Post on 16-Dec-2015
NORMAL DEVELOPMENT
PART 1.
HEAD CONTROL
CONSIDERATION
POSTURAL CONTROL POSTURAL ORIENTATION
INTERNAL REPRESENTATION BODY CONCEPT(Awareness, Schema ,
Image ) SENSORY CHANNEL MUSCULOSKELETAL COMPONENT NEUROMUSCULAR COMPONENT CENTRAL PATTERN GENERATOR
HEAD CONTROL
PELVISHIP
kNEE
ANKLEMOVEMENT
SHOULDERSCAPULAR
ELBOWHAND
PROXIMAL(ALIGNMENT)
STATOKINETIC REACTION
STABILITY/ MOBILITY = WORKS TOGETHER WHILE DOING
SOMETHING. ( PURPOSEFUL MOVEMENT) = WE CALL IT POSTURAL CONTROL. = BASIS OF MOVEMENT = RR. ER, SR
CENTRAL PATTERN GENERATOR
POSURAL ALIGNMENT MOVEMENT ACIVATION FROM THE MUSCLES PROGRAMED MOVEMENT INFORMATION
Central Pattern Generators. Spinal circuits act as central pattern
generators. The existence of pacemaker cells within
neural tissue demonstrate the ability for circuits to be active without sensory input.
The overall stepping pattern consists of a rhythmic alteration in the contractions of flexor and extensor muscles.
The pattern of the pattern generator is written into the CNS map i.e. it is genetic.
Central Pattern Generators. EACH LIMB HAS IT’S OWN
PATTERN GENERATOR EACH OF WHICH CAN ACT INDEPENDENTLY OF THE OTHER GENERATOR.
THE LIMBS ARE TIMED SPATIALLLY AND TEMPORALLY BY CEREBELLAR CONTROL.
MIDBRAIN LOCOMOTOR AREA
3 DIFFERENT ZONAL AREAS IN BASE OF THE FOREBRAIN HAVE BEEN IDENTIFIED, EACH CAPABLE OF INITIATING WALKING FOR DIFFERENT REASONS.
1. LATERAL HYOTHALAMUS2. ZONAL INCERTA3. PERIVENTRICULAR ZONE
ASSESSMENT
MUSCLE Length Direction Strength Synergist ROM
SKELETAL DIRECTION LENGTH SIZE MOBILITY
HEAD CONTROL
Most important part of the body - Appearance (expression) - Function of vision, breathing, eating,
speech, auditory - Mirror of postural control Neck space, Chin tuck, Hyperextended neck
- Initiation of all kind of activity
HEAD CONTROL
Base of support Trunk control(proximal
stability) Rib cage, Scapular, Pelvis
Neck elongation Shape of head
HEAD CONTROL(III)
Vestibulocollic reflex
Vestibulospinal reflex
Vestibuloocular reflex
Optokinetic reflex
Tongue Maseters
DEVELOPMENT OF HEAD CONTROL
Starting from rolling to side to side Rolling means - Neck space (Elongation) - Dissociation from the shoulder & Arms, Trunk, lower part of the
body - Dissociation each part of the body
RIB CAGE SCAPULAR SHOULDER ARM, HAND
HEAD CONTROL
PROXIMALABDOMEN,TRUNK,
PELVIS
HIP KNEE ANKLE
RIB CAGE SCAPULAR SHOULDER ARM, HAND
HEAD CONTROL
PROXIMALABDOMEN,TRUNK,
PELVIS
HIP KNEE ANKLE
ARM MOVEMENT
ARM MOVEMENT
HEAD VISION & AUDITORY RIB CAGE , UPPER BACK
MUSCLES SCAPULAR ABDOMINAL , BACK MUSCLES PELVIS & LOWER EXTREMITY
PATHOLOGIC ARM MOVEMENT
Moves in together Hyperextended Neck and Back Muscle
Adducted scapular as a PUMP LACK OF PROXIMAL STABILITY
HEAVY ARM FIXATION OF SCAPULAR COMPENSATORY HEAD FIXATION UPWARD GAZE POOR STABILITY FROM PROXIMAL & LEGS
PATHOLOGIC ARM MOVEMENT
PATTERN WITH LESS MOVEMENT CHANGING DIRCTION AND MUSCLE PROPERTIES
RETRACED OR PROTRACTED SHOULDER PRONATED ELBOW FLEXED WRIST AND FINGERS
TRUNK
BACK MUSCLE GROUP
- STEREOTYPED DIRECTION
- CHANGING DIRECTION
a) LESS MOVEMENT b) TOO SHORT c) ASYMMETRY
RIB CAGE
ASYMMETRY
POOR MOBILITY
HIGHER POSITION
LOWER STABILITY
PELVIS
LEGS
HEAD CONTROL
TRUNK CONTROL
* LENGTH THROUGH PROXIMAL STABILITY W.T SHIFTING ELONGATION
* RIB CAGE CONTROL * FOUNDATION OF MOVEMENTS
PATHOLOGIC TRUNK MOVEMENT
MOVES TOGETHER HIGHER RIB CAGE ASYMMTRY RIB CAGE PULLED BACK AND FIXATED SCAPULAR IMMOBILIZES RID CAGE POOR STABILITY FROM PROXIMAL & LEGS PELVIS INSTABILITY
PELVIS
BACK MUSCLE GROUP
- STEREOTYPED DIRECTION
- CHANGING DIRECTION
a) LESS MOVEMENT b) TOO SHORT c) ASYMMETRY
RIB CAGE
ASYMMETRY
POOR MOBILITY
HIGHER POSITION
LOWER STABILITY
PELVIS
LEGS
FEET
HEAD CONTROL
PELVIC CONTROL
SIZE OF PELVIS MOBILITY OF PELVIS ( DISSOCIATION)
- POSTERIOR . ANTERIOR TILTING PROXIMAL STABILITY ANGLE OF HIP JOINT LENGTH AND STRENGTH OF MUSCLES DIRECTION OF LEG MOVEMENT
PATHOLOGIC PELVIC MOVEMENT
MOVES TOGETHER LACK OF PROXIMAL STABILITY TYPICAL PATTERN SMALL RANGE OF MOVEMENT POOR DISSOCIATION
INFLUENCE TO LEG MOVEMENT
LEG & FEET
BACK MUSCLE GROUP
- STEREOTYPED DIRECTION
- CHANGING DIRECTION
a) LESS MOVEMENTb) TOO SHORTc) ASYMMETRY
RIB CAGE
ASYMMETRY
POOR MOBILITY
HIGHER POSITION
PELVIS
HEAD CONTROL
LEG AND FEET CONTROL
LEG & Feet MOVEMENT SIZE OF PELVIS PROXIMAL STABILITY ANGLE OF HIP JOINT LENGTH AND STRENGTH OF
THE MUSCLULATURES DIRECTION OF LEG MOVEMENT
PATHOLOGIC LEG AND FEET MOVEMENT
1. LACK OF PROXIMAL STABILITY2. TYPICAL PATTERN3. SMALL RANGE OF MOVEMENT4. POOR DISSOCIATION5. CAN’T EXTEND THE LEGS – CHANGED DIRECTION6. ANKLE INSTABILITY7. SMALL FEET ( MAINLY MEDIAL PART)8. POOR MUSCULATURE ACTIVITY
SITTING
ALIGNMENT + B.O.S WEIGHT BEARING ON BONES,
MUSCLE, LIGAMENTS, SKINS TRUNK MOVES AGAINST PELVIS PELVIS SHOULD BE STABILIZED-
MOVES LATERALLY POSURAL CONTROL
SITTING
PROXIMAL QUADRICEPS & HAMSTRING, GLUTEUS GROUP STABILIZE
PELVIS ANKLE GUIDES PELVIS MOVEMENT AND STABILIZE PELVIS ANKLE IS THE SIGNAL OF PICTURE OF THE PELVIS
PATHOLOGIC LEG AND FEET MOVEMENT
1. LACK OF PROXIMAL STABILITY2. TYPICAL PATTERN3. SMALL RANGE OF MOVEMENT4. POOR DISSOCIATION5. CAN’T EXTEND THE LEGS – CHANGED DIRECTION6. ANKLE INSTABILITY7. SMALL FEET ( MAINLY MEDIAL PART)8. POOR MUSCULATURE ACTIVITY
PATHOLOGIC SITTING
STRUCTUAL PROBLEMS SMALL, IMMOBILIZATION, ASYMMETRY
DIRECTION OF THE JOINT AND MUSCLES
POOR PERCEPTUAL MOTOR EXPERIENCES
STANDING UP
NORMAL 1) Tibillis anterior2) Rhomboides3) Trapezius4) Quadriceps
ABNORMAL
1) Rhomboideus2) Trapezius3) Tibialis anterior4) Quadriceps
STANDING
ALIGNMENT COG tends to move forward because
of instability on trunk and pelvis.
- Especially, poor structure of abdominal muscles and stereotyped direction of the back muscles .
WALKING
Spinal CordThe spinal cord is necessary but not sufficient for the expression of even the most rudementary of stepping behaviour (Bronstein, Brandt and Woollacott 1996)
Central Pattern generatorsNeuronal networks in the spinal cord capable of producing rhythmical movements such as walking. (Mackay-Lyons 2002) Produce stereotyped locomotor patternsEach limb has its own pattern generator ( Leonard 1998)
Descending tractsProvide modulation to the spinal circuitry during locomotion
Timing
Somatosensory System– input comes from afferent receptors in muscles tendons skin.– Gives us information on orientation of body parts, movement of body parts,
muscle tension, orientation of support surfaces and body with reference to support surface.
Visual Systemvisual clues help in alignment, step frequency and even step length. Gives
us movement relative to environment.
CerebellumTiming cannot be considered without considering the cerebellum
Co-ordination
Cerebellum receives a huge amount of information during locomotion.
If information is unexpected the olive is able to modify walking via the reticulospinal, vestibulospinal and rubrospinal tracts.
The cerebellum does not initiate walking but is more involved in the modulation of CPGs where necessary.
In order to learn to cope with a variety of of complex environments there is a need to be exposed to different situations to enable the cerebellum to develop strategies.
It is also thought that the cerebellum can alter step cycle according to visual information received.
The overall function of the cerebellum is improved inter and inter limb co-ordination
Motivation
Limbic System
Involved in core emotions / motivations (eg fight or flight reactions)