Making the Grade
Lydia is a PTA performing a test for spasticity on a new patient. She has no difficulty performing PROM slowly, but when she moves his arm fast, she encounters a slight catch and a small amount of resistance through the rest of the movement. She records this grade in the chart:
What is a 1+ on the Modified Ashworth Scale?
According to the systems theory of motor control, posture and movement adapt to the _______ in which the movement takes place.
What is environment?
Bonus: How does this relate to clinical practice?
You are testing a 77-year-old woman with arthritis using the Timed-Up-and-Go test. She takes 14 seconds from the moment she leaves the chair, walks around the goal and returns to her seat. How would you interpret this score?
What is an increased risk for falls?
A preprogrammed set of ages when skills appear
What are milestones?
A memory structure that provides instructions for the control of actions
What is a CPG (central pattern generator)?
What is 4+ hyperactive?
Bonus: Is this response indicative of an UMN or LMN lesion?
You're running late and just barely made the bus, but there are no seats available. You take a spot in the aisle, grabbing the bar. When the bus begins to move, you instinctively widen your stance to lower your center of gravity and tense your leg muscles to remain upright. This is an example of what aspect of postural control?
What is Environmental Adaptation?
A part of this objective measurement involves the examiner pushing the subject in the chest three times to see if he begins to fall.
What is Tinetti's Performance Oriented Mobility Assessment (POMA)?
90 percent of mobility is achieved by this age
What is 12 years?
The fact that a baby learns to hold up his head before his trunk is evidence that postural control usually develops in a _____ direction.
What is cephocaudal?
These types of exams might involve performing karaoke, standing in tandem, unilateral stance with perturbations
What are coordination assessments in weight bearing?
A child protege sits down and performs a flawless rendition of Rachmaninoff's Piano Sonata no. 2 in B flat minor. He seems to move without thinking. This is an example of what aspect of the Systems Model of Motor Control?
What is open-loop motor control?
You are using the DGI to conduct balance testing on a 35-year-old patient who sustained concussion during a car wreck. If his score was LESS than ____, you would classify him as at risk for falls.
What is 19?
As she enters her eighth decade around the sun, Madeline begins to find it harder to maintain the upright posture of her youth. What four factors are causing her stooped stance?
1) Decreased disc height
2) Changes in spinal curvature
3) Tissue stiffness
4) Muscle loss
Colin touched a hot stove and instantly snatched his hand back. He reacted even before he was consciously aware of the heat. That is because the reflex occurred at this level:
What is the spinal cord?
Michelle is worried. She's been suffering intense headaches and went to therapy for an assessment. When the PT left the room, she peaked at her chart and it said the muscle tone in her cervical region is a 2+. She does a google search and finds out her tone is this: ____.
What is normal?
In order to tell whether your body is moving, your brain organizes sensory information from these three systems:
What are Vision, Vestibular, and Somatosensation?
Ex: If somatosensation says you are moving, and vision says you are not, vestibular input should be able to resolve the conflict.
Bert's family members were concerned after he fell for the second time in a month. They convinced him to come to a PT for an evaluation. The therapist made him stand up and sit down, pick things up off the floor, turn around quickly, look behind his back, and stand on one foot. Bert was hoping to score higher than ____ to show his family he was not a risk for falls.
Zelda's bones stopped getting longer when she reached her adult height at age 14. This is when she reached ________ maturity, marking the end of the secondary ossification process.
What is epiphysial maturity?
Bonus: When does primary ossification take place?
According to the Reflex and Hierarchical Theory of Motor Control, this represents the top level of control and is capable of inhibiting lower reflexes.
What is the cortex?
A therapist is testing Jafar for graphesthesia by drawing shapes on his skin and asking him to identify them. She tests each side of his body ten times.
He gets everything correct on his left arm. On his right side, he takes a long time to answer and gets two answers wrong. What grade does she give him for his right side?
What is impaired? (75 or 100 percent accurate with decreased response time)
In order to walk smoothly and steadily, your quads, hamstrings, gastroc, tib anterior and all the rest of the leg and foot muscles must fire in a precisely synchronized sequence. Otherwise, you'll fall on your nose. What aspect of postural control does this represent?
What is Motor Coordination?
Carlos is recovering from an ischemic attack that impaired the function of the left hemisphere of his brain. Which objective measurement would likely be used to assess his recovery?
What is Fugi-Meyer?
When you get older, it can take longer to get around. We can expect our steps to get shorter and our stance to get wider. We find it harder to talk on the phone while walking on an uneven sidewalk. Our muscles are less coordinated. Because of this, we spend more time in this phase of gait.
What is double limb support?
Xander is standing on a tilt table. When the table tilts to the right, he leans to the left. This helps to keep him upright with regard to changes between his COM and COG. This is an example of an ______.
What is an equilibrium reaction?