Download Kinesiology and SEnsorimotor

Kinesiology and Sensorimotor
Functioning
Chapter 5, Vol. 1
Terminology
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Flexion – bending a joint
Extension – straightening of joint
Dorsiflexion – bend at ankle, point toe upward
Plantar flexion – bend at ankle, point toe down
Abduction – sideward motion of arm/thigh
away from middle
• Adduction - sidward motion of arm/thigh toward
midline
Why should you know these terms?
• Understnaidng of these basic terms, allows
the O&M specialist to analyze the
performance of mobility and other motor
skills
• Allows for exchange of information efficiently
among health care professionals such at PT’s
and OTs.
Principles of Sensorimotor
Development
• Cephalocaudal – the development of motor
skills in infants proceed from head to toe.
• Proximo – distal – Infants first gain motor
control of motions at joints closest to the
trunk then those furthest away
• Gross to fine – and general to specific – Motor
skill development begins with large, general
motions. Small, refined motions develop later.
Sensorimotor Development of
Children
• Critical state of motor development occurs
when the infant spends time in the prone
(stomach – lying) position
• This is critical for head control, weight bearing
on forearms, and sensory information that
stimulates proprioceptive functioning
Sensorimotor Development of
Children with Visual Impairments
• Remember, infants with visual impairments don’t
get the “reward” of lifting their head
• These children often fail to fully develop muscle
strength and control of the head, neck and trunk
which can cause issues later with posture.
• Generally children with visual impairments
achieve motor skills that require independent
movemetn much later than sighted children
(Adelson & Fraiberg, 1974)
In addition…
• Infants who are blind do not reach for objects
until later than their sighted peers
• Often do not begin walking until aorund 18
months of age
• Lower activity in belly crawling, and crawling
on all fours
• Lack the postural stability in their trunk and
back and shouldter girdle and have difficulty
getting into and out of all crawling positions
Sensory Awareness
• ALL CHILDREN use sensory information to
learn about :
– Their bodies
– Their enviornment
– To develop spatial and enviornmental concepts
7 Types of Sensory Input to Brain
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Visual
Tactile
Vestibular
Proprioceptive
Audtiory
Olfactory
Gustatory
Visual System
• “Vision, together with the vestibular and
proprioceptive systems, provides the feedback
mechanism by which children develop, selfmonitor, refine and integrate sensorimotor
skills into daily functioning.”
• Imitative Learning
• Integrating other sensory systems –vision
helps integrate tactile, proprioceptive and
vestibular functions in the early years.
Tactile System
• Six types of sensory information provided by
touch:
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Deep touch (awareness of touch)
Light touch (textures)
Vibration
Pain
Temperature
Two-point touch (identification of the number of
points of contact an object has with the skin at any
time)
Proprioceptive System
• Sensors located in the muscles, tendons and
joints o the body and provide an awareness of
STATIC body position at any given moment
and the relationship of the body parts to one
another.
• Begins to develop in infancy and occurs
through a combination of movement
experiences and visual feedback.
Proprioception and Visual Impairment
• The lack of visual incentive to play (initially
with hands and feet) results in missed
opportunities for propriocetpive input and
development of trunk strength because of lack
of leg movements.
• Proprioceptive sensory ability plays a major in
body awareness including laterality,
direcitonality and spatial awareness
• Also is connected to musle tone and balance.
Haptic Awareness
• Combination of proprioception and tactile
awareness.
• The person’s ability to determine the
properties (texture, size, shape and
temperature) of an object by handling it.
Vestibular System
• Located in the inner ear
• Registers
– Speed
– Force
– Direciton of movement
– Effect of gravity on the body
– Head position
Vestibular System
• Fully functional at birth
• First sensory system to mature
• Children learn to use this sytem through
motor activities
• Vision plays a role in how the vestibular
system develops and how input is used.
Vestibular System and Children with
Visual Impairment
• If the child is unable to use vestibular inputs
efficiently the child may have difficulty:
– maintaining their head upright
– developing good balance and equilibrium
– Developing mature gross motor skills requiring
coordination of both sides of the body
Muscle Tone
• Motoric “readiness for movement”
• Related to proprioception
• Low muscle tone is a recognized problem for
children with congenital visual impariment
(Boehme, 1990)
• Children with poor muscle tone lack stable
postural foundation
• Domino effect
Stability and Mobility
• Stability – body’s ability to maintain static
posture
• Mobility – the body’s ability to perform
unrestircted motions
• Both impacted by low muscle tone
Coordination
• Neurological system’s co-ordering of activity
to organize movement.
• Begins in infancy with primative reflexes
• Reflexes and reactions are the building blocks
of coordination
Reflexes
• Reflexes are stereotypical responses to
specific stimuli (rooting reflex)
• Provide tactile, proprioceptive and kinesthetic
stimulation as children interact with their
environment (ATNR)
• Reflexes integrate
Reactions
• Reactions are automatic movements that
occur in response to changes in the body’s
position relative to gravity. (falling)
• Neurological responses that remain
throughout life.
• Contribute to 3 types of motor functioning:
– Righting reactions
– Protective and support reactions
– Equilibrium
Posture
• Fundamental concepts that underly the
development of good posture:
– Body Planes
• Frontal plane (divides front from back)
• Transverse planes (divides top from bottom)
• Sagital plane (divides left from right)
Body segments are alighed with respect to one another
in the three planes
Posture (cont)
• Center of Gravity
– Every body segment has a center of gravity
– Optimal body posure segments are aligned on on
top of the other
– The BODY’s center of gravity is the intersection of
the three body planes at the (upper sacral region
of the) pelvis
Balance
• Static
– Used to maintain a static posture such as sitting or
standing
– Proprioception is in use
• Dynamic
– Used during movement
– Vestibular system is engaged
Balance and Children with Visual
Impairments
• Bouchard (2000) reports inadequate balance
reactions in the majority of school children with
low vision
• Gipsman (1981) found dynamic balance was
impaired in children who had a range of
congenital visual impairments
• Rosen (1989) found that limited balance
correlated with the presence of immature gait
characteristics such as out-toeing and short stride
Gait
• Gait is the normal manner of walking
• Gait pattern is one’s collection of specific gait
characteristics
• 2 phases of gait
– Stance
– Swing
Gait and Children with Visual
Impairments
• Spatial gait pattern may not fully develop, but
plateaus at an immature level that is
characteristic of a sighted toddler (Rosen
1986)
• Reasons for the immature gait pattern
include:
– Loss of sensory data needed to time steps
– Impoverished balance
– Difficiency of protective reactions
Gait and Children with Visual
Impairments (cont)
• Motoric influences
– Hypertonia
– Limited proprioceptive awareness
– Poor integration of primitive reflexes
– Poor integration of mature reactions
– Poor trunk rotation necessary to keep trunk facing
forwarde while rotating the pelvis
Implicatons?
• It is ALL connected
• Early intervention is ESSENTIAL!
• Make sure to assess all of these areas