Postural Control

Question 1

What do postural actions consist of

what are the components

Answer 1

• the person
• the environment
• the task

Question 2

Postural tone

Answer 2

• amount of muscle activity that is required to maintain posture
• varies from situation to situation and is changing

Question 3

Postural control definition and its aspects

Answer 3

• maintaining position of the part of the body with respect of an external reference frame
• the environment
• an external object moving in the environment
• the body itself

Question 4

What are the types of postural control

Answer 4

• static
• dynamic

Question 5

static postural control and what is involved

Answer 5

maintain stability in a steady state
- involved control of COM over BOS
- muscel tone/posutral tone
- sensory input
- influence of head and neck position
- tonic neck reflexes (head/neck position plays an effect on how much you use your extensors/changes COM)

Question 6

dynamic postural control/types

Answer 6

for function and movement
- reactive and anticipatory
- used during functional movement

Question 7

Reactive postural control

Answer 7

• part of dynamic postural control
• feedback control
• feedforward control: changing an activity while it is occurring

Question 8

Anticipatory postural control

Answer 8

• internal control/before movement starts
• proactive postural control
• preparatory action before a movement

Question 9

how/when does development of postural control occur generally

Answer 9

• occurs before birth
• 7-8 weeks gestational age: fetal side bending as a precursor to postural control
• all postural movements of trunk and limbs are evident at the end of 1st trimester
• little control needed due to amniotic fluid/reduced gravity

Question 10

Development of postural control during the first year

Answer 10

• flexion control followed by extension
• head control
• sitting balance
• standing balance
• walking
• intra and inter-individual variations in development are influenced by genetic and environment
• development shows the hierarchy of control

Question 11

How is Postural control developed beyond the 1st year/walking

Answer 11

• modified and refined through practice
• movements become more efficient, less variable
• walking:
  1. early “high guard” walking changes
  - decreased step width
  - increased step length
  - interlimb coordination

Question 12

Sensory contributions of postural control

Answer 12

• vision
• somatosensation: proprioception, cutaneous sensation, feet, hands and UE
• vestibular system: where head/body is in space
• important for steady state and reactive/proactive control

Question 13

Development of the sensory systems

Answer 13

• mostly vision and somatosensation
• gradually improves from birth until 7-9 years old
• visual acuity, depth perception, cutaneous sensation, proprioception
• coincides with mature balance reactions that compensate to avoid falling

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Question 14

Development of the vestibular system

Answer 14

• timeline is less clear
• vestibulo-ocular reflex (VOR) develops shortly after birth (moving your eyes to adjust for head movements)
• vestibular system development less apparent
• usually evident if other systems impaired

Question 15

Steady state balance

Answer 15

• quiet stance is not totally quiet, there is some postural sway
• also true of quiet sitting
• considerations when testing static balance

Question 16

Strategies for maintaining postural control while in standing position

Answer 16

1. ankle strategy: shifting weight back and forth (tends to be DF/PF)
2. Hip strategy: Flex forward/backward once DF and PF did not work to maintain balance
3. stepping strategy: taking a step to increase the BOS

Question 17

Postural control strategies

Answer 17

• anterior-posterior
• mediolateral: tend to take a step/cross over
• multidirectional
• these strategies are a combination of synergies and continuous feedback

Question 18

Adaptation/strategies of reactive control and how they are refined and tuned

Answer 18

• postural sway is reactive
• refining and tuning muscle strategies:
  1. postural synergies not fixed, stereotypical reactions (modify based on needs that change)
  2. they are refined and tuned in response to changing demands in task and environment
  3. adaptation: movements in response to task demands

Question 19

Cognition and attention in postural control

Answer 19

• cognition and attention are needed with some tasks more than others
• depends on complexity of task and activity
• in children, tasks that require increased attention may reduce postural sway as children tend to tighten up