September 30, 2019
Pondering Postural Control: Sensory Strategies
Postural control is an example of dynamic systems theory in action – there are so many individual yet interdependent systems all working to create a successful outcome. We have already discussed several important sensory systems; visual, vestibular and proprioceptive. The discussion of sensory strategies is really a further discussion about these integrated relationships – that is, how the senses work together to support the creation of efficient postural control.
The vestibular system is intimately connected to the visual system to create a stable visual gaze so we know where we are in space. But the vestibular system also has links to the emotional system and impacts arousal. It also impacts spatial perceptual skills and cognition. The proprioceptive and tactile systems work together to provide critical information that maps the somatosensory cortex and gives us an accurate body schema so we know where we are in relation to our environment. However the vestibular, visual and proprioceptive systems are constantly coordinating during self-motion to give us accurate information about our body position as we move. The interoceptive system gives us the ability to process bodily sensations and associate them with feelings (thirsty, anxious etc.) and this contributes to emotional regulation. Learning about the development and interdependence of the senses through a study of sensory integration has given me a much greater appreciation of these systems and how much our clients struggle. It is obvious that children with sensory processing disorder have challenges with sensory strategies, but so do our children with cerebral palsy as well as those with developmental coordination disorder, ADHD and torticollis. Careful observation and assessment allow us to choose an appropriate intervention. When a child is younger or is more motorically involved, our ability to observe the child and the impact of a treatment strategy become essential to the process of determining what may be of most benefit for that child.
The senses inform the motor system prior to movement but there is also continuous feedback during the movement as the sensory information allows the motor programme to be tweaked continuously so we are successful, coordinated and efficient in the completion of the task. It is only when this process doesn’t happen automatically that movement looks clumsy and inefficient. The ability of the brain to integrate all these sensations for efficient postural control is truly amazing.