Q

what makes up sensorimotor integration

A

vision
proprioception
vestibular function

32
Q

what clinical test is used to assess VOR

A

head impulse/thrust test

33
Q

stabilizes the body, multiple reflexes working together, information from vestibular system used to guide postural reflexes for body righting

A

vestibulospinal reflex (VSR)

34
Q

input from neck proprioceptors; assists with eye movement; low gain; important during vestibular therapy; may be adaptable with therapy; assesses where your head is on your neck

A

cervico-ocular reflex (COR)

35
Q

what nuclei help maintain where our head is on our neck (COR)

A

C1-3

36
Q

input from neck proprioceptors; helps stabilize the body; works at low gain

A

cervicospinal reflex (CSR)

37
Q

how to measure sensorimotor integration

A
  • romberg/sharpened
  • balance master
  • clinical test for sensory interaction in balance
  • mCTSIB
38
Q

what are the 3 strategies used to control COM over BOS

A

ankle strategy
hip strategy
stepping strategy

39
Q

occurs in quiet, static standing; lower level of sway; disturbances in COM are small and within LOS; recruitement from distal to proximal mm

A

ankle strategy

40
Q

what muscles are activated with a forward sway for ankle strategy

A

posterior muscles: gastroc/soleus, HS, paraspinals

41
Q

what mm are activated by backward sway for ankle strategy

A

anterior muscles: anterior tibialis, quads, abdominals

42
Q

shifts in COM by flexing or extending the hips; provides mediolateral stability in static/perturbed standing; recruited when sway frequency is faster, larger disturbance of COM within BOS, small or compliant surface; proximal then distal mm recruited

A

hip strategy

43
Q

what mm are activated with forward sway hip strategy

A

abdominals –> quads

44
Q

what mm are activated with backward sway hip strategy

A

paraspinals –> HS

45
Q

upper or lower limbs reach or step out to align COM within BOS when fast, large perturbations occur or when ankle/hip strategies fail; protective; CNS continually uses feedback to monitor and adapt posture using these strategies

A

stepping/reach strategies

46
Q

weakness in antigravity mm will influence recruitment of strategies; observe responses in static and perturbated stance; perturbate in both AP and ML directions to note ability to restabilize

A

standing control

47
Q

observe in quiet sitting noting symmetry in BOS; observe sway responses; note pelvic position in regard to rotation and elevation; observe for grasping and hooking strategies

A

seated control

48
Q

backward sway in sitting would active what mm

A

hip flexors, abs and neck flexors

49
Q

forward sway in sitting should activate what mm

A

extensors throughout

50
Q

create opportunities to randomly destabilize; raise arms overhead, lift feef from the surface when in sitting; ball toss; common to see deficits in reaction times, motor recruitement

A

anticipatory control

51
Q

perform secondary cognitive or motor tasks while observing static and dynamic posture; remember the theory of cognitive reserve from motor control

A

dual task control

PT 642 DDxI Adult Neuro (15 decks)

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