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| Rooting; Sucking Reflexes |
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| Asymmetrical Tonic Neck Reflex (ATNR) |
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| Tonic Labyrinthine Reflex (TLR) |
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| Symmetrical Tonic Neck Reflex (STNR) |
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| Protective Extension Sideways Reaction |
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| Protective Extension Backwards Reaction |
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Definition
1mos --> brain & spinal cord developed in embryo
8 weeks --> vestibular system starts to form
8-9 weeks -->now a fetus
7-9weeks --> touch sensitivity (mvmt) |
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| 20 weeks --> auditory system is developed |
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28 weeks --> lung fxn is developed
auditory, vestibular, & olfactory systems intact
visual system nearly set
sensation of light touch |
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| 3rd week post birth --> end of 1st year |
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| Is movement perfected in one skill before another skill is practiced |
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Definition
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Cephalocaudal
Proximal --> distal
Asymmetric --> symmetric --> controlled asymmetric
Gross motor --> fine motor |
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| Sagittal Plane --> Frontal plane --> Transverse plane |
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Definition
| physiological flexion (extensors elongated), can fixate on objects |
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pelvis is high & in anterior tilt
weight on chest & face
can lift & turn head enough to clear airway |
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spine is rounded
pelvis is perpendicular to surface |
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chest is triangular w/ ribs horizontal
thin Intercostal spaces (chest to abdomen ration = 1:3)
no respiratory reserve |
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head more laterally oriented
LE more extended
UE more ER |
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| can lift head & turn using hyperextension |
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| head & hands are more often in midline |
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active head extension to 90 w/o bobbing
UEs in line w/ shoulders |
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more head lifting & pushing up on arms (passive extension)
Lateral Flexion- weight of body goes in direction of head turn |
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Can visually follow objs
still not developed active extension except in neck |
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holds head up
scapula back w/ humeral extension (high guard) |
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More controlled symmetrical mvmt
begin to see active extension
use rotation in cervical spine w/ head turning & weight shifting |
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hands consistently midline
active flexion w/ hands to feet (Rolls) |
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“swimming”
“prone prop”
begin to see head righting reaction
develops into a mature weight shift |
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Definition
child has achieved voluntary asymmetry & dissociation
trunk muscles=3AG |
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Definition
plays w/ feet
can bridge
rolls to prone |
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Definition
mature weight shift on UEs
lots of pushing w/ extensors |
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| can sit independently in midline w/ good control (Static) |
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occurs w/ support & is static
will bounce
lack of hip extension |
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| chest is now more rectangular but ribs still horizontal |
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Definition
worked in 4-pt
Belly Crawled
weight shift & rotation while sitting |
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| active sensory-spatial exploration = visual feedback 4 postural control |
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Definition
can sit alone & reach away from midline
long sit
bear crawl
vaulting
side sit w/ rotation
CREEPING |
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| w/ support & still no eccentric lowering |
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| Cruising sideways & forwards |
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Independent Movement
gained all necessary ROM to develop higher skills
mature weight shifts except in standing |
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Definition
| being upright allowed gravity & abdominals to rotate ribs down 1:1 |
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Definition
reflex that appears during gestation or at birth & becomes integrated by about 6mos age
neural circuit is at the spinal cord or brain stem level |
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Postural responses that begin to appear in infancy or childhood as a
child develops balance in various positions --> remain throughout life
Righting Rxns / Equilibrium Rxns / Protective Rxns |
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Definition
| involuntary stereotypic motor response to a specific stimulus |
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Definition
body’s accommodation to changes in the center of gravity (orientation in space)
reactions seen in the head, trunk, and extremities
allows function in upright position with hands free and develops into mature weight shifts |
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Help keep the head oriented in relation to the body
adjusts body part to vertical |
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Allow the infant to use the extremities to protect from falls by weight bearing on them
Will develop with child in prone, supine, sitting, & standing as the child gains these postures |
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Definition
overall state of tension in the body
body’s readiness to move & it’s
ability to resist downward pull of gravity. |
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Definition
resistance of muscle to passive elongation or stretch
flaccid; hypotonia; hypertonia; dystonia |
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Definition
increased contractions of muscles causing stiff & awkward movements
velocity dependent response to passive stretch
presence of a spastic catch
“clasp-knife”, clonus, decerebrate & decorticate rigidity |
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Definition
resistance to stretch throughout the passive ROM
independent of velocity & equal resistance in both directions
leadpipe & cogwheel |
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involuntary sustained or intermittent muscle contractions causing twisting/repetitive movements, abnormal postures or both (ACTIVE)
-hypertonic vs. hyperkinetic dystonia |
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| Cerebellar Impairments to coordination |
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Definition
Hypotonia, Dysmetria, Dysdiadochokinesia, Intention
Tremor (“titubations”), Dyssynergia & Asynergia, Ataxia, Dysarthria, Asthenia, Rebound Phenomenon, Nystagmus |
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| Basal Ganglia Impairments to coordination |
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Definition
Bradykinesia & Akinesia, Rigidity, Resting Tremor,
Chorea, Athetosis (“wormlike”), Choreoathetosis, Hemiballismus (“flailing”), Dystonia |
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Term
| Dorsal Column Impairments to coordination |
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Definition
| Decreased proprioception, kinesthesia, & discriminative touch |
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Term
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Definition
Biomechanical/Musculoskeletal
Coordinated normal motor strategies (anticipatory/feedforward & compensatory/feedback)
Sensory Organization (somatosensory; visual; vestibular) |
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| Coordinated normal motor strategies |
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Definition
Ankle Strategy (small perturbations; distal --> proximal)
Weight-Shift Strategy (pelvis, hip ABD & ADD)
Hip Strategy (lg perturbations; narrow BOS; COG near LOS; proximal --> distal)
-Anterior = abdominals then quads
-Posterior = Erector Spinae then hamstrings
Stepping Strategy
Sitting Strategies & Suspensory Strategy (Protective ext.; lowering COG) |
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Term
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Definition
-Romberg; Foam & Dome Test; Dynamic Posturography
-Functional Reach; Berg Balance Scale; POMA; Timed Get Up & Go; Timed Walking; BES |
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| Treatment approach for coordination and balance |
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Definition
1)Address vertigo & nausea 1st
2)Safety & fall prevention (environmental factors & lifestyle changes)
3)Address musculoskeletal problems & faulty postural alignement
4)Address Static control
5)Address Dynamic control
6)Address sensory organization
7)Compensatory training if necessary |
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Term
| Surgical Managment of amputations |
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Definition
remove part of limb
allow wound healing
construct residual limb |
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Term
| Postoperative management of amputation |
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Definition
monitor healing
prepare limb for prosthesis
increase patients strength and endurance
provide interim means of performing ADLs |
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Term
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Definition
foot-ankle assembly
shank
socket
suspension system
knee unit |
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Term
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Definition
1. Nonarticulated Feet (SACH, SAFE or energy-storing/elastic keel)
2. Articulated Feet (Single-axis or Multi-axis=PF, DF, IV, EV)
3. Custom Feet |
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Term
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Definition
1. Exoskeletal- “Crustacean”
-wood or plastic outer shell; body wt carried by walls of shell (heavier)
2. Endoskeletal- “Modular”
-central aluminum or rigid plastic pylon covered w/ foam rubber=natural |
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Term
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Definition
Transtibial - PTB (use with stump sock)
Transfemoral
-Quadrilateral (ischial tuberosity & gluteal—narrower ant-posterior)
-Ischial Containment Socket (CAT-CAM) (gluteals & sides & bottom of limb—narrower med-lateral) |
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Term
| Basic phase of prosthetic training |
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Definition
A. Instruction in don/doff prosthesis
B. Balance/Pre Gait Exs
C. Basic Transitions
D. Ambulation in Parallel Bars |
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| Intermediate phase of prothetic training |
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Definition
| ambulation outside of parallel bars (level surfaces) |
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| Advanced phase of prosthetic training |
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Definition
A. Ascend/Descend stairs
B. Step over obstacles
C. Stand to floor to back up
D. Bending down to get objects |
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Term
Transtibial Prosthetic Gait Analysis
Early Stance: |
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Definition
1)Excessive Knee Flexion
a.Prosthetic Causes: high shoe heel, insufficient PF, socket too far anterior
b.Anatomic Causes: flexion contracture, weak quads
2)Insufficient Knee Flexion
a.Prosthetic Causes: low shoe heel, excessive PF, socket too far posterior, socket insufficiently flexed
b.Anatomic Causes: extensor hyperreflexia, weak quads, anterodistal pn, arthritis |
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Transtibial Prosthetic Gait Analysis
Mid Stance: |
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Definition
NO ANATOMICAL CAUSES
1)Excessive Lateral Thrust
a.Prosthetic Causes: excessive foot inset
2)Excessive Medial Thrust
a.Prosthetic Causes: excessive foot outset |
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Transtibial Prosthetic Gait Analysis
Late Stance: |
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Definition
1)Early Knee Flexion: drop off
a.Prosthetic Causes: high shoe heel, insufficient PF
b.Anatomic Causes: knee flexion contracture
2)Delayed Knee Flexion: walking uphill
a.Prosthetic Causes: low shoe heel, excessive PF
b.Anatomic Causes: extensor hyperreflexia |
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Term
Transfemoral Prosthetic Gait Analysis
Abduction: prosthetic side in stance |
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Definition
a.Prosthetic Causes: long prosthesis, sharp or high medial wall
b.Anatomic Causes: ABD contracture, ADD redundancy/roll, laterodistal pain,
instability (pt. insecure) |
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Transfemoral Prosthetic Gait Analysis
Circumduction: prosthetic side in swing |
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Definition
a.Prosthetic Causes: long prosthesis, locked knee unit, loose friction @ knee,
inadequate suspension(slips down), socket 2 small, foot PF
b.Anatomic Causes: ABD contracture, poor knee control, easier for pt |
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Transfemoral Prosthetic Gait Analysis
Trunk Shifts
Lateral Bend: prosthetic side in stance |
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Definition
a.Prosthetic Causes: short prosthesis, sharp or high medial wall
b.Anatomic Causes: ABD contracture, weak ABDs, hip pn, instability |
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Transfemoral Prosthetic Gait Analysis
Trunk Shifts:
Forward Flexion: prosthetic side in stance |
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Definition
a.Prosthetic Causes: unstable knee unit
b.Anatomic Causes: instability |
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Term
Transfemoral Prosthetic Gait Analysis
Trunk Shifts
Lordosis: prosthetic side in stance |
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Definition
a.Prosthetic Causes: inadequate socket flexion
b.Anatomic Causes: hip flexion contracture, weak hip extensors |
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Term
Transfemoral Prosthetic Gait Analysis
Rotations |
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Definition
1)Medial/lateral whip: prosthetic side @ heel off (usually probs w/ prosthesis)
2)Foot Rotation @ heel contact (usually probs w/ prosthesis) |
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Term
Transfemoral Prosthetic Gait Analysis
Excessive Knee Motion |
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Definition
1)High Heel Rise: early swing (flexes too fast & too soon)
a.Prosthetic Causes: inadequate knee unit friction, slack extension aid
b.Anatomic Causes: forceful hip flexion
2)Terminal Impact: late swing
a.Prosthetic Causes: inadequate friction, taut extension aid
b.Anatomic Causes: abrupt & forceful hip extension as knee reaches extension |
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Transfemoral Prosthetic Gait Analysis
Reduced Knee Motion |
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Definition
1)Vault: prosthetic side in swing
a.Prosthetic Causes: same as for circumduction
b.Anatomic Causes: easier for pt than to control knee unit |
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Term
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Definition
| Level at which the greatest vertebral damage has occurred |
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Term
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Definition
| The most caudal segment of the spinal cord with normal sensory functions as determined by testing the 28 dermatomes on each side of body |
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Definition
| The most caudal segment of the spinal cord with normal motor function as determined by testing 10 myotomes on each side of the body |
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| Neurological level of SCI |
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Definition
| The most caudal segment of the spinal cord with normal sensory and motor function bilaterally |
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Term
| what is the prediction of self-care and ambulation based on in SCI |
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Definition
period immediately following the injury during which there is an absence of reflex activity, flaccidity, and loss of sensation below the level of the lesion
may last several hours up to several weeks
early resolution is good prognostic sign |
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1) Respiratory Impairment* (C1-3 (phrenic nerve) + abdominals, intercostals & pectorals)
2) Spasticity (increase 1st 6 mos, plateau @ 1yr; influenced by many factors)
3) Impaired Temperature Control
4) Autonomic Dysreflexia (Hyperreflexia) = above T6 (HTN, sweating, H/A, spasticity)
5) Postural Hypotension
6) Pressure Sores/Ulcerations
7) Bowel & Bladder Dysfunction (reflex vs. non-reflexic neurogenic B&B)
8) Sexual Dysfunction
9) Pain = traumatic; nerve root; dysesthesias; musculoskeletal pain
10) Miscellaneous: Heterotropic Bone Formation; Contractures; DVT; Osteoporosis;
Kidney Stones; other injuries |
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Term
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Definition
1) Pt & Family Education
2) Respiratory Management (exs: diaphragmatic, glossopharyngeal; strengthening; coughing; support)
3) Maintain or Increase ROM
4) Positioning (prevent skin breakdown & increase tolerance to upright)
5) Selective Strengthening (RESISTANCE is contraindicated the 1st few weeks) |
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Term
| Restricted motions for Parapeligia |
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Definition
| avoid trunk or excessive hip motion (SLR>60; hip & knee flexion >90) |
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Term
| Restricted motions for tetraplegia |
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Definition
| avoid head, neck, & UE motion |
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Term
| What is the rate of progression determined by for SCI |
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Definition
pt tolerance
medical status
psychological status
certain restrictions due to stabilization procedure |
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Term
| What is used as a foundation of PT approach in SCI |
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Definition
Mat program
develops strength, ROM, endurance, coordination, & early use of substitutions & compensations for balance & mvmt |
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Term
| What are the principles used to increase functional movement in SCI |
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Definition
1) Head/Hips Relationship (will inversely affect pelvis & lower trunk)
2) Elbow Locking Mechanism in Tetraplegia (ER & ADDanterior deltoid & pec major)
3) Leverage
4) Force Vectors (direction/line of force)
5) Momentum & Velocity (2+ mvmts must occur for max force)
6) Timing
7) Reverse Action of Muscle Pull (stabilize distally to move proximally) |
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Term
| Sequence of learning of activities in SCI |
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Definition
| develop stability in a position --> develop controlled mobility --> develop fxl skill |
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Term
| What are the criteria for ambulation in SCI |
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Definition
Adequate strength
Adequate ROM
Adequate endurance (cardiovascular)
Good postural alignment
No other medical /health factors that might interfere |
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Term
| What is the progression of ambulation with SCI |
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Definition
1) Don/doff braces
2) Static & dynamic balance in para-stance in pb
3) Stand to sit in pb
4) Ambulate w/ appropriate gait pattern in pb (swing-to & swing through vs. 4-pt)
5) Sit to stand in pb
6) Ambulate outside of pb w/ crutches
7) Falling & getting up
8) Advanced gait skills |
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Term
| what is the ankle locked at for dorsiflexion in an orthosis to have the patient's COG shifted anteriorly |
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Definition
| 5-15 degrees of dorsiflexion |
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Term
| What are the types of burns |
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Definition
Thermal
Electrical
Chemical
Radiation |
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Term
| What are the types of thermal burns |
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Definition
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Term
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Definition
-Neck- neutral to slight hyperextension
-Shoulder- 90 ABD w/ 10 horiz. ADD w/ slight ER
-Elbow- full extension & forearm in neutral
-Wrist/Hand- Wrist=0-30EXT, MCPs=50-70FLEX, IPs=straight,
-Thumb= btwn ABD & EXT
-Hip & Knee- Neutral rotation w/ slight ABD 10-15 & knees EXT
-Foot & Ankle- 90 dorsiflexion/neutral, Heel suspended
**Position of comfort = position of contracture** |
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Term
| Exercise Contraindications for Burns |
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Definition
exposed joints
tendon exposure over the PIP jt
DVT
Compartment Syndrome
Fresh Skin Graft |
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Term
| exercise precautions for burns |
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Definition
| heterotrophic bone formation |
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Term
| Exercise Target areas for burns |
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Definition
areas likely to develop contractures
areas over/near jts |
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Definition
| Active, red, raised, rigid (can still change) |
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Definition
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| Factors affecting scar management |
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Definition
prolonged healing time
repeated harvesting of
donor sites
race/increased pigment
age
location
depth
tension (across jts)
gender (female>male) |
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Definition
| characterized by limited variation of motor strategies & limited ability to vary motor behavior to address specific situations |
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Term
| established risks for atypical development |
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Definition
events that have occurred that pose obvious problems
i.e: hydrocephalus, chromosomal abnormalities, congenital myopathies… |
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Term
| Environmental Risks for atypical development |
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Definition
| i.e: single parent, maternal age/problems/health |
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