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Postural Control Flashcards

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1
Q

Why is postural control important in physical therapy?

A

Postural control is essential for movement and activities of daily living such as standing, walking, and climbing stairs.

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2
Q

How does postural control relate to skilled movements?

A

Good posture and balance are necessary for executing finer skilled movements, such as painting, where core stability is important.

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3
Q

What types of patients do physical therapists work with regarding balance?

A

Physical therapists treat patients with varying levels of balance abilities, from those with extremely poor balance to athletes with excellent balance.

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4
Q

Why is understanding the science of postural control crucial for physical therapists?

A

It allows therapists to apply evidence-based practices, understand the neural basis of balance, and assess and treat balance disorders effectively.

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5
Q

What is the significance of evidence-based practice in physical therapy?

A

Evidence-based practice relies on research findings to inform clinical decision-making and treatment strategies for balance and postural control.

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6
Q

What foundational knowledge do physical therapists need for assessing balance?

A

Therapists need to understand the tests and measures necessary to evaluate balance control and the factors contributing to imbalance.

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7
Q

What are the key components of this part of the lecture on postural control?

A

The basic science of motor control, the biomechanical basis of posture, systems involved in postural control, and principles of assessment and treatment based on the movement system framework.

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8
Q

How does postural control relate to the movement system framework?

A

Postural control is a crucial aspect of the movement system framework that informs assessment and treatment strategies for patients.

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9
Q

What are the two main parts of postural control?

A

Postural orientation and postural stability.

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10
Q

Define postural orientation.

A

The ability to maintain a favorable relationship between different body segments and between the body and the environment.

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11
Q

What is the purpose of postural control?

A

To control the body’s position in space for stability and orientation.

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12
Q

What does postural stability refer to?

A

The ability to control the center of mass in relation to the base of support.

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13
Q

How does postural orientation relate to task performance?

A

Good postural orientation is task-dependent; the alignment of body segments must be appropriate for the specific task being performed.

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14
Q

What is the difference between static and dynamic balance?

A

Static balance refers to maintaining a steady posture, while dynamic balance involves maintaining stability while the center of gravity and base of support are moving.

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15
Q

What is functional balance?

A

The ability to perform daily movement tasks that require balance, involving both static and dynamic balance.

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16
Q

How are postural orientation and postural stability interrelated?

A

Changes in postural orientation can affect postural stability, as alignment influences the control of the center of mass relative to the base of support.

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17
Q

What happens to postural orientation during a task that requires maintaining stability?

A

The focus shifts to maintaining stability, which may alter the postural orientation to achieve that goal.

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18
Q

Describe the impact of a forward bent posture on stability.

A

A forward bent posture shifts the line of gravity anteriorly within the base of support, compromising stability and increasing the risk of falls.

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19
Q

How can postural stability be regained if it is compromised?

A

By changing postural orientation, such as adjusting body segments to bring the center of mass back over the base of support.

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20
Q

Why is it important to consider task requirements when assessing postural control?

A

Task requirements influence both postural orientation and stability, making it crucial for evaluating and developing effective treatment strategies.

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21
Q

What are the key biomechanical constructs related to postural control?

A

Base of support, center of gravity, center of pressure, and stability limits.

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22
Q

Define base of support.

A

The area of the body in contact with the support surface; larger base of support equals more stability.

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23
Q

How does base of support change when moving from sitting to standing?

A

The base of support reduces significantly, leading to potential balance issues.

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24
Q

What is the center of mass?

A

The point at which the total body mass is concentrated, typically around the L2 vertebral level in standing humans.

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25
Differentiate between center of mass and center of gravity.
Center of mass is a three-dimensional point in space, while center of gravity is the vertical projection of the center of mass onto a two-dimensional plane (ground).
26
How does the height of the center of mass affect stability?
A higher center of mass reduces stability, while a lower center of mass increases stability due to the moment arm effect.
27
What is center of pressure?
The point of application of the ground reaction force vector, reflecting the net distribution of forces applied to the support surface.
28
What is the relationship between center of gravity and base of support?
When the center of gravity is within the base of support, stability is greater; when it is outside, stability is compromised.
29
Define stability limits.
The boundaries within which the body can maintain stability without changing the base of support.
30
How do position and velocity of the center of mass influence stability limits?
Stability limits are determined by both the position and velocity of the center of mass; if either exceeds certain thresholds, a step may be necessary to maintain balance.
31
Why might patients with poor balance move slowly?
They may slow their movement to minimize center of mass velocity, thereby enhancing stability.
32
What clinical implication arises from understanding center of mass velocity?
Testing and assessing balance should be conducted at different speeds to accurately gauge a patient's balance abilities.
33
What model is being used to discuss postural control?
The dynamical systems model.
34
What is the primary goal of the postural control system?
To ensure postural orientation and stability.
35
How does the dynamical systems model view the nervous system?
As an interactive system that recognizes the importance of other systems contributing to movement control.
36
What are the key components considered in the control of posture and balance?
The nervous system, biomechanical system, task, and environment.
37
How is postural control achieved during motor tasks?
By controlling the center of pressure through active muscle control during self-initiated movements and unexpected perturbations.
38
What is an example of a self-initiated motor task?
A sit-to-stand movement.
39
What defines an unexpected perturbation?
An unanticipated event that affects balance, such as a sudden stop of a subway or being pushed.
40
What are the outstanding questions in motor control of posture?
How the nervous system controls variables affecting posture and balance, factors influencing control, and systems that enable postural control.
41
What is the purpose of research in understanding postural control?
To create a framework for assessing balance and treating postural control issues.
42
How can research findings be utilized in clinical practice?
By organizing them into an easily translatable framework for clinicians.
43
What does postural control emerge from?
The interaction of the individual within an environment while trying to accomplish a specific task.
44
What three systems contribute to an individual's control of balance?
Motor, sensory, and cognitive systems.
45
What factors affect the motor system in postural control?
Musculoskeletal linkages, muscle strength, and muscle synergies.
46
Why is muscle strength important for postural control?
Muscles need to contract to maintain the center of pressure over the center of mass
47
48
What are the three types of postural tasks?
Steady state tasks, reactive tasks, and proactive tasks.
49
What defines a steady state task?
A task where the base of support remains unchanged and the control of the center of mass is predictable, such as sitting or standing.
50
What is a reactive task?
A task requiring the ability to recover stability following an unexpected perturbation, like slipping on ice while walking.
51
How does the nervous system respond to unexpected perturbations?
It activates reactive strategies to prevent falls and restore stability.
52
What distinguishes a proactive task from a reactive task?
Proactive tasks involve muscle activation in anticipation of potential destabilizing movements, while reactive tasks respond to unexpected disturbances.
53
What is an example of a proactive strategy?
Planting your foot flat on the ground while walking on slippery pavement to prevent a fall.
54
What is the concept of feedback versus feedforward in postural control?
Feedforward processes are proactive and rely on anticipation, while feedback processes respond to perturbations.
55
How does feedforward control work in postural tasks?
It involves making anticipatory adjustments to prevent postural disturbances before they occur.
56
How does feedback control function?
It triggers postural responses based on sensory feedback from unexpected perturbations.
57
What are the two main modes of postural control?
Feedback control (reactive) and feedforward control (anticipatory).
58
How is feedforward control studied in scientific literature?
Through measurements of EMG muscle activity during tasks that involve sudden movements, such as shoulder flexions.
59
What muscles might be involved in studying feedforward control during shoulder flexion?
Deltoid, external oblique, transverse abdominis, and internal oblique.
60
What happens to the center of mass during sudden shoulder flexion?
The center of mass moves forward, creating a potential destabilizing moment.
61
What does EMG timing reveal about anticipatory postural control?
The transverse abdominis activates before the deltoid during shoulder flexion, indicating the CNS anticipates the movement's effect on the center of mass.
62
How is feedforward control measured in the clinic?
By observing patients performing voluntary actions like sitting, standing, or reaching, and assessing their speed and efficiency.
63
What characterizes feedback strategies in postural control?
They involve maintaining stability in response to external perturbations while in a steady state.
64
How is feedback control studied in research?
By applying unexpected perturbations to a person standing on a movable surface and observing muscle activation patterns to regain balance.
65
What is the order of muscle activation in response to an external perturbation?
First, the gastrocnemius, then the hamstrings, followed by the paraspinal muscles.
66
What is an "ankle synergy"?
A coordinated muscle response activated in sequence to regain balance after a perturbation.
67
How do environmental constraints affect postural control?
Factors like surface type (concrete vs. uneven), lighting, and clutter can influence a patient's balance and movement.
68
Why might a patient's progress in therapy not translate to home?
Differences in the home environment, such as clutter, can affect their ability to maintain balance outside the clinic.
69
What role do sensory systems play in postural control?
They provide crucial information about body position and movement, enabling effective postural adjustments.
70
How does closing one's eyes affect balance?
It reduces input from the visual system, increasing postural sway and potentially destabilizing balance.
71
What cognitive factors influence postural control?
Motivation, fear of falling, and the ability to multitask can significantly affect balance performance.
72
What is the BESTest?
The Balance Evaluation Systems Test assesses various aspects of balance and postural control, helping identify specific deficits in patients.
73
What is the movement system framework for assessment?
It includes the activity, environment, and factors such as motion, force, energy, and motor control to evaluate postural control.
74
What is the first principle of balance training?
Enhance the individual's capacity regarding force, range of motion, and energy based on a movement system assessment.
75
How can you improve motor control in balance training?
Through high-intensity challenging practice that focuses on the specific task needing improvement.
76
Why is challenge crucial in balance training?
Challenge is essential because it pushes patients to work at their stability limits, making tasks feel challenging and promoting improvement.
77
What should patients feel during balance training?
Patients should feel a sense of instability during treatment, indicating that they are being adequately challenged.
78
How should therapists ensure patient safety while challenging their balance?
Therapists should guard patients closely and provide support, ensuring they do not fall while facing challenges.
79
How can environments be modified to increase challenge in balance training?
Change environments frequently, use different surfaces, and adjust lighting or noise levels to enhance the challenge.
80
What role do cognitive loads play in balance training?
Adding cognitive tasks, such as walking while talking or solving puzzles, increases the challenge and helps improve balance.
81
Why is varying sensory input important in balance training?
Modifying sensory input, such as reducing vision or using different surfaces, creates additional challenges that enhance postural control.
82
How does increasing speed affect balance training?
Adding speed to tasks is an effective way to challenge balance and encourage stability limits.
83
What is a key takeaway regarding challenge in patient treatment?
If a patient is not feeling challenged or unstable during treatment, the therapist is not effectively promoting improvement.

PT663 (22 decks)

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