Gift of Positioning

The gift of positioning enables a person to orient oneself, and to interact in various ways with the environment. This requires voluntary movement, often involving coordination of many parts of the body, all while maintaining mechanical stability. This is the topic of other courses, including courses taught in the past by this instructor, and some offered here at Marquette by Drs. Harris, Schmit and Scheidt. Thus this section will be brief. There is a considerable literature in this area, including two 47-chapter books that I have had the pleasure of editing.

Review

• Review of terminology and foundations
  • see Chapter 1 in the Biomechanics and Neural Control of Posture and Movement book, or
  • the brief review that was part of Module 1
• Review of Basics of Neuromusculoskeletal Systems Physiology:
  • Neurons
  • Neuromuscular conduction: action potentials, firing rate, EMG
  • Muscle fiber composition
  • Neuromuscular mapping
  • Musculotendon sensors
  • Muscle action

Reflexes: Sensorimotor Integrative Behavior at a Basic Level

• Sensors Within Musculoskeletal Tissue
• Sensorimotor "Reflexes"
• Structural Neuro-Mechanical Intimacy and Multi-Segmental Reflexes

Mechanics of Postural Stability

• Necessary: Static Equilibrium
• Neceesary: Equilibrium is Stable
  • Potential Energy: must increase with perturbation
• Sources of Neuromusculoskeletal Stiffness
  • Dynamic Stiffness: series element of muscle-tendon unit
  • Quasi-Static Intrinsic Stiffness: dominated by contractile tension-length property
  • Reflex-based Stiffness: change in force induced by kinematic feedback (but time delay)

Postural Analysis: Neuromechanical Principles and Considerations

• Movement as a Transition in Posture (sometimes)
  • Challenges in Transitioning to a Stable Posture
• Integrative Neuromechanics in Posture and Balance
  • Vestibular contribution
  • Neck and vision contribution
• Body Segmental Neuro-Coordination
  • Key Findings from Floor Platform Perturbation Studies
  • Key Findings from Body Perturbation Studies

Postural Disability: Positioning Challenges, Accommodations

• Key Functional Impairments
• Classic Examples of Dysfunction
  • Multisegmental Postural Coordination
  • Spacticity and Tone
    • Pathophysiology
    • Intervention strategies
  • Tremor (many types)
  • Muscle Weakness
  • Slower Sensory, Motor and Central Processes
• Classic Examples of Functional Activities:
  • Standing and gait
  • Seating/positioning
  • Reaching and maintaining hand position
  • Head and gaze orientation