Posture 1yr+ Flashcards
(82 cards)
1
Q
define postural control
A
controlling the body’s position in space
2
Q
goal of postural control system
A
stable vertical posture of head/trunk against gravity to provide a base for dynamic activities
3
Q
COM at birth
A
xiphoid process
4
Q
COM in adults
A
iliac crest, S2-S3
5
Q
a correction strategy is required when…
A
COM approaches BOS
6
Q
static postural control
A
maintaining COM within BOS
7
Q
dynamic postural control
A
governs movement of COM in/out of BOS
8
Q
righting rxn
A
orient self to environment
9
Q
equilibrium rxn
A
maintain balance when COM disturbed
10
Q
protective rxn
A
restore balance if equilibrium cannot
11
Q
components of postural control
A
- sensory organization
- eye-head stabilization
- MSK system
- postural sway strategies
- predictive central set
- environmental adaptation
- motor coordination
12
Q
sensory organization: visual system 0-3yrs
A
dominates postural responses
13
Q
sensory organization: visual system 4-6yrs
A
source of primary info
14
Q
sensory organization: somatosensory system 7-10yrs
A
adult-like ability to use somatosensory info for balance
15
Q
sensory organization: vestibular system 7-10yr
A
adult-like ability to use vestibular info for balance
continues developing to age 16
16
Q
eye-head stabilization
A
using eyes and labyrinths to provide sensory input about movement of surroundings & head
17
Q
MSK system contributes to postural control by…
A
body size/proportions
viscoelasticity
muscle tone
18
Q
postural sway strategies: ankle
A
small perturbations (thing that disrupts balance) foot fully supported
19
Q
postural sway strategies: hip
A
large perturbations
foot not fully supported
20
Q
postural sway strategies: step
A
perturbation is too large to recover without a protective step
21
Q
postural sway strategies: age 4-6
A
varying strategies used
22
Q
postural sway strategies: age 7-10
A
consistent ankle strategy used
23
Q
predictive central set
A
postural readiness
24
Q
predictive central set: feed forward mechanism
A
anticipatory postural adjustment to prepare for movement and/or assist in movement (by adding force or velocity)
25
environmental adaptations
changes in posture in response to perceived needs (e.g. walking on something slippery, walking on sand)
26
motor coordination
The ability to coordinate muscle activation in a sequence that preserves posture.
27
motor coordination: strategies used
muscle synergies
postural rxns
sway strategies
28
prerequisites to motor coordination
adequate strength and muscle tone
29
Periods of rapid increases in bone mineral density
1-4yrs
Puberty
90-95% of peak bone mass before age 20
30
childhood bone growth is primarily...
LE
31
adolescent bone growth is primarily...
trunk
32
adolescent bone growth occurs at age
girls: 12-13yr
boys: 15-17yr
33
factors affecting bone growth
```
genetics
nutrition
hormones
physical activity
general health status
```
34
normal femoral inclination angle
130deg
35
femoral inclination angle - coxa valga
160deg
36
femoral inclination angle - coxa vara
105deg
37
femoral inclination angle at birth
slight coxa valga
38
femoral inclination angle ____ (increase or decrease) from birth to adulthood
decrease
39
antetorsion ____ (increase or decrease) from birth to adulthood
decrease
40
anteversion ____ (increase or decrease) from birth to adulthood
decrease
41
normal bone growth: load is _____ to growth plate or _____ to direction of growth.
perpendicular to growth plate
| parallel to direction of growth
42
effects of too much/too little load on bone growth
too much load = may interfere with bone growth (Blount's)
| too little load = may not stimulate appropriate bone growth (Hemiplegia)
43
effects of unequal load on bone growth
change direction of bone growth
| ex) limb length discrepancy
44
effects of torsional load on bone growth
result in rotational changes
| e.g. from W-sitting
45
effects of shearing load on bone growth
displace growth plate (Slipped capital femoral epiphysis)
46
Blount's disease: what is it?
progressive growth disorder
deceleration of growth at medial knee
results in tib vara
47
Blount's disease: risk factors
obesity
genetics
vit D deficiency
boys > girls
48
Blount's disease: clinical presentation
bowing out
limb length discrepancy
abnorm gait
in-toeing (frequent tripping)
49
Blount's disease: role of PT
bracing (HKAFO - Hip Knee Ankle Foot Orthosis)
surgery if conservative tx not worked by 4yr.
surgery = better alignment when done before age 4.
surgery = lower re-occurance rate if done after age 4.5
50
Osgood-Schlatter's Disease: what is it?
Activity-related knee pain/edema at insertion of patellar tendon.
minor separation of tibial tubercle from tensile force from patellar tendon.
51
Osgood-Schlatter's Disease: causes
repetitive strain
trauma
muscle tightness
boys > girls
52
Osgood-Schlatter's Disease: role of PT
```
ice/rest
modify activity
flexibility (esp quads)
neoprene bracing or taping
immobilization if severe
resolves by age 15 (tubercle fuses)
```
53
Legg-Calve-Perthes Disease: what is it?
Abnormal blood supply to femoral head
Avascular necrosis
4-8 years old
54
Legg-Calve-Perthes Disease: causes
```
Nutrition
delayed bone growth
abnormal clotting or venous drainage
decreased birth weight
boys > girls
```
55
Legg-Calve-Perthes Disease: clinical presentation
Muscle weakness
Decreased ROM - hip ABD & IR
gait deviations (Trendelenburg)
pain in groin, hip, knee
56
Legg-Calve-Perthes Disease: role of PT
Goal: decrease compression on joint, maintain ROM, prevent arthritis.
Mobility, strength, gait.
57
Legg-Calve-Perthes Disease: conservative treatments
```
full hip ABD w/ bracing
steroids
ROM
strength
NWB if severe.
```
58
Legg-Calve-Perthes Disease: surgery treatments
Free Vascularized Fibular Grafting (FVFG)
Proximal Femoral Varus Derotation Osteotomy (VDRO)
NWB
AROM lower leg
59
Slipped Capital Femoral Epiphysis (SCFE): what is it?
Femoral head displaced posteriorly/inferiorly (in relation to the femoral neck).
Age 10-15.
Boys > girls.
60
Slipped Capital Femoral Epiphysis (SCFE): causes
mechanical
endocrine
obesity
61
Slipped Capital Femoral Epiphysis (SCFE): clinical presentation
Acute or chronic pain: groin, medial thigh, knee.
Antalgic Gait
Decreased hip ROM: Flex, ABD, IR, ER noted with hip flexion
62
Slipped Capital Femoral Epiphysis (SCFE): role of PT
Refer to ortho
Surgery to stabilize growth plate (NWB initially).
PT: strength & gait (as WB allows).
Return to normal activity: 3-6 months
63
Scoliosis: What is it (& Cobb angle)
Abnormal lateral curvature
| Cobb >10 degrees
64
Infantile scoliosis
<3yr
<1% of cases
idiopathic
resolves spontaneously
65
Juvenile scoliosis
3-9yr
| High rate of progression/severe deformity if untreated
66
Adolescent scoliosis
80% of cases
| Only 3-9% of these cases require interventions
67
Scoliosis: role of PT
Orthosis: 18-23 hours/day until skeletal maturity.
Exercise
Transfer & gait training
Pain management
Patient education: Bend, Lift, Twist; Backpack management
68
Muscle mass increase - gender differences
Boys 5x
| Girls 3.5x
69
Strength improvements - prepubescent
improved force output
NOT muscle mass
neuro adaptations
70
Strength improvements - postpubescent
improved force output
| improved muscle mass
71
Ex rx for kids: ___ reps & ____ resistance
high reps
| mod resist
72
what causes muscle tightness?
Long bone growth exceeds rate muscle lengthens
73
Metabolic heat dissipated with exercise is _____ (more/less) in kids than adults?
more
74
T/F: Children acclimate slower to changes in temperature
true
75
T/F: Children have greater dependence on vasoconstriction
false, children depend more on vasoDILATION
76
T/F: Sweat rate is higher in kids
false, sweat rate is LOWER in kids than adults
77
Why is sweat rate lower in kids?
Children have increased density of sweat glands.
| Adult gland produces 2.5x more sweat.
78
How does nervous system development impact motor skills?
ongoing myelination = conduction improves = reduced rxn time (time btwn presentation of stim & motor response)
79
How does the sensory system become more refined?
Increased abilities to:
attend >1 trait of a stimulus
attach meaning to sensory stimuli
plan motor response
80
When does the vestibular system reach maturity?
10-14yr
81
When does the hearing system reach maturity?
13yr
82
When does the visual system reach it's best ability?
10yr
