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POSTURAL CONTROL AND BALANCE (NORMAL POSTURAL TONE (High enough to…
POSTURAL CONTROL AND BALANCE
NORMAL POSTURAL TONE
High enough to maintain posture
Varies between individuals
Low enough to take up base of support (BOS)
Automatic tonal changes in response to displacement or voluntary movement
Proprioceptive awareness of BOS
BALANCE
: Maintains COG over BOS
Centre of mass/gravity (COG): the point where the mass of the body can be considered to be located - is a constant downward force
Base of support (BOS): the supporting surface and the body part in contact with it and the relationship between the two
VISUAL SYSTEM
Often the most utilised component of balance
Important aspects for balance: visual acuity, depth perception
Provides continual updates on position in relation to the environment
VESTIBULAR SYSTEM
Vestibular reflexes
Vestibulospinal Reflex: Vestibular input used for posture and stability in a gravity environment. Coordinates antigravity muscles to maintain posture
Vestibular-Ocular Reflex (VOR): Maintains fixation of the eyes on an object with movement of the head. Gaze stabilisation
Vestibular system signals the position of the head in relation to gravity, and changes in velocity in linear and angular direction
Maintains visual fixation during head movements (coordinate head and eyes)
Maintains posture and antigravity lower muscular control
PROPRIOCEPTIVE SYSTEM
Definition: joint position sense
Sensory receptors sensitive to stretch or pressure
Ankle and cervical proprioception particularly important for balance
Dominates balance control under fixed support surface conditions
CEREBELLUM AND CEREBRAL CORTEX
Contribute to previously learnt information
POSTURAL STABILITY ACHIEVED THROUGH
EQUILIBRIUM REACTION
Movements that help maintain balance when COG is disturbed
Trunk and body will move in opposite direction to the force
Used with slow/gentle movement
PROTECTIVE REACTION
Protect the body from harm (a fall)
Clinical terms: stepping response and saving response
Occur in same direction of displacing force
RIGHTING REACTION
Head righting (onset: birth – 2 months, persists throughout life)
Allows body to move freely around head
Maintain alignment of head in space, and trunk in relation to the head
HAND FUNCTION
Reach and grasp: to place the hand in appropriate position and orientation in space to interact with the environment
Transportation - hand moves quickly to the target
Manipulation - hand moves more slowly, under visual control to adjust apertures (between thumb and finger(s) just before grasp. The hand starts to open for grasp.
Brunnstrom Synergy Patterns
Flexion synergy:
Scapula retraction & elevation, shoulder abduction & external rotation, elbow flexion, forearm supination. Hand & finger position is variable, generally flexed
Extensor synergy:
Scapula protraction, shoulder adduction & internal rotation, elbow extension, forearm