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UM - Neuro Science > Posture/Balance/Transfers/Gait Motor Control - E1 > Flashcards

Posture/Balance/Transfers/Gait Motor Control - E1 Flashcards

1
Q

Define balance

A

The ability to control one’s COM w/respect to the BOS

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2
Q

Define BOS

A

The area of the body in contact w/the support surface

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3
Q

What is postural stability?

A

Balance!

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4
Q

What is Center of Pressure

A

The center of the distribution of total forces applied to the support surface

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5
Q

Define “cone of stability”

A

The boundaries w/in which the body can maintain stability w/o changing the BOS

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6
Q

What is another word for “cone of stability”

A

Stability limits

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7
Q

Define 0 balance

A

Unable to maintain balance or no attempt made

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8
Q

Define poor balance

A

Able to balance w/ or w/o UE support for 5 seconds or less

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9
Q

Define fair balance

A

Able to balance w/ or w/o UE support for 15-60s and/or able to hold against slight resistance

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10
Q

Define good balance

A

Able to hold balance against moderate resistance

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11
Q

List the 4 types of balance

A

Static
Dynamic
Protective
Functional

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12
Q

List the types of static balance

A

Static - time as measure (T)
Static - resistance as measure (R)
Static - anticipatory, feed-forward (AFF)

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13
Q

List the types of dynamic balance

A

Dynamic - reactive, feedback (RFB)

Dynamic - anticipatory, feedforward (AFF)

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14
Q

Static Balance T
A) objective or subjective?
B) what are you doing?

A

A) Time is an objective measure

B) maintain a position over time

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15
Q

How do you test Static Balance R
A) objective or subjective?
B) what are you doing?

A

A) Can be subjective or objective
B) Attempt to assume near-normal posture w/w/o BUE support and maintain position against gradual matched manual resistance

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16
Q

What are the Static Balance Basic Procedures - w/Pt in sitting

A

1) Height-adjustable table
2) Feet flat on floor
3) Hips & knees at 90
4) Max thigh contact on support surface
5) UE supported or unsupported

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17
Q

What is PT force application….

a) positions
b) instructions
c) duration
d) end?

A 
a) anterior - mid sternum
posterior - mid upper back
R/L - acromion
b) Hold, don't let me move you
c) Gradual build up 3-4 sec
d) End when displaced approx 1 inch
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18
Q

Is the (a/b) reliability high for sitting strength tests

a) Intra-rater
b) inter-rater

A

Yes & yes - both are fairly high of ICCs

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19
Q

What is Static Balance AFF

A

The individual is anticipating or predicting what trunk and proximal mm actions or motor control is necessary to prevent falling due to the progressively increasing weight of the arm during reaching

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20
Q

What is the goal of Static AFF balance?

A

Stability

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21
Q

What are you doing with Dynamic Balance - RFB

A

Manually displace the COM toward the edges of BOS to elicit the equilibrium or balance rxns

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22
Q

How do you describe a perturbation?

A

Based on the direction the patient is moving

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23
Q

What occurs w/lateral displacement?

a) head/neck
b) trunk
c) arms
d) legs

A

a) CL (to displacement) lat flexion
b) CL (to displacement) lat flexion, ipsi elongation
c) CL (to displacement)
d) CL IR (to displacement) and IPSI ER

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24
Q

What are you doing in dynamic balance - AFF

A

Reach in various directions beyond arm’s length to elicit trunk and arm (sitting) and whole body (standing) balance reaction

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25
Q

What is an objective test of dynamic sitting and standing AFF balance

A

The Multi-Directional Reach test (MDRT): using a meterstick

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26
Q

What type of reactions are protective reactions?

A

Reactive, feedback reactions

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27
Q

How do you test protective reactions?

A

PT uses manual perturbations to move PT beyond BOS, 1st slow and then 2nd relatively faster

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28
Q

What are some examples of functional balance tests?

A

BERG
Tinetti
Mini-BEST test

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29
Q

What is functional balance?

A

The utilization of effective balance strategies while performing a set of functional tasks which progress in difficulty

30
Q

What is the momentum strategy for rolling?

A

Generates momentum by initiating motion by head, lead shldr, and trunk w/either simultaneous or immediately followed by lead UE reaching

31
Q

What is the first common form of rolling?

a) arm
b) HT
c) Leg

A

It is the momentum strategy where
A) arms lift and reach above shldr pattern
B) shldr girdle leads
C) Unilateral lift

32
Q

What is the 3rd common form of rolling?

a) arm
b) HT
c) Leg

A

It is a momentum pattern where
A) Lift and reach above shldr level
B) Shldr girdle leads
C) Bilateral lift

33
Q

What is the Force-control strategy of rolling?

A

Pt pushes w/LE either in a flexed or semi-flexed position which propels the body to SL w/flexion of shldr, head, trunk, and lead UE assists in the motion

34
Q

What is the second common form of rolling?

a) arm
b) HT
c) Leg

A

It is a force control strategy with
A) Lift and reach above shldr level
B) Shoulder girdle leads
C) Unilateral push

35
Q

T or F: Supine to erect stance is not variable for adults 20-35 years old

A

False - there is lots of variability

36
Q

What is the first common form of supine to standing?
A) UE
B) Axial
C) LE

A

A symmetrical Force strategy
A) UE: symmetrical push
B) Axial: symmetrical
C) LE: symmetrical squat

37
Q

What is the 2nd common form of supine to standing?
A) UE
B) Axial
C) LE

A

Symmetrical except for LEGS
A) UE: symmetrical push
B) Axial: symmetrical
C) LE: asymmetric squat

38
Q

What is the 3rd common form of standing?
A) UE
B) Axial
C) LE

A

Rotation Strategy
A) UE: asymmetrical push and reach
B) Axial: partial rotation
C) LE: half kneel

39
Q

What form of supine to erect stance requires the greatest force production?

A

Symmetrical form of rising requires greatest control of direction and force production

40
Q

What factors can influence a movement pattern

A
  • Taller and lighter = more symmetrical

- Shorter and heavier = asymmetrical

41
Q

What is included in the task of STS

A

Move the COM from BOS defined by buttock to the BOS defined by the feet

42
Q

What type of curve is present at the tragus during sit to stand?

A

C curve

43
Q

What kind of curve is present at the acromion during STS?

A

C curve

44
Q

What kind of curve is present at the top of the pelvis during STS?

A

S curve

45
Q

What kind of curve is present at the bottom of the pelvis during STS?

A

S curve

46
Q

What kind of curve is present at the knee during STS?

A

Anterior translation 1st

47
Q

What major movements occur during STS at…

a) neck
b) trunk
c) pelvis
d) hip
e) knee
f) ankle

A 
A) Flex --> extension
B) Flex --> extension
C) APT --> PPT
D) Flex --> extension
E) Extension throughout
F) Flex --> extension
48
Q

Define STS Momentum Strategy

A

Requires at least a certain amount of speed and no breaks in motion - accel then decel the COM

49
Q

Define STS Force Strategy

A

Trunk generates F to bring COM over the BOS - stop or nearly stop - then LE forces lift the body to the vertical position

50
Q

What occurs at each phase in the Neck during STS?
A) total movement
B) each phase

A 
A) 8 degrees
B)
0%    2 flex below horizontal
30%    4 flexed, begin extension
100%    +4 exten above horizontal
51
Q

What occurs at each phase in the Trunk during STS?
A) total movement
B) each phase

A 
A) 32 total degrees
B)
0%    10 deg flexed from vertical --> RAPID FLEXION
45%    42 flexion --> RAPID EXTENSION
100%    extended to vertical
52
Q

What occurs at each phase in the pelvis during STS?
A) total movement
B) each phase

A

A) 38 deg total
B)
0% 26 deg behind vert in PPT, moving toward flexion
50% 12 deg fwd vert in APT, now move toward PPT
100% 1 deg fwd of vertical

53
Q

What occurs at each phase in the Hip during STS?

A) each phase

A

A)
Flexion first 40%
Extension second 60%

54
Q

What occurs at each phase in the Knee during STS?
A) Total movement
B) each phase

A

A) 70 deg
B)
Very little ext 1st 40% (6 deg)
Rapid extension 2nd 60% of movement (76 deg)

55
Q

List the 4 phases of the Momentum Strategy STS

A

Phase 1 - Flexion-Momentum Phase
Phase 2- Momentum-Transfer Phase
Phase 3 - Extension Phase
Phase 4 - Stabilization phase

56
Q

A) What occurs in STS Phase 1: Flexion-Momentum

B) mm?

A

A) Begins w/mvmt initiation and ends b4 butt lift-off w/horiz WS of COM

B) Ecc control of fwd momentum by ES

57
Q

A) What occurs in STS Phase 2: Momentum- Transfer Phase

B) mm?

A

A) Begins as butt lifts and ends w/max ankle DF w/transfer of momentum from upper body to total body (lift)

B) Co-activation of hip and knee extensors

58
Q

A) What occurs in STS Phase 3: Extension Phase

B) What direction do you moev

A

A) Begins just after max DF and ends when hips first cease to extend w/lift or extension phase - ext of hips and knees

B) Moves body vertical

59
Q

A) What occurs in STS Phase 4: Stabilization Phase

A

Begins after hip ext is reached and ends when all motion assoc w/stabilization is completed

60
Q

What is required of the Momentum Strategy for STS?

A
  • Concentric to propel the body

- Eccentric to control the motion of the body

61
Q

What are some safety concerns of momentum strategy for STS?

A
  • bkwd fall if try to transfer momentum from trunk to legs b4 COM is over feet
  • fwd fall if Pt unable to control horiz F @ end of STS movement
62
Q

What Pts might not be good for utilizing the momentum strategy?

A
  • Orthostatic hypotension
  • Vestibular problems
  • Dizziness
63
Q

What occurs in Phase 1 of the Force Control Strategy STS?

A

Trunk flexion and APT to bring COM over feet

64
Q

What occurs in Phase 2 of the Force Control Strategy STS?

A

Extension of trunk, hips and knees w/sufficient force to bring the body to the vertical position

65
Q

What occurs in Phase 3 of the Force Control Strategy STS?

A

Stabilization

66
Q

What can you strengthen to augment Force-control Strategy for STS?

A

Trunk, hip, and knee extensors can be strengthened

67
Q

What considerations should be made for both the Momentum and Force STS Strategies?

A
  • manually assist @ knee
  • Progress from high to low seat
  • P downward thru knee to increase WB sensation of the foot on the contact surface
  • P thru dorsum of foot to facilitate WB on that LE
68
Q

What are the rules of STS

A

1) Feet shldr width apart
2) Symmetrical alignment anterior view
3) Aligned altho feet can be staggered
4) W or w/o arms

69
Q

STS Variability
A) Intra-subject
B) Inter-subject

A

A) intra-subj is variable w/same start position, and even more variable w/o standard start position
B) High variability

70
Q

What occurs in Stand to Sit?

A
  • Eccentric control of body weight as lowered
  • Ecc. paraspinals, quads, and GS
  • Relies on some passive tension

UM - Neuro Science (9 decks)

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