NDT Perspective Posture and Movement Body Systems Functional Activities

Function Gross Motor Fine Motor Oral Motor ADL Communication Look For Functional Activities Functional Limitations.

Posture And Movement

Postural System Alignment

Postural System BOS / COM

Postural System BOS/COM BOS: Definition. Bigger/Smaller BOS. COM/COG: Definition. Normal Position. Change of COM during movement. Control of changing COM over the changing BOS.

Anticipation & Counter-balance Postural System Anticipation & Counter-balance Anticipation is not cognitive, but neurological.

Movement System Inertia

Movement Strategies Plane of Movement Saggital Frontal Transverse

Movement Characteristics Range of Motion Speed

Strategies used for Stability/Mobility Muscle Synergies. “Freeze out mobility in order to achieve stability.”

Integration of Posture & Movement All the body parts have both Postural & Movement characteristics. We need integration of posture and movement in order to achieve: Balance Transition Accuracy Efficiency

Individual Body Systems

Body Systems Regulatory System The state of arousal. Can the child Self regulate? Sudden or gradual change in the regulation.

Regulatory System Limbic System. Autonomic Nervous System.

Musculo-Skeletal System Body Systems Musculo-Skeletal System Range of Motion. Strength: In pattern. Isolated. Strength is probably not the primary impairment, but it could be a profound secondary impairment.

Musculo-Skeletal System

Neuro-Muscular System Body Systems Neuro-Muscular System Ability to Sustain Initiate Sustain Terminate

Neuro-Muscular System Selective Recruitment of: Postural Motor Units Vs Movement Motor Units.

Neuro-Muscular System Ability to perform: Concentric Isometric Eccentric Muscle work. Eccentric is the 1st affected in cerebral palsy. The role of Gamma MN/Ms Spindle.

Neuro-Muscular System Recruitment of Co-contraction Vs Reciprocal Inhibition. Sometimes we need co-contraction proximally & R.I. distally or vice versa. Importance in Postural & Movt. System. The role of M.S./GTO.

Neuro-Muscular System Synergy Selectivity: MASSED I S O L A T E D Isolated, fractionated movements. Gives us disassociation. Repertoire of Movement. The Hallmark of Normal Movement.

Neuro-Muscular System Stiffness E.g., Spring. Control & Co-ordination of stiffness.

Neuro-Muscular System Extraneous Movements Tremors Clonus Nystagmus Chorea movements. Damping. Probably based on myelination of the nerves. Probably CB/BG is also very important.

Body Systems Sensory Systems VISION SOMATO-SENSORY SYSTEM VESTIBULAR SYSTEM AUDITORY SYSTEM TASTE & SMELL

Vision Primary sensory system for Postural control. Focal Vision. Ambient Vision. Posture & Movement both are affected by vision. Visual System is adaptive, more so under the age of 4.

Somato-Sensory System Provides awareness. The receptors are Muscle & Joint receptors. The joint receptors get mature & sensitive with compression of 2 bones.

Vestibular System Head Position, Head Movement. Movement of body in space & in relation to gravity. Works between the Visual & Somato-sensory systems.

The integration of VISION, SOMATO-SENSORY & VESTIBULAR Systems helps to get awareness of the relationship of One body part to another, Body with object, Body with space, & Body in relation to gravity.

Auditory System Starts functioning in utero. We may develop asymmetry. Auditory processing. May have associated vestibular system problems also.

Taste & Smell Orientation may be based on taste & smell. Infants do early bonding through smell. Infant as old as 10 days can identify a beaker of mother’s milk from across a room.

CARDIO VASCULAR SYSTEM Body Systems CARDIO VASCULAR SYSTEM Blood circulation to distal parts. Children may bite/hit self. Thus, CV system may affect the movement.

Body Systems RESPIRATORY SYSTEM How does the child breath? e.g. Post. Breathing. Look at ribcage mobility. Get stability by breath holding. Freedom to breath with mobility. Diaphragm as a postural ms to get stability rather than a respiratory ms.

Body Systems Respiratory System

GASTRO-INTESTINAL SYSTEM Body Systems GASTRO-INTESTINAL SYSTEM Issues of reflux are important- may be misunderstood as opisthotonos. Facilitation can lead to reflux. Issue of Constipation.

Body Systems SKIN Color Extensibility. Thickness. Rashes/wounds.

Masoom Physiotherapy Clinic 204, 3rd Floor, Surgicare, Sardar Patel Colony, Naranpura. Ph: 079-66621030. M:98256 52537.