Analysis of Typical Movement Development Flashcards
What is normal?
Muscles MUST work together in alignment.
Muscle control in variable patterns.
A balance between flexors and extensors.
Stability proximally = controlled movement distally
What is a transition?
the ability to move from one position to another
What is the proper progress of planes of movement?
Sagittal > Frontal > Transverse
Sagittal: trunk flexion/extension > extremity flexion/extension
Frontal: lateral trunk flexion > shoulder & hip abduction/adduction
Transverse: trunk rotation > shoulder and hip rotation
4 Months: Prone
Total body extension with scapular adduction to assist
Forearm weight bearing (prone on elbows)
Shoulder adduction > abdominal activation > head flexion/chin tuck (neck elongation)
Moves head in and out of midline with control (bilateral symmetrical control of flexor and extensors)
Pelvic tilting
- Anterior = lumbar extension, hip & knee flexion, and ankle DF
- Posterior = hip and knee extension & ankle PF
4 Months: Sitting, Supine, Standing
Sitting
- Pull to sit!
- Initiates lifting head symmetrically
- Lifts pelvis with abdominals
- Flexes elbows, hips, and knees
- Shoulders elevate to stabilize head
- If supported, leans forward at hip with trunk extension
Supine
- Lifts head, arms, and legs (hands touch knees)
- Rolling may occur (initiated with head rotation)
- Rolls as a unit (head, shoulder, and hip all stay aligned)
- Vision & vestibular systems initiate head righting in side lying
Standing
- Takes weight on feet
- Can be supported at hands (increasing hip and trunk control)
5 Months: Prone
Forearm weight bearing
Reaches with one hand by shifting weight laterally and laterally flexing trunk
Extended arm weight-bearing
- Trunk extensor and flexor muscle (abdominals and pectoral) co-contraction control
- Shoulder girdle stability, active elbow, wrist, and finger extension with hip extension, adduction, and neutral rotation
- Proprioceptive feedback to all weight bearing joints, developing stability to become more upright
Increased stability and lateral weight shifting allows for asymmetrical movement to allow head righting / dissociated movement
- Weight shift to the right to reach with the left causes a head righting reaction to the left to align eyes parallel to the surface
- Unweighted LE produces a balance reaction of hip abduction, flexion, and ER
- Weight-bearing LE adducts, extends, and IR to neutral
5 Months: Supine, Sitting, Standing
Supine
- Feet in mouth! (increased abdominal control with posterior pelvic tilt)
- Roll to sidelying > lateral flexion of head and trunk to bring head off floor (bottom LE extended & adducted, top LE flexed & abducted)
Sitting
- Pull to sit using UE!
- No head lag or shoulder elevation due to increased abdominal control of the rib cage & neck flexion
- LEs in complete flexion
- Leans forward because hip extensors are not strong enough
- Leans on extended UEs with scapula adduction
- Cannot reach forward
Standing
- Supported only!
- Uses knee extension for pull to stand
- Bears weight on LEs
6 Months
Prone
- Weight shifts on forearms or extended arm to reach for toys
- Trunk extensors balanced by abdominals, allowing hip extension and stabilization of the pelvis (stable base!)
- Can pivot!
- Head control against gravity
Sitting
- Independently!
- Extended spine and chin tucked
- Increased hip extensor control stabilizes pelvis
Supine
- Lifts pelvis with LEs extended above the body and holds here to play with feet
- Supine > prone initiated with head of LEs (ROLLS!)
Standing
- Bears weight on LEs
- Trunk and hip control allows independent standing with HHA or surface
- Bounces in standing
Why is W-sitting so bad?
(1) Can lead to a hip deformity (in-toeing in standing and gait)
(2) Lacks core muscle activation
(3) Decreases ability to rotate/cross midline
IT IS OK FOR TRANSITIONS
7 Months
Prone preferred position
- Moves into quadruped!
- Lateral weight shifts > flexed LEs > lifts pelvis up with elbow extension
- Tummy time exposure!!!!!
- Rocking <3
Sitting
- Independently!
- Shifts weight (can go from quadruped to sitting)
- Protective extension reactions (sideways)
- Dissociation of trunk from LEs
- Rotation initiated by vision
Supine
Standing
- Pulls to stand from quadruped
- Reaches overhead with UEs to a surface, lumbar spine extended
- Relies on UEs for stability
- Flexes and extends both LEs but cannot laterally weight shift to lift LE
8 Months
Sitting
- Increased trunk control
- Long sitting!
- Half long/ring sitting!
- UE protective reactions
- Sitting > quadruped (half ring side)
Standing
- Quadruped via kneeling and half kneeling
- Cruises sideways with support surface
Gait
- Only with hands held!
- ‘Steppage gait’ = wide BOS, LEs in abduction, ER, and flexion
- Cannot propel forward due to lack of hip extension
Crawling/Creeping
- Trunk must control counterrotation of shoulder and pelvic girdles
Why is bottom scooting bad?
(1) Asymmetrical ROM, muscle strength and movement pattern development
(2) Impedes the development progression of future gross motor skills
9 Months
Developing fine motor skills!
Increased control of LEs (ER and IR) with little reaction from the rest of the body
Easily performs…
- Sitting <> quadruped
- Kneeling > half-kneeling > pull to stand with UE for support
- Cruises!
Starts to climb
10 Months
Refining fine motor skills
Improved hip/pelvic mobility and control in kneeling, half kneeling, and climbing
Increased trunk rotation in standing
Can hold with only one hand when cruising and faces direction moving
Lowers self from standing with posterior pelvic tilt
Gait
- Decreased hip abduction
- Increased hip extension and pelvic rotation
- Bigger step length
- Stability mainly from UE
11 Months
Increasing exploration!
Rotation in long sitting
Balance reactions are well developed
Pulls to stand via kneel > half kneel > squat > stand (less use of UEs)
Needs little UE in standing (uses wider BOS)
Gait
- Trunk rotation allowing weight shifting
- Step length longer with BUE support than single UE support
- High guard position if no UE support
