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Neuromuscular Rehabilitation > Gross Motor Skills > Flashcards

Gross Motor Skills Flashcards

1
Q

True or False
It is clinically appropriate to measure strength in children through examination of functional movement patterns and sustaining common functional positions or postures

A

True
Important to document quantity (time, distance, reps) and quality (timing, sequencing, etc.) of the movement, consider compensations and age-expected performance values

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2
Q

Describe supine flexion as a skill

A

Referred to as egg. Head, neck, trunk, and pelvis are actively flexed, arms are crossed on chest and legs are in hip and knee flexion with ankle dorsiflexion.

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3
Q

Describe prone extension as a skill

A

Referred to as superman. Head, neck, and trunk are actively extended, arms are in full shoulder flexion with neutral rotation and elbows, wrists, and fingers are extended. the chest is off the surface and legs are extended with hips in neutral rotation and abduction with ankles in plantarflexion. Knees should be extended but not hyperextended.

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4
Q

Describe wheelbarrow walk

A

The child is prone on extended arms, scapular co-activation is present. The head is slightly extended and back is straight, which allows the child to see. Therapist holds child’s legs at their knees keeping the legs and pelvis level.

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5
Q

Describe crabwalk

A

Child maintains the positions with elbows in extension but not hyperextension and hips are less than 30 degrees flexed. When moving, children with have a 2 point or 4 point reciprocal pattern forwards or backwards. If child cannot walk at least 5 feet, there is marked midline weakness present

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6
Q

What are some other positions/activities that can be used to measure strength in children?

A
  • Sit-ups/push-ups completed in 30 sec
  • Plank/modified plank
  • Repeated sit-to-stand in a fixed amount of time
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7
Q

Describe early throwing of a large ball

A
  • Tossed underhand with both hands in a movement driven by elbow flexion, the ball will likely go overhead and not travel far
  • This is usually seen around 15-18 months (1.5 years)
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8
Q

Describe early throwing of a small ball

A
  • Thrown overhand with one arm, motion is driven by elbow extension pushing the ball forward towards the floor with limited accuracy or rotation
  • Motion does not come from shoulder because Sh range is still limited at this age
  • This is usually seen are 17-22 months (almost 2 years)
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9
Q

What must develop in order for later throwing to occur? What continues to improve up through age 6?

A
  • Trunk rotation as well as greater excursion of the UE into ER and abduction
  • Counterbalance is required, the opposite arm comes forward to counterbalance the “wind up” of the throwing arm
  • The ability to step forward with the opposite foot and follow through
  • Accuracy and distance improves with practice and age
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10
Q

In catching, what is required to understand the variables relating to the ball/environment and to successfully plan to catch the ball?

A

Significant information processing

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11
Q

Describe early catching

A
  • Initially may not even make an attempt to catch or may react to slowly
  • Arms are held stiffly away from the body, ball often bounces off arms/chest/face and bounces away
  • Large ball can be caught with both arms trapping the ball against the body (2 years)
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12
Q

Describe later catching

A
  • Progresses to more relaxed arms at side when anticipating a throw and then moving once the ball is in the air to catch the ball with hands instead of arms
  • More advanced skills are required to catch using one hand, a smaller ball, a sport-specific ball, or farther distance
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13
Q

Describe early kicking

A
  • Child walks into the ball and it will bounce off of them, not a purposeful kick around 15-18 months (1.5 years)
  • Evolves into short kicking motion that only goes forward, motion lacks swing back, trunk rotation, and follow through, the trunk is erect and arms are used to maintain balance
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14
Q

Describe later kicking

A
  • Back swing with knee flexion develops, overtime the motion becomes more hip driven with greater follow through
  • The trunk flexes and arms will swing in opposite directions in a more mature pattern due to increased strength and postural control, this can continue to mature from ages 7-9
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15
Q

Jumping is developed as a skill during what age range (in months)?

A

24-38 months

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16
Q

When does the early “accidental” jump typically occur in normal development?

A

24 months (2 years)

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17
Q

When does two footed purposeful jumping typically occur in normal development?

A

Around 28 months

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18
Q

Describe early jumping

A
  • Decreased crouch, legs do not fully extend at take-off
  • Either take-off or landing will be asymmetrical
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19
Q

Describe later jumping

A
  • Increased crouch, arms are thrust forward symmetrically to aide take-off and landing
  • Development of long jump and vertical jump patterns
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20
Q

Galloping is developed as a skill during what age range (in years)?

A

2-3 years

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21
Q

What is required for a child to be able to gallop?

A

Coordination to switch from walking to an asymmetrical pattern of locomotion

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22
Q

Describe early galloping

A
  • UEs are stiff and up in high guard
  • Stride is short, trailing leg may end up in front of leading leg
  • Stiff, foot flat landing
  • Decreased trunk rotation
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23
Q

Describe later galloping

A
  • Arms are not in high guard, as they are not needed for balance anymore
  • Heel to toe landing that is cushioned with slight knee flexion
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24
Q

Hopping is developed as a skill during what age range (in years)?

A

3-4 years

25
Q

Describe early hopping

A
  • UEs are up in high guard
  • Ineffective leg swing leads to decreased force production
  • Stance leg may or may not clear the surface
26
Q

Describe later hopping

A
  • UEs move in opposition to swing leg for momentum
  • LE extends on stance leg while opposite leg swings from momentum
27
Q

Skipping is developed as a skill during what age range (in years)?

A

4-5 years

28
Q

What is required for a child to be able to skip?

A

Coordination of both limbs in an asymmetrical pattern that switches

29
Q

Describe early skipping

A
  • Arrhythmic and stiff movements
  • Have trouble maintaining pattern and will often revert back to a gallop
30
Q

Describe later skipping

A
  • Arms swing rhythmically and in opposition of each other
  • Forefoot or heel to foot landing
31
Q

When do children begin to run?
When do children begin to run easily?

A

Begin to run at 2 years
Begin to run easily at 4 years

32
Q

At what age are children able to run both quick “dash” events AND longer distances up to approximately 1 mile?

A

5 Years old
Children under 5 years old should focus on “dash” events that range from a few yards to 400 meters
Children over 5 years can participate in “fun runs” 1/2 mile to 1 mile long with periods of running and walking

33
Q

When can a child attempt single limb stance? Hold it for 5 seconds? Hold it for 10 seconds?

A

Attempt: 2 years and 6 months
5 seconds: 4 years
10 seconds: 5 years

34
Q

What skill must be acquired before a child can walk on a line?

A

Single limb stance

35
Q

At what age can children walk between 12 inch parallel lines?

A

2 years and 6 months

36
Q

At what age can a child walk a 4 inch wide X 10 foot long line?

A

4 years

37
Q

At what age can a child walk on a 4 inch wide X 10 foot long line with tandem foot placement?

A

4 years and 6 months

38
Q

At what age can a child walk a 4 inch wide X 10 foot long line on their tip toes?

A

5 years

39
Q

A what age can a child walk backwards for at least 6 steps using a toe to heel pattern?

A

5 years old

40
Q

What skill must be acquired before a child can walk on a 2 inch balance beam?

A

Walk on 4 inch line

41
Q

At what age can a child walk with one foot on the balance beam and the other on the ground?

A

2 years and 6 months

42
Q

At what age will a child be able to side-step for 6 steps with both feet on the balance beam? Walk forward? Walk backwards?

A

Side-step: 4 years
Forward: 4 years and 9 months
Backwards: 6 years

43
Q

When will a child be able to walk forward on a balance beam for 10 feet while their eyes are focused on an eye-level target?

A

7 years

44
Q

When does early walking begin to develop?

A

7-15 months

45
Q

Describe early walking

A
  • Short stride with minimal hip extension, feet are flat with a widened BOS, toed-out, UE are in high guard
  • Lots of stability in this position, less mobility, less ability to adapt to changes
46
Q

At what age do children develop to ability to walk sideways or backwards?

A

18 months with continued maturation of patterns into 21 months

47
Q

When does more proficient walking develop?

A

2-5 years

48
Q

Describe proficient walking

A
  • Stride increases with increased force production from hip extension
  • Heel to foot progression, decreased BOS with a more upright trunk and reciprocal UE swing
  • Most components are in place at age 2, refinement and maturation occurs through age 5
49
Q

Improved strength and developments of hip strategies in children around 4 years old allow for them to do what?

A

Ambulate of ramps and steep terrain

50
Q

Stair negotiation develops and progresses as a skill during which age range (months to years)

A

8-13.5 months to 4 .5 years

51
Q

What develops in the child’s body to allow them to progress through stair negotiation?

A
  • Improved postural control
  • Core stability
  • Single limb stance skill
  • Eccentric control
52
Q

What can impact the progression of stair negotiation?

A
  • Stair surface
  • Depth perception
  • Affordances related to body morphology
  • Affordances related to practice opportunities (are there stairs in the home?)
53
Q

True or False
Patterns used for ascending stair must match the pattern for descending stairs for proper development

A

False
Patterns used for ascending stairs do not need to match descending patterns while the skill is developing

54
Q

How would a a child negotiate stairs at 8-13.5 months to 15 months of age?

A

Creeping or hitching upstairs, may bump down stairs until about 15 months when they are able to creep backwards to descend stairs

55
Q

How would a child negotiate stairs at 15 months to 2 years of age?

A

Ascend and descend non-reciprocally while holding the rail with one UE and holding parent hand with other UE (2 UE support). This can then progress to non-reciprocal ascending/descending while holding only the rail with 2 UEs

56
Q

How would a child negotiate stairs at 2 years of age?

A

Ascends and descends non-reciprocally with one UE on the rail (1 UE support)

57
Q

How would a child negotiate stair at 2.5 to 3 years of age?

A

Ascends and descends stairs reciprocally with one UE on the rail (1 UE support)

58
Q

How would a child negotiate stairs at 3.5 years of age?

A

Ascends and descends non-reciprocally without the hand rail (no UE support)

59
Q

How would a child negotiate stairs at 4 to 4.5 years of age?

A

Ascends and descends reciprocally without the rail (no UE support). Confidence and sense of safety will begin to improve leading to increased speed and efficiency. Child will begin to be able to carry objects without reverting to previous patterns

Neuromuscular Rehabilitation (12 decks)

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