How do cervical and lumbar lordosis develop?
4 months- increased lordosis
7 months- Lordosis in quad with hips abducted, Trunk straight, may see slight lordosis
8 months- Hip in line with body in standing due to lordosis, hip extension still incomplete
How does the hand develop?
Newborn: Hands open as arms abduct, loosely flexed, related to arm mvmt
1-2 months: May voluntarily retain object placed in hand for brief period
3 months: eye hand regard
4 months: Hands to knees and other body parts, Can bring hands together but not yet transfer, Prone on Elbows- frees face side hand for reach,
8 months: Walk with hand held
note the pic means to say 3 months
What is the progression for different types of grasp?
Newborn: Strong grasp but hand loosely flexed at rest
1-2 moths: Grasp reflex decreased
3 moths: plantar grasp reflex
4 moths: Primitive ulnar grasp and squeezing pattern
5 months: Palmar grasp
6 months: Palmar and radial palmar grasp
How do infants track?
3 months: Able to track 180 degrees with head extended, eye hand regard
4 moths: Visual tracking without head turning
What is the best way to assess vision in a baby?
Newborn: Easiest to fixate on a moving object laterally and vertically Prefer strong contrasts Best at 8-9 inches away
What is dissociation?
Rotation requires balanced control of flexion and extension and dissociation between body segments
Dissociation is the breaking up of the mass pattern, it is the ability to separate movement in one body part from associated movement in another
Lack may show atypical development
Example: head dissociation
LEs respond to lateral WS with dissociation, quadruped req it, huge increase at 12 months
What does early gait look like? 6
New walker
Flat feet
Toes out
Wide BOS
Short steps
No trunk rotation
High guard arms → progress to middle, low
Rate limiters to walking
Reciprocal leg movements
Strength to support on single limb
Balance
Proficient walking patterns
Stride length increases
Heel strike develops
BOS narrows
Pelvic rotation
Decreased forward trunk inclination
Arm swing
When does running develop?
Develops 6-7 months after walking emerges * Double support never occurs in running * Flight phase - no foot on ground * Early attempts - “fast walks”
When do kids walk up stairs, ride tricycles, bicycles, button clothes?
3 y.o: walk up stairs, tricycle
4 y.o: small bike, large buttons
ATNR testing
Newborns: Use a visual stimulus to encourage the infant to focus and follow the stimulus through an arc of 180 degrees, or observation
6+ years: Railroad track or arm extension test (arms up eyes closed passively rotate head), quadraped test (same but in quadruped eyes track target), supine test (pic, child turns head to the right and left)
ATNR
The Asymmetrical Tonic Neck Reflex
When turning the head to one side causes the arm and leg on that side to straighten while the opposite arm and leg bend, creating a “fencing” position
TLR & testing for it
Tonic Labyrinthine Reflex
A reflex where head position relative to gravity changes overall muscle tone in the body.
Supine → increases extensor tone (body stiffens into extension)
Prone → increases flexor tone (body curls into flexion)
Test:
Infant: prone then supine with head in midline and extremities rest by side, observe, passively move extremities and note tone, then move to sitting and note tone
Older: note tone
Airplane
Monkey
Ball (from supine, no arms over knees
STNR
Symmetrical Tonic Neck Reflex
Neck flexion → arms flex, legs extend
Neck extension → arms extend, legs flex
Test in:
Ventral suspension over the examiners hand
Prone over your lap
Supported sitting
All fours (resisted creeping)
Standing plantigrade (tippy toes
Grasp
Palmar and Plantar Grasp
Pressure placed in the palm/ foot causes the fingers to flex and tightly grasp the object.
Bite
Phasic Bite Reflex to protect airway 28 wks (7 months) Pressure to gums-> bite down Responsible for early munching (vertical chewing) patterns
Galant
Galant/ Trunk Incurvation Reaction Sharp stroke along paravertebral line from scapula to top of iliac crest results in lateral trunk flexion toward stimulated side (0-2mos), check if symmetrical to both sides
How do the kinematics of reach and grasp vary depending on the goal - such as point vs hit vs grasp
Pointing
-all segments of the arm are controlled as a unit
Reach and grasp
-Transport phase: arm moves towards object
-Grasp phase: hand
-Each controlled by separate brain areas
-Grasping
–Longer movement duration
–Requires precision
–Longer deceleration phase (visual feedback for accuracy)
Point and hit
–Shorter duration
–Less need for precise grip
–Faster
Reaching tasks
-Acceleration phase is shorter
-Deceleration phase is longer - allows fine adjustments
What area of the CNS is responsible for predicting grip forces?
Cerebellum
Feedforward control of grip forces
Uses previous experience to scale grip force appropriately
Damage = poor predictive grip control
Cortical lesions = normal timing but reduced response to amplitude
What is the position of the fingers and thumb in a power grip?
Finger pads and thumb are directed toward palm
Forces are transmitted into the palm
Designed for force production, not precision
Examples:
Hook grasp (suitcase handle)
Spherical grasp (ball)
Cylindrical grasp (bottle)
(Precision grip → forces directed between thumb and fingers)
How does pointing vary from reach and grasp?
Pointing
Arm segments move as unit
Single coordinated movement
Shorter movement duration
Less precision
Reach & grasp
Hand and arm controlled separately
Hand movement begins during transport phase
Brain control is separate but coupled
Longer movement duration (especially during deceleration)
Higher precision
What are the most rapid times for bone growth?
“Appositional growth “ (new bone on bone surface)
Prenatal
7 years
Adolescence
What does the concept flexure drift refer to?
Bone straightens some degree of misalignment
Happens bc of repetitive loading strain
Bone is reabsorbed from the convex side and laid down in the concave side
Example: as newborns, femurs have some varum, this straightens through flexure drift
What is the typical position/posture/ROM limitations of the newborn? (11)
hint- at elbow, spine, hips, knee, foot, ankle
Neonatal contractures- physiological limitations in motion
-Elbow flexion
-Kyphosis
-Hips shallow and unstable, abd, ER, coxa valga (pic), flexion
-Knee 20-30 degree flexion, bowing (apparent may not be “true”)
-Slight tibial external torsion
-Possible PF limitation, foot should have a taught lateral boarder, if its a “C” that is metatarsus adductus (pic)
When are the basic structures of the joints formed?
**6-8 weeks of gestation **
Begins as cartilaginous models
Final shape in early childhood
Lack of fetel mvmt= joints not shaped
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1 Neuroplasticity30
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2 Intro to motor control14
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3 + 4 Theories of motor control29
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5 Motor Learning14
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6 motor learning theorys7
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7 motor learning: setting stage & org the enviro15
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8-11 normal development30
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12 PDMS, DAY-C, AIMS30
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13 MSK across lifespan30
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14 gross motor development8
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15 developmental assesment6
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16 Reach grasp and manipulation14
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Final Study Guide42
