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Questions and Answers

What are the two primary functions of the Postural System?

Stability and Orientation

Which of the following are NOT included in the Postural Control (Neural) Mechanism?

  • Muscular Conditioning (correct)
  • Emotional Regulation (correct)
  • Sensory Integration
  • Anticipatory Motor Synergies
  • Steady State
  • Reactive
  • Cognitive Strategies

    • Postural control behavior is uniform across all tasks and does not adapt to changing conditions.

    False

    What factors influence the amount of attentional resources needed to maintain balance?

    <p>The complexity of the task and/or the amount of impairment of the individual.</p> Signup and view all the answers

    Define the 'stability limits' in the context of postural control, specifically steady state movement strategies.

    <p>The stability limits refer to the point at which an individual will change their base of support (BOS) configuration to maintain stability.</p> Signup and view all the answers

    The 'stability limits' are fixed and unchanging boundaries in postural control.

    <p>False</p> Signup and view all the answers

    What are the two main postural movement strategies associated with Reactive Balance?

    <p>Ankle strategy and Hip strategy.</p> Signup and view all the answers

    Which strategy is more likely to be used in Reactive Balance if impairments exist in distal motor or vestibular sensory systems?

    <p>Hip Strategy</p> Signup and view all the answers

    What is the primary function of the 'Perceptual System' in postural control?

    <p>Integration and organization of sensory information.</p> Signup and view all the answers

    What are the three types of sensory information gathered by the Perceptual System to inform postural control?

    <p>Visual information (about head movement in relation to surroundings), Vestibular information (about head movement in relation to gravity), and Somatosensory information (about body's relationship to supporting surfaces).</p> Signup and view all the answers

    What are the three main components of the 'Cognitive System' in postural control?

    <p>Attention, motivation, and intention.</p> Signup and view all the answers

    The 'Cognitive System' in postural control has no bearing on 'Adaptive Postural Control'?

    <p>False</p> Signup and view all the answers

    What are the four main types of postural control described by Shumway Cook & Woollcott?

    <p>Steady State balance, Reactive balance, Anticipatory Postural Control, and Cognitive systems in postural control.</p> Signup and view all the answers

    Describe the function of 'Anticipatory Postural Control' and provide another term for it.

    <p>Anticipatory Postural Control, also known as Predictive Control or Proactive Control, involves programming postural adjustments in advance of voluntary movement. Essentially, our brain anticipates the movement and prepares our body to counter any potential instability.</p> Signup and view all the answers

    What is the primary purpose of 'Automatic Postural Adjustments (APAs)'?

    <p>APAs are context-specific movements that adjust posture automatically in response to environmental or task demands.</p> Signup and view all the answers

    Individuals with neurological conditions never exhibit problems with anticipatory postural control.

    <p>False</p> Signup and view all the answers

    Which of the following are potential ways clinicians can manipulate to improve anticipatory postural control?

    <p>All of the above</p> Signup and view all the answers

    Describe the concept of 'Dual Task' in the context of postural control.

    <p>Dual Task situations involve performing two tasks concurrently, often one postural task and one secondary task (either cognitive or motor).</p> Signup and view all the answers

    In general, younger adults require more attentional resources for postural control compared to older adults.

    <p>False</p> Signup and view all the answers

    What is the primary role of the 'Brainstem' in postural control?

    <p>The Brainstem regulates postural tone in conjunction with the Cerebellum, helping to maintain a stable upright posture.</p> Signup and view all the answers

    What is the primary role of the 'Cerebellum' in postural control?

    <p>The Cerebellum is involved in adapting postural muscle responses to changing tasks and environmental conditions. Essentially, it contributes to the smooth and accurate execution of postural movements.</p> Signup and view all the answers

    What is the primary role of the 'Basal Ganglia' in postural control?

    <p>The Basal Ganglia work to quickly adjust muscle patterns, ensuring postural stability in the face of changing task demands and environmental conditions.</p> Signup and view all the answers

    Describe the influence of the 'Visual System' on postural control.

    <p>The Visual System provides valuable information about the body's position and movement in relation to surrounding objects, contributing to postural stability.</p> Signup and view all the answers

    Studies have shown that long-term effects of mild traumatic brain injuries (mTBIs) can lead to an increased reliance on the visual system for postural control.

    <p>True</p> Signup and view all the answers

    What is the purpose of the 'Sensory Organization Test (SOT)'?

    <p>The SOT evaluates the ability of the individual to maintain balance under different sensory conditions, assessing how their postural control changes when certain sensory inputs are altered.</p> Signup and view all the answers

    Why is it clinically important to address 'sensory organization' in addition to 'movement strategies' when improving balance in patients?

    <p>Addressing sensory organization is critical because it often underlies the root cause of balance problems. By improving how the nervous system processes and integrates sensory information, patients can better adjust their postural control, leading to improved balance and stability.</p> Signup and view all the answers

    The 'Cognitive System' in postural control is entirely independent of the 'Sensory System' and does not rely on information from it.

    <p>False</p> Signup and view all the answers

    Individuals who can compensate for somatosensory loss will always be able to perform equally well in a dark environment.

    <p>False</p> Signup and view all the answers

    Describe the primary concern associated with losing multiple sensory inputs in the context of balance.

    <p>Losing multiple sensory inputs can lead to a significant loss of postural control because the nervous system relies on redundancy across sensory systems for stability and balance.</p> Signup and view all the answers

    Which of the following conditions are often associated with challenges in sensory redundancy and selection?

    <p>All of the above</p> Signup and view all the answers

    Clinical approaches to improving balance should focus solely on improving movement strategies, as sensory organization does not play a significant role.

    <p>False</p> Signup and view all the answers

    How does the nervous system prepare the motor system for upcoming sensory changes in anticipatory postural control?

    <p>The nervous system utilizes a 'central set,' which involves preparing the motor system in advance of sensory changes anticipated due to movement or environmental factors. This preparation allows for smoother and more controlled postural adjustments.</p> Signup and view all the answers

    What is the primary issue associated with 'Anticipatory Control Problems,' and what are some conditions often associated with these problems?

    <p>The primary issue is the lack of postural synergies in advance of voluntary movement or a reduction in their effectiveness, leading to more instability during intended movements. Conditions such as stroke, cerebral palsy, traumatic brain injury, Down syndrome, Parkinson's disease, and cerebellar disorders often disrupt anticipatory control, leading to challenges with movement coordination and balance.</p> Signup and view all the answers

    The complexity of the secondary task assigned in a 'Dual Task' situation does not influence the difficulty experienced by the postural system.

    <p>False</p> Signup and view all the answers

    Describe the primary role of the 'Spinal Cord' in postural control.

    <p>The Spinal Cord primarily contributes to postural control through ground reaction forces and the tonic activity of extensor muscles, assisting in maintaining upright posture and stability.</p> Signup and view all the answers

    Study Notes

    Postural Control Overview

    • Postural control involves two key functions: stability and orientation
    • Neural mechanisms for postural control include steady-state, reactive, and anticipatory motor synergies, integrating sensory input and cognitive strategies
    • Postural control behavior is adaptable and task-specific, with attentional resources dependent on task complexity and individual impairment.

    Dynamic Systems Theory Perspective

    • Postural control is not a simple top-down command system, but an interaction between individual, task, and environmental constraints.
    • The center of mass (COM) and base of support (BOS) are crucial for stability, with the COP representing the distribution of forces on the support surface.
    • The CNS constantly monitors and adjusts muscle activity to maintain equilibrium, requiring sensory inputs from the visual, vestibular, and somatosensory systems.
    • Strategies for maintaining balance include ankle strategies (low frequency), hip strategies (low frequency), and high frequency strategies, optimizing for various types and speeds of perturbation and adjusting based on task requirements.
    • Movement strategies for maintaining balance during perturbations (reactive balance) are fundamental aspects of postural control

    Learning Objectives

    • Defining postural control within the context of task-oriented movement
    • Identifying motor and sensory strategies associated with postural control
    • Describing how these strategies adapt to changes in the individual, task, and environmental constraints
    • Relating motor and sensory strategies to clinical practice

    Biomechanical Analysis

    • Patla, Ishac, Winter (2002) provided insights into the mechanical aspects of postural control and the CNS's role in addressing mechanical challenges.
    • This includes whether postural system is viewed as an inverted pendulum.

    Measurement of Postural Stability

    • Force plates measure distance and variability of the center of pressure (COP)
    • COP changes during quiet standing can indicate postural stability.
    • Body sway amplitude can also be measured using sensors.

    Neural Components of Postural Control

    • Action systems involve neuromuscular synergies for motor control.
    • Perceptual systems involve sensory integration and organization for posture.
    • Cognitive systems (attention, motivation, and intention) influence adaptive postural control.

    Normal Control Mechanisms

    • Motor control for steady-state balance involves small amounts of postural sway, body alignment, and muscle tone.
    • Muscles provide inherent stiffness, and postural tone is maintained through extensor muscles.

    Steady-State Balance

    • Stability limits represent the point when a person adapts their base of support (BOS) to maintain balance.
    • Postural control in steady state is not solely reliant on fixed boundaries. It is largely influenced by perceptual and cognitive factors and is more complex than just the position of the body.

    Ideal Postural Alignment

    • Optimal body alignment minimizes muscular effort.

    Base of Support (BOS)

    • Increasing base of support is a response to various disturbances during posture control

    Movement Strategies for Steady State and Reactive Balance

    • Inverted pendulum model describes ankle and hip strategies for movement during steady state.
    • Ankle strategies utilize primary movements around the ankle with coordinated leg and trunk movement in phase.
    • Hip strategies utilize primary movements around the hip, utilizing leg and trunk movements out of phase.

    Reactive Balance

    • Feedback control strategies are employed in response to external disturbances.
    • Strategies used for reactive balance include ankle, hip, and stepping strategies.

    Anterior-Posterior Stability for Reactive Balance

    • Ankle strategies are employed in response to stable or minimal perturbation in the anterior-posterior plane.
    • Hip strategies are utilized when instability is more significant which leads to more rapid movements of center of mass.

    Other Planes of Movement

    • Mediolateral and multidirectional adjustments of balance control are just as important as the front-back control mechanisms
    • Control of hip and leg movement is employed to ensure balance in all planes

    Reactive Control Strategies are Adaptive

    • The effectiveness of reactive control strategies adapts and evolves with practice

    Physiological significance of synergies

    • Synergies represent functional groupings of muscles working together as a unit, with fixed weighting and producing a specific direction of force.

    Importance to the Clinician

    • Steady-state and reactive postural control need to be considered in clinical settings.
    • Clinicians should assess and modulate various postural control mechanisms to improve balance.

    Anticipatory Postural Control

    • Anticipatory postural adjustments (APAs) comprise pre-programming movements to prepare for voluntary movements which precede voluntary activity, usually by at least 50 msec.
    • This mechanism helps to mitigate potential instabilities when initiating movement.

    Anticipatory Control problems

    • Problems with anticipatory control in patients are often seen with various neurological conditions.

    Clinical Implications of Anticipatory postural control

    • Assessing and modifying anticipatory postural adjustments is crucial for clinical purposes given its role in mitigating postural disturbances, especially during task and environmental changes.

    Cognitive System in Postural Control

    • The cognitive system in postural control is closely tied to attention demands, with increased complexity leading to higher attention demands.
    • Dual-task paradigms can reveal losses in control when cognitive load exceeds attention capacity.
    • Secondary tasks, such as visual or cognitive demands, influence the complexity of postural control.

    Clinical Importance of the Cognitive System

    • Understanding the influence of attention demands on postural control strategies, particularly for patients with neurological disabilities, allows clinicians to target specific aspects of postural instability.

    Distribution of CNS Control

    • Postural control relies on various CNS structures, from the spinal cord to the cortex, each with its own contributions and influence.

    Sensory Organization and Systems

    • Sensory organization during steady-state balance involves multiple sensory inputs (visual, vestibular, and somatosensory).
    • Visual input is directly relevant to objects in the surrounding environment/space.
    • Vestibular input is important for maintaining relationships between body position and gravity, while somatosensory feedback comes from the body’s position relative to the ground/supporting surfaces.

    Sensory Systems Redundancy

    • Compensatory strategies for loss of a sensory input depend on other functioning sensory systems and the environment.
    • If multiple sensory systems are lost or impaired, compensatory mechanisms might not be possible.

    Summary

    • Postural control is a complex mechanism utilizing multiple neural and sensory systems.
    • Balance is dynamic and relies on the individual, task, and environment continually adapting and adjusting.
    • Understanding postural control is crucial for effective clinical interventions.

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