Flashcards
Lecture 2 Atypical Motor Development
Cards in this deck (65)
- 1Physiological flexor tone is organizing force for _______, _________, and _________.1. Movement and posture
2. Sensory experience
3. Self-regulatory behavior and social interactions - 2Consider the lack of flexion contracture and motor development in preterm babies.Lack of ability to bring limb back after kicking.
- 3What are some risks for positional deformities of preterm infants.1. long and narrow head due to constant side-lying
2. less sensory input due to time spending in NICU
3. parents also have less time to interact with kid - 4When does capital and cervical flexion mostly onset?About 4 months
- 5What are the key head and neck extensors?1. suboccipital muscles
2. upper trapezius - 6What are some key head and neck flexors?1. SCM
2. prevertebral muscles - 7What are the benefits for capital flexion with cervical flexion?1. supports downward visual gaze
2. stabilizes tongue and jaw - 8What does atypical neck hyperextension lead to ?1. decreased head control
2. maintenance of upward visual gaze
3. decreased control of swallowing
4. decreased control of tongue and jaw muscles - 9What effect does decreased head control have?over-elongation of capital and cervical flexors
- 10What effect does maintenance of upward gaze have?1. difficulty with convergence and binocular vision
2. decreased body awareness due to unable to see body - 11What effect does decreased control of swallowing have?1. drooling
2. aspiration - 12What effect does decreased control of tongue and jaw muscles have?1. decreased feeding
2. decreased vocalization/ articulation (open mouth, clench teeth for stability, retract tongue for stability) - 13Practice facilitation skills for 3 month-olds: 1. activate capital and cervical flexors 2.Supine on therapist's lap/ bed
Induce posterior pelvic tilt
Use toys to guide gaze - 14Newborns have (more/less) scapular elevtaion and their elbows are (forward/ over) their elbows.more scapular elevation
elbow behind shouler. - 15T/F: at 4 months, a child should be able to support him/herself by putting elbow directly below shoulder.T
- 16What are some typical scapular elevators?1. levator scapulae
2. upper trap
3. rhomboids - 17What are some scapular depressors?1. lower trapezius
2. latissimus dorsi - 18T/F: to achieve elbow under shoulder, a child needs to have adequate scapular elevation.F. Scapular depression.
- 19Recognize the impaired muscle in 'grasshopper position'scapular depressors.
- 20What atypical body positions will result from atypical scapular elevation?1 .capital and cervical hyperextension
2. thoracic flexion - 21What are the functional/ developmental delays due to capital/ cervical hyperextension?1. vision
2. speech, swallowing, feeding - 22What impact might thoracic flexion have on a child?1. decreased vital capacity due to tight anterior rib cage (decreased speech volumes, decreased endurance)
2. decreased ability to reach with upper extremities - 23Practice activating scapular depressors.1. stretch upper trap (supine on lap)
2. work on active shoulder flexion > 90 degrees (distance of toy etc.) - 24when do you expect to see scapular stabilization in sitting?Beyond 6 months.
- 25What impact does scapular winging have on a childre sitting?difficulty breathing due to constricted rib movement.
- 26Which muscle stabilizes the scapular?serratus anterior
allows reaching in all planes - 27What other effect does scapular winging have on chlidren?1. limited reaching
2. tightness of muscles between scapular and humerus (lats, teres major, long head biceps)
3. prevents the development of independent, dissociated humeral movement - 28What does a typical 'TV shoulder' deonstrate?1. inactivity of serratus anterior
2. inactivity of lower trapezius
3. neck hyperextension - 29How to activate serratus in 6 month-olds?pushing
- 30If a 6 month-old child does not have abdominal activation, what movement do they do to compensate?Anterior pelvic tilt
- 31Activation of abdominal muscles allows core stability during _____, ______, and _______ movements.neck, UE and LE.
- 32If a child does not have adequate abdominal strength, he/she overutilizes ___________ (muscle) and __________ (position)hip flexors.
anterior pelvic tilt - 33Why is chin tuck affected by less abdominal activation?1. tendency for neck hyperextension
2. decreased body awareness due to visual constraints - 34Why does late abdominal activation affect hand on knees and feet play?1. decreased body awareness
2. tight hamstrings
3. tactile hypersensitivity of feet
4. decreased ability to dissociate lower extremities
5. decreased ability to transition from supine to side-lying - 35Practice skills to activate abdominals.Supine on lap: approximate hands and feet to allow feet play... mini baby crunches!
- 36Which muscle is able to get more stretch when the baby can go prone on hand?hip flexors and TFL
- 37Why is prone on hand important for 6-month olds?allows them to laterally shift their weight and reach using their UE.
- 38Why is extensor activation important for prone on hands?Stabilizes pelvis
- 39What happens when hip extensors and thoracic extensors are not properly activated?- Increased anterior tilt (due to over-elongated abdominal obliques and tight hip flexors)
- increased neck hyperextension
- decreased ability to reach - 40What are some good ways activate lumbar and hip extensors?- sitting on lap/floor with toys up high
- reaching exercises - 41Neutral pelvis with thoracolumbar flexion in a 2-month old when sitting is: typical/atypical.Typical
- 42What problems may arise when a 6-7 month-old cannot sit with upright trunk?- capital and cervical hyperextension (affects vision, speech, swallowing and feeding)
- scapular elevation and winging (decreased ROM, uses adduction to reinforce thoracic extension)
- Tightness of anterior rib cage (decreased vital capacity for vocalization and endurance activities)
- Rib cage moves excessively over pelvis (hypermobility of T12 - L1, extreme ranges of pelvic motion, upper body weight loads on diaphragm which further compromises respiration) - 43Which muscles can you stretch to improve thoracic extension? And how?Pecs.
Put toys diagonally behind child and encourage reaching backwards. - 44Which direction should pelvic tilt be encouraged in child lacking thoracic extension?Anteriorly
- 45T/F: a 6 month-old boy can move his entire spine and pelvis over femur.F. (only upper spine moving over lower spine)
9 month-old can move over femur. - 46Which muscles are working in synergy to move entire spine and pelvis over femur?- back extensors and abdominal obliques
- 47What happens when there is atypical spine/pelvis/hip association?- separation of upper and lower spine
- extreme ranges of pelvis motion
- tightness of ribcage, thoracic spine, and UE into flexion
- hypermobility at T12 - L1
- tendency to stabilize with UE
- tendency to strongly couple LE - 48Activities to perform to encourage trunk stabilization?- place toys around and encourage reaching while PT stabilizes trunk as 1 unit.
- 49When should more hip extension be observed in a typically developing child?12 months
- 50Hip extension promotes extension of _______. it reinforces appropriate alignment for energy efficient standing and gait.Entire LE.
- 51Atypical hip flexion leads to _____ pelvic tilt, which inhibits the _____ muscle by overstretching it, limiting movement in the ______ plane.anterior pelvic tilt.
Inhibits oblique abdominus
Limits movement in the transverse plane - 52What is a crouched standing posture?- knee flexion
- ankle dorsiflexion/ plantarflexion
- midtarsal breakdown
- inefficient gait - 53What are some good ways to activate LE extensors?- stretch hip flexors
- work on strengthening of gluts, quads, and plantarflexors. - 54How long after initial onset of walking does heel-toe gait pattern surface?5 months
- 55Toe-walking is normal up until _____.2 years old.
- 56Vertical force is more stable during (heel-toe walking/ equinus gait)Equinus gait.
- 57Which muscle needs to gain strength before normal gait can occur?gastroc
- 58Equinus gait adapts for insufficient peak force-generation capacity for _______.gastrocs
- 59Kid needs sufficient _____ and _____ ROM and strength to maintain a relatively extended position.hip and knee
- 60What are some potential risks for equinus walking?- plantarflexion contracture
- decreased strength and range of hip and knee musculature
- muscle fatigue and increased metabolic cost of walking - 61As a child gains BW, he/she may adapt ______ gait instead of equinus gait, which shifts ground reaction force from _____ to _____ of the knee. Prolonged force on gastrocsoleus complex results in ______ mechanism of the tendon and overlengthens the _______ tendon.As a child gains BW, he/she may adapt [CROUCHED] gait instead of equinus gait, which shifts ground reaction force from [ANTERIOR] to [POSTERIOR] of the knee. Prolonged force on gastrocsoleus complex results in [CREEP] mechanism and overlengthens the [ACHIILES] tendon.
- 62Crouched gait results in insufficient strength of _____ and decreased ROM of ________. It also (increases/decreases) metabolic cost of walking.Insufficient force of gastrocsoleus
Insufficient hip and knee ROM.
Increases metabolic cost. - 63Two peaks of walking cessation of individuals with CP.1. 25 years (fatigue, insufficient movement)
2. 45 years (pain in weight-bearing joints) - 64PT for equinus prevention in CP1. strengthening gastrocsoleus. exercise or e-stim.
2. decrease stiffness of gastrocsoleus complex (leaf or hinged AFO, botox) - 65How can you optimally prevent crouched gait in CP?-Aggressively maintain ground reaction force vector anterior to knee
- manage spasticity
-minimize hip and knee flexion contractures
- increasing strength of hip, knee, and ankle extensors
- orthotics
- judicious surgery
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- PT 529 Lifespan Motor Development Flashcards on Lecture 2 Atypical Motor Development, created by Mia Li on 04/02/2018.
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