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abnormal dev

QuestionAnswer
Head/Neck Hyperextension and Tongue Retraction: abnormal development Head/neck flexors do not develop adequately to counterbalance the extensors
Head/Neck Hyperextension and Tongue Retraction: effects on Postural Control and Movement • No active neck flexion • No elongation of neck extensors • Develops resistance to PROM of neck extensors
Head/Neck Hyperextension and Tongue Retraction: compensation Hyperextension of head/neck with shoulder elevation to stabilize head/forward flexion of the trunk
Head/Neck Hyperextension and Tongue Retraction: functional consequences • Poor midline orientation • Poor downward gaze and visual convergence • Inability to dissociate head from shoulders • Limited lateral gaze and lateral righting reactions
Head/Neck Hyperextension and Tongue Retraction: tx goals • Early activation of neck flexors and extensors • Passive elongation of neck extensors • Dissociation of shoulders and head • Reinforce scapular depression
Humeral Extension/Adduction/Internal Rotation abnormal development Development of thoracic extension is more difficult. ● Compensation: use scapular adduction and IR to “fix” in attempt to get thoracic extension. ● Lack of thoracic extension prevents elongation of abdominals and posterior weight shift.
Humeral Extension/Adduction/Internal Rotation effects on Postural Control and Movement Lose humeral flexion ● No dissociation of scapula and humerus ● Shortened, inactive abdominals
Humeral Extension/Adduction/Internal Rotation functional consequences Sits with rounded shoulders with COG in front of hips ● Get head and neck hyperextension to compensate ● Shortened rectus abdominus pulls pelvis into posterior pelvic tilt.
Humeral Extension/Adduction/Internal Rotation tx goals Elongation of abdominals ● Strengthen thoracic extension while lengthening muscles between scapula and humerus ● May use adaptive equipment for sitting to prevent kyphotic posture
Lumbar Extension/Hip Flexion/Abduction/External Rotation abnormal development Hypotonia is most evident in hips and trunk. ● Cannot develop extension due to low tone in trunk. ● Abdominals not active. ● Stay in wide-based LE posture in prone.
Lumbar Extension/Hip Flexion/Abduction/External Rotation effects on Postural Control and Movement Difficult to weight shift laterally in prone or sitting due to wide BOS, Overuse UE’s to compensate for immobility in trunk, Stands with hyperextended knees and legs adducted for stability due to decreased tone in trunk. Tend to use W sitting for pelvic s
Lumbar Extension/Hip Flexion/Abduction/External Rotation functional consequences Difficulty with transitional movements, lateral weight shifting (due to wide BOS). Lateral righting and equilibrium reactions develop late. At risk for contractures of hip adductors, hip flexors, and hamstrings.
Lumbar Extension/Hip Flexion/Abduction/External Rotation tx goals Prevent contractures ● Increase tone and mobility in lower trunk. ● Work on balance and trunk mobility in alternative sitting positions. ● Focus on lateral righting reactions early in treatment.
Hip Extension/Adduction abnormal development Problems with lower trunk and abdomen. ● Lack elongation and rotation in trunk. ● Does not get into the frog-leg stability position ● Let’s start to extend and adduct – baby uses this posture to fixate trying to stabilize the pelvi
Hip Extension/Adduction effects on Postural Control and Movement
Hip Extension/Adduction compensation
Hip Extension/Adduction functional consequences
Hip Extension/Adduction tx goals
Created by: antd210
 

 



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