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3 stages of motor learning
- cognitive - trial and error to understand the task
- associative - refinement - concentrate on how to do it, rather than what
- autonomous - it's automatic now
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asymmetrical tonic neck reflex (ATNR)
head rotates to one side, and the nose-side UE and LE extends, occipital side UE LE flex
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ATNR should last from __ to __
birth to 4-6 months
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crossed extension reflex
noxious stim to ball of foot of LE in extension, and the contralat LE should flex, then add and ext
(pt w hemiplegia -- lift uninvolved LE off ground in amb, and involved leg should have increased extensor tone)
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crossed extension reflex lasts when to when
28 wks gestation to 1-2 months
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equilibrium reactions
tilt person to one side, and limbs should ext and abd on that side
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onset of equilibrium reaction
- 6 months in prone
- 7-8 months in supine and sitting
- 9-12 in kneeling
- 12-21 in standing
it's never integrated, rather we keep it
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grasp reflex
maintain pressure in palm or plantar surface of foot, and hand should grasp or toes should flex
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grasp reflex, when to when?
- palmar: birth to 4-6 months
- plantar: 28 wks gestation to 9 months
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Landau's reflex
describe
- lift kid in prone with your hand on thorax,
- head, then back and legs should extend
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Landau's reflex, when to when?
3 mo to 2 years
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optical and labyrinthine righting reflexes
tip kid in various directions and head should orient to vertical, mouth should be horizontal
for labyrinthine, cover the eyes
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optical and labyrinthine righting reflexes, when to when?
birth or 2 months - forever
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positive supporting reaction
describe
stim to ball of foot while standing --> rigid ext of LE w PF, inv, toes clawing, hip IR
can't ambulate if this is present bc can't DF or properly move leg jts
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positive supporting reaction in pt with CP
adductor spasm may occur
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positive supporting reaction in pt with hemiplegia
may produce hip abd
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positive supporting reaction when to when?
birth - 6 months
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protective extension reaction
describe
when to when
- if tilted, abd limbs on that sie
- onset: arms 4-6 months, legs 6-9 months
- integration: persists
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rooting reflex
describe
when to when
- stim side of face w light touch and kid turns head that way and opens month
- birth - 3 months
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symmetrical tonic neck reflex
describe
when to when
- flex head: UE flex, LE ext
- ext head: UE ext, LE flex
- 4-6 months to 8-12
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tonic labyrinthine reflex
describe
when to when
- in prone: increased flex tone
- in supine: increased ext tone
- (body curls towards the floor each way)
- birth to 6 months
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traction reflex
describe
when to when
- grasp forearm and pull from supine to sit -- pt should flex UE and head lags behind, then lifts, then flexes
- 28 wks gestation to 2-5 months
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apgar ranges
- 4 or less -- requires immediate care
- 5-6 - some care
- 7-10 normal
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Erb's palsy - the pathology?
C5-C6 are stretched during birthing
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Erb's palsy - weak where? what posture?
- weak: GH abd, ER, elbow flexion, supination
- posture: waiter's tip -- GH is add, IR
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Klumpke's paralysis -- pathology?
C8 and T1 nerve roots are stretched during birth process
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Klumpke's paralysis - presents how?
- weak hand and wrist flexors
- claw hand appearance is common
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