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Flashcards in Exam 2 Deck (118):
1

distributed vs massed has to do with

intensity

2

Blocked vs random has to do with

sequence

3

explain constant vs variable

has to do with variability. consistant performance of the same task, vs varying char of the task

4

guidance vs discovery

how much you are involved, are you letting them discover most of the solutions themselves or are you primarily guiding them

5

KR vs KP

knowledge of results vs knowledge of performance (KR better)

6

Serial, continuous and discrete

serial - multiple discrete tasks in a row
continuous-no beginning or end
discrete- has beginning and end

7

4 main factors contributing to postural control

MSK sx
neuro sx - sensation
Neuromusular sx - control and coordination
enviroment

8

postural control develops cephalo caudel, meaning

head to toe

9

reflexes that effect the tone of the entire body

attitudinal/postural

10

3 main types of reflexes

attitudinal/postural
righting
balance/protective

11

in the hierarchial theory of development, what reflex type is the foundation

attitudinal/postural (lack of these often indicate dev delay or pathologies)

12

List the 3 attitudinal/postural reflexes

asymmetrical tonic neck reflex
symmetrical tonic neck reflex
tonic labyrinthine

13

explain asymmetrical tonic neck reflex

fencer pose

14

asymmetrical tonic age range

birth - 6 mos

15

explain symmetrical tonic neck reflex

whatever neck does, UE follow, and LE do opp

16

explain tonic labyrinthine reflex

when placed prone, babies will flex their bodies inward
when placed supine, they will extend outward

17

age range of tonic labyrinthine reflex

up to 6 mos

18

5 righting rxns

labyrinthine righting
optical righting
body on head righting
body on body righting
neck on body righting

19

what is labyrinthine righting

you do something to restrict/prevent their vision, and as you tilt the suspended body, they maintain upright head (horizontal gaze)

20

what is optical righting

same as labyrinthine, but without loss of vision

21

how long do we have labyrinthine and optical righting

over the lifespan

22

what is body on head righting

when the body is placed prone, the head will want to be upright

23

how long do we have body on head righting

up to 5 yrs

24

what is body on body righting

if you rotate a segment of the body (ex UE) the opposing segment (LE) will follow to align

25

what is neck on body righting

as you rotate their head, the body will follow suit

26

___________ are innate reactions that align the body for proper alignment

righting reactions

27

List the balance/protective reactions

equilibrium (tilting)
Postural fixation

28

List the time frames of when we start to see balance/protective reactions for prone, supine, sitting, quadruped, standing

Months
prone 6
supine 7-8
sitting 7-8
quad 9-2
wallking 12-21

29

protective reactions occur when

COG is outside of the normal limits or when there is a LOS

30

which balance/prot rxn is when the baby curves the trunk and uses extremities to try and correct/straighten the tilting

equilibrium

31

which balance/protection rxn occurs as baby is reaching, displacing COG and the baby curves the trunk towards the external force

postural fixation

32

as the dev of reflexes become integrated they reinforce what

muscle tone

33

typical age of starting to crawl

8-10 mos

34

typical age of sitting upright

6-7 mos

35

typical age of leaning against something as they stand

9-10 mos

36

typical age of independent stance

12 mos

37

what is a key component to dx dev delay in babies, what are we looking at very early

head control

38

normal posture control depends on

COM
BOS

39

reflex hierarchial theory states that reflexes are all____ to balance

reactive

40

according to hierarchial theory, list the tiers or levels of what babies achieve in regards to balance/posture

1st - attitudinal reflexes
2nd -righting reflexes
3rd - balance/protective reflexes
then postural control

41

what is systems theory

states that anticipatory responses act when we are aware of the need to change our position/posture. anticipatory responses develop parallel to reactive

42

4 stages of motor control

initial mobility
stability
controlled mobility
skill
(I S C S)

43

explain initial mobility stage

AROM is required for posture (ex: baby prone on elbows)

44

explain stability stage

baby can hold the posture (maintains it)

45

explain controlled mobility stage

baby can control or shift wt

46

explain skill stage

baby can reach out in front

47

prominent sensory system used at birth-few days (newborn)

visual

48

prominent sensory sx used around 1 yr

somatosensory (proprio)

49

prominent sensory sx used at 7 yrs

vestibular

50

1st postural reflex developed

postural support reflex (you hold a baby upright over the floor and have their feet touch, they will try to support their wt)

51

explain landau reflex

prone baby, they will kind of stiffen up and extend

52

components to include when looking at the INDIVIDUAL in a posture/balance assessment

body structure
body function
cognition

53

babies begin to extend neck fully at what age

2 mos

54

motor control relates to ___ and ____ function

brain and spinal cord

55

motor performance is influenced by what body systems

all

56

what were the 4 components of motor learning

retention
generalizability
quality of movement
resistance to contextual change

57

postural control is the ability to maintain equilibrium both ___ and ___

statically and dynamically

58

what is posture orientation

maintaining appropriate relationship btwn body segments

59

how to measure static control

how controlled are they for a certain amt of TIME

60

what is meant by limits of stability

your movement is contigent on your BOS, if your BOS is small and narrow, your movement will be too

61

how to improve limits of stability

make your BOS larger

62

4 strategies of postural control

sensory
motor (the mvmt)
sensory motor (the coordination involved)
attentional (degree of attention required)

63

3 factors contributing to quiet stance

muscle stiffness
tone
antigravity contractions

64

3 main antigravity synergy sxs

abs and erectors
hip flexors and gluts
plantar/dorsiflexors

65

3 ways to objectively measure posture control

EM (electromyography)
kinematic analysis
kinetic analysis

66

which way to measure postural control involves videos with markers on the pt to check symmetry, includes forces velocity

kinematic

67

which way to measure postural control involves use of internal and external forces with plates and gages

kinetic

68

in general, forward sway, causing ankle strategy inacts what muscles

ALL post leg (plantar flexors and hams), and paraspinals

69

Hip strategy: backward sway inacts what muscles

abs, quads

70

forward pert (hip strategy) enacts what muscles

hams, paraspinals

71

high velocity pert. use what strategy

hip

72

velocity of pert. that causes loss of control

stepping

73

lateral pelvic mvmt or mediolateral, when you shift your wt, the leg you are loading the wt on is ADD or ABD

load bearing leg is ADD
other leg is ABD

74

antigravity support muscles are provided by ____(mono articulating or biarticulating) muscles

mono

75

horizontal stability muscles in hip

quads (biarticulate)

76

when training a pt with a new LE prosthetic, its important to teach them to

bear wt on new prosthetic side to avoid hip hike/imbalance

77

sensory components of postural control (main contributors)

vision
vestibular
somatosensory
touch

78

Postural control depends on 5 important aspects of the INDIVIDUAL

COM
BOS
LOS
motor strategies
sensory strategies

79

As we age we lose ___muscle fibers

fast twitch

80

postural responses in older adults are ____ and___

delayed and weaker

81

what is foam and dome

clinical test for sensory integration/balance

82

goal writing strategy (saying)

FSMART
functional, specific, measurable, attainable, relevant, time

83

How does the infant’s BOS and COM change through the developmental stages?

goes from flat and big to smaller and narrow (belly on floor to feet on floor)

84

COM for a child goes from

low to high

85

independent stance for babies comes at what age

12 mos

86

what muscles are activated for quiet stance

Erector Spinae, Iliopsoas, Glute med, Abs, TFL, Gastroc, Soleus, Tibialis anterior (A E I G G T T S)

87

What factors (intrinsic and extrinsic) affect postural control?

stiffness, tone, antigravity muscles contracting body systems, proprioception all are intrinsic examples

floor, environment, shoeware are examples of extrinsic

88

at hip, mediolaterally, what is going on with the muscles in regards to strategies for muscle control

hip flexors unload
hip extensors load

89

list muscles in quiet stance

AEI GG ST (abs, erectors, iliopsoas, gastroc, gluts, soleus tibialis ant

90

muscles inacted with backward ankle strategy (pushed back)

ant tib, quads abs

91

overall, list some deformities that can occur from most of the reflexes if they continued

spine abnormalities, contracted vs lengthened imbalances, weak muscles

92

postural asymmetry could lead to

scoliosis

93

if the optical righting isn't working, what could this lead to

torticolis or kyphosis or altered perception dt altered vision

94

how could protective extension imbalance (child extending arm when falling to the ground) somehow lead to an issue

if they favor one side the other is inhibited

95

optical righting happens at what age

2 mos

96

prone to elbows what age

2 mos

97

log rolling what age

4 mos

98

age of walking

14 mos

99

How does sensory input for postural control changes across the lifespan

mostly decreases, vision, proprioception, tactile sensation, all decline

100

list some extrinsic reasons that elderly pts fall

lighting, stairs, pets, assistive devices, weather.

101

list some intrinsic reasons why elderly pts fall

type II fibers decrease, vision, proprioception, age, gender, meds, any psychosocial or physical

102

What types of therapeutic interventions are appropriate for balance problems, based upon risk factors leading to increased fall risk

balance training: changing surfaces, obstacles, eyes open eyes closed
MSK - strengthen muscles involved in strategies, and endurance
NM - pertebations
Sensory -proprioceptive drills
Postural - increase anticipatory ability
Cognitive - mental practice
Education on risk factors
Referral if needed (glasses, devices)

103

15. How would a physical therapist progress a treatment plan based upon cephalo-caudal development and the development of postural control?

Gradually changing the COG by changing the base of support. For example, from a large BOS, prone head raising, to a smaller BOS, supported sitting, to changing the COG even more, sitting with movement, to standing supported, standing unsupported, standing and reaching, etc.

104

which reflexes contribute to the dev of postural control

ALL
Attitudinal or Postural Reflexes (reflexes that influence the tone of the entire body)
Righting Reactions (reactions that right the body for proper alignment)
Balance and Protective reactions – Reactions that contribute to the maintenance of balance

105

what are some reflexes that contribute to head control early on

the righting ones that try to keep vision horizontal (optical righting, labyrinthine)

106

What reflex contributes to prone on elbows

body on head

107

body on head righting reflex starts/ends when

starts birth ends 5 yrs

108

labyrinthine and optical righting lasts

lifetime

109

neck on on body and body onn body start/end when

6 mos -5 yrs

110

the ability of a baby to control its head increases with

sensory input

111

in regards to fall assessment, what are 3 first things to ask

have you fallen, how manytimes, was there a specific cause

112

what are specific goals to focus on for fall intervention/prevention

speed (TUG), strength of muscles involved in strategies, education, proprioception

113

with aging, postural sway (inc or dec)

increases, their perception or feelings are decreasing

114

most falls occur when

walking lifting or carrying, this stuff should be incorprated late in balance training

115

dont forget to include the pts ___ in your plans/goals

env (bath mat, rug, dog, grab bars)

116

what 2 righting reflexes should be present at birth

lab, optical

117

postural stability

COM over BOS = equilibrium

118

plumb line

mastoid, ant shoulder, behind hip, ant knee, ant ankle