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Motor Development > Posture 1yr+ > Flashcards

Posture 1yr+ Flashcards

1
Q

define postural control

A

controlling the body’s position in space

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2
Q

goal of postural control system

A

stable vertical posture of head/trunk against gravity to provide a base for dynamic activities

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3
Q

COM at birth

A

xiphoid process

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4
Q

COM in adults

A

iliac crest, S2-S3

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5
Q

a correction strategy is required when…

A

COM approaches BOS

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6
Q

static postural control

A

maintaining COM within BOS

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7
Q

dynamic postural control

A

governs movement of COM in/out of BOS

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8
Q

righting rxn

A

orient self to environment

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9
Q

equilibrium rxn

A

maintain balance when COM disturbed

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10
Q

protective rxn

A

restore balance if equilibrium cannot

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11
Q

components of postural control

A
  1. sensory organization
  2. eye-head stabilization
  3. MSK system
  4. postural sway strategies
  5. predictive central set
  6. environmental adaptation
  7. motor coordination
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12
Q

sensory organization: visual system 0-3yrs

A

dominates postural responses

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13
Q

sensory organization: visual system 4-6yrs

A

source of primary info

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14
Q

sensory organization: somatosensory system 7-10yrs

A

adult-like ability to use somatosensory info for balance

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15
Q

sensory organization: vestibular system 7-10yr

A

adult-like ability to use vestibular info for balance

continues developing to age 16

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16
Q

eye-head stabilization

A

using eyes and labyrinths to provide sensory input about movement of surroundings & head

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17
Q

MSK system contributes to postural control by…

A

body size/proportions
viscoelasticity
muscle tone

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18
Q

postural sway strategies: ankle

A 
small perturbations (thing that disrupts balance)
foot fully supported
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19
Q

postural sway strategies: hip

A

large perturbations

foot not fully supported

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20
Q

postural sway strategies: step

A

perturbation is too large to recover without a protective step

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21
Q

postural sway strategies: age 4-6

A

varying strategies used

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22
Q

postural sway strategies: age 7-10

A

consistent ankle strategy used

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23
Q

predictive central set

A

postural readiness

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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)

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25
Q

environmental adaptations

A

changes in posture in response to perceived needs (e.g. walking on something slippery, walking on sand)

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26
Q

motor coordination

A

The ability to coordinate muscle activation in a sequence that preserves posture.

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27
Q

motor coordination: strategies used

A

muscle synergies
postural rxns
sway strategies

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28
Q

prerequisites to motor coordination

A

adequate strength and muscle tone

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29
Q

Periods of rapid increases in bone mineral density

A

1-4yrs
Puberty
90-95% of peak bone mass before age 20

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30
Q

childhood bone growth is primarily…

A

LE

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31
Q

adolescent bone growth is primarily…

A

trunk

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32
Q

adolescent bone growth occurs at age

A

girls: 12-13yr
boys: 15-17yr

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33
Q

factors affecting bone growth

A 
genetics
nutrition
hormones
physical activity
general health status
34
Q

normal femoral inclination angle

A

130deg

35
Q

femoral inclination angle - coxa valga

A

160deg

36
Q

femoral inclination angle - coxa vara

A

105deg

37
Q

femoral inclination angle at birth

A

slight coxa valga

38
Q

femoral inclination angle ____ (increase or decrease) from birth to adulthood

A

decrease

39
Q

antetorsion ____ (increase or decrease) from birth to adulthood

A

decrease

40
Q

anteversion ____ (increase or decrease) from birth to adulthood

A

decrease

41
Q

normal bone growth: load is _____ to growth plate or _____ to direction of growth.

A

perpendicular to growth plate

parallel to direction of growth

42
Q

effects of too much/too little load on bone growth

A

too much load = may interfere with bone growth (Blount’s)

too little load = may not stimulate appropriate bone growth (Hemiplegia)

43
Q

effects of unequal load on bone growth

A

change direction of bone growth

ex) limb length discrepancy

44
Q

effects of torsional load on bone growth

A

result in rotational changes

e.g. from W-sitting

45
Q

effects of shearing load on bone growth

A

displace growth plate (Slipped capital femoral epiphysis)

46
Q

Blount’s disease: what is it?

A

progressive growth disorder
deceleration of growth at medial knee
results in tib vara

47
Q

Blount’s disease: risk factors

A

obesity
genetics
vit D deficiency
boys > girls

48
Q

Blount’s disease: clinical presentation

A

bowing out
limb length discrepancy
abnorm gait
in-toeing (frequent tripping)

49
Q

Blount’s disease: role of PT

A

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
Q

Osgood-Schlatter’s Disease: what is it?

A

Activity-related knee pain/edema at insertion of patellar tendon.
minor separation of tibial tubercle from tensile force from patellar tendon.

51
Q

Osgood-Schlatter’s Disease: causes

A

repetitive strain
trauma
muscle tightness
boys > girls

52
Q

Osgood-Schlatter’s Disease: role of PT

A 
ice/rest
modify activity
flexibility (esp quads)
neoprene bracing or taping
immobilization if severe
resolves by age 15 (tubercle fuses)
53
Q

Legg-Calve-Perthes Disease: what is it?

A

Abnormal blood supply to femoral head
Avascular necrosis
4-8 years old

54
Q

Legg-Calve-Perthes Disease: causes

A 
Nutrition
delayed bone growth
abnormal clotting or venous drainage
decreased birth weight
boys > girls
55
Q

Legg-Calve-Perthes Disease: clinical presentation

A

Muscle weakness
Decreased ROM - hip ABD & IR
gait deviations (Trendelenburg)
pain in groin, hip, knee

56
Q

Legg-Calve-Perthes Disease: role of PT

A

Goal: decrease compression on joint, maintain ROM, prevent arthritis.
Mobility, strength, gait.

57
Q

Legg-Calve-Perthes Disease: conservative treatments

A 
full hip ABD w/ bracing
steroids
ROM
strength
NWB if severe.
58
Q

Legg-Calve-Perthes Disease: surgery treatments

A

Free Vascularized Fibular Grafting (FVFG)
Proximal Femoral Varus Derotation Osteotomy (VDRO)
NWB
AROM lower leg

59
Q

Slipped Capital Femoral Epiphysis (SCFE): what is it?

A

Femoral head displaced posteriorly/inferiorly (in relation to the femoral neck).
Age 10-15.
Boys > girls.

60
Q

Slipped Capital Femoral Epiphysis (SCFE): causes

A

mechanical
endocrine
obesity

61
Q

Slipped Capital Femoral Epiphysis (SCFE): clinical presentation

A

Acute or chronic pain: groin, medial thigh, knee.
Antalgic Gait
Decreased hip ROM: Flex, ABD, IR, ER noted with hip flexion

62
Q

Slipped Capital Femoral Epiphysis (SCFE): role of PT

A

Refer to ortho
Surgery to stabilize growth plate (NWB initially).
PT: strength & gait (as WB allows).
Return to normal activity: 3-6 months

63
Q

Scoliosis: What is it (& Cobb angle)

A

Abnormal lateral curvature

Cobb >10 degrees

64
Q

Infantile scoliosis

A

<3yr
<1% of cases
idiopathic
resolves spontaneously

65
Q

Juvenile scoliosis

A

3-9yr

High rate of progression/severe deformity if untreated

66
Q

Adolescent scoliosis

A

80% of cases

Only 3-9% of these cases require interventions

67
Q

Scoliosis: role of PT

A

Orthosis: 18-23 hours/day until skeletal maturity.
Exercise
Transfer & gait training
Pain management
Patient education: Bend, Lift, Twist; Backpack management

68
Q

Muscle mass increase - gender differences

A

Boys 5x

Girls 3.5x

69
Q

Strength improvements - prepubescent

A

improved force output
NOT muscle mass
neuro adaptations

70
Q

Strength improvements - postpubescent

A

improved force output

improved muscle mass

71
Q

Ex rx for kids: ___ reps & ____ resistance

A

high reps

mod resist

72
Q

what causes muscle tightness?

A

Long bone growth exceeds rate muscle lengthens

73
Q

Metabolic heat dissipated with exercise is _____ (more/less) in kids than adults?

A

more

74
Q

T/F: Children acclimate slower to changes in temperature

A

true

75
Q

T/F: Children have greater dependence on vasoconstriction

A

false, children depend more on vasoDILATION

76
Q

T/F: Sweat rate is higher in kids

A

false, sweat rate is LOWER in kids than adults

77
Q

Why is sweat rate lower in kids?

A

Children have increased density of sweat glands.

Adult gland produces 2.5x more sweat.

78
Q

How does nervous system development impact motor skills?

A

ongoing myelination = conduction improves = reduced rxn time (time btwn presentation of stim & motor response)

79
Q

How does the sensory system become more refined?

A

Increased abilities to:
attend >1 trait of a stimulus
attach meaning to sensory stimuli
plan motor response

80
Q

When does the vestibular system reach maturity?

A

10-14yr

81
Q

When does the hearing system reach maturity?

A

13yr

82
Q

When does the visual system reach it’s best ability?

A

10yr

Motor Development (16 decks)

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