Before Midterm Flashcards
What type of practice is this: Pt types for 15 minutes then rests for 2 minutes
massed
What type of practice is this: pt practices grasp of multiple types of objects cup, water, pitcher, spoon in one OT session
random
What type of practice is this: Pt performs entire bathing routine during morning ADL session
whole
What type of practice is this: pt cuts vegetables for 5 minutes and rests for 10
distributed
What is the systems model of motor control?
the interactions between a person and their environment. Suggests that a persons motor behavior emerges from a persons’ multiple systems interacting with unique tasks and environmental contexts.
What is the ecological approach to perception and action?
“emphasizes the study of interaction between the person and the environment during everyday, functional tasks and the close linkage between perception and action (i.e., purposeful movement).”
What is dynamical system theory?
Dynamical systems theory proposes that behaviors emerge from the interaction of many systems and subsystems. Because the behavior is not specified but is emergent, it is considered to be self-organizing.
What are phase shifts in the theory of dynamic systems?
transitions in behavior during times of instability (ex. stroke)
What is the systems view of motor development?
changes over time are caused by multiple factors or systems such as maturation of the nervous system, biomechanical constraints and resources, and the impact of the physical and social environment.
Neuro Developmental Treatment NDT
To help pts be able to use their postural control with as little compensation as possible. help them reach more normal functional motor motion.
Historical significance to ROOD
Margaret Rood. wanted to make the theory more purposeful and meaningful activity.
Augmented feedback:
information about task performance that is fed back to the patient by artificial means; sometimes called extrinsic feedback.
Blocked practice:
a practice schedule in which many trials on a single task are practiced consecutively and uninterrupted by practice of other tasks.
Continuous task:
a task in which the action is performed without a recognizable beginning or end.
Discrete task:
a task that has a recognizable beginning and end.
Distributed practice:
a practice schedule in which the duration of rest between practice trials is equal to or greater than the time spent in practice.
External focus of attention:
attention directed outside the body to an object or environmental goal.
Inherent feedback:
information that is normally received during performance of a task; sometimes called intrinsic feedback.
Internal focus of attention:
attention directed to locations inside the body (e.g., motor or sensory information).
Knowledge of performance (KP):
augmented feedback about the nature of performance (movement patterns).
Knowledge of results (KR):
augmented feedback about the outcome of the performance with respect to the task goal.
Massed practice:
a practice schedule in which the amount of rest between practice trials is relatively short, often less than the length of the practice trial.
Serial task:
a task consisting of several discrete tasks strung together to make a whole; order of the actions is usually critical for successful performance.
Task-oriented approaches assume that
people learn or relearn motor skills by actively attempting to solve motor problems during the performance of functional tasks.
Motor learning is defined as:
“a set of processes associated with practice or experience leading to relatively permanent changes in the capability for skilled movement.”
Reflex theory for motor control
stimulus response view of motor theory. Complex patterns of movement are the result of combining individual reflexes.
hierarchical theory for motor control
Top–down organizational control of movement with higher levels always exerting full control over lower levels
motor programming theory for motor control
Central motor program contains the “rules” for generating an action. Program can be activated by sensory input or by central processes.
system theory for motor control
Describes the body as a mechanical system that is subject to both external (e.g., gravity) and internal forces (e.g., inertial forces) Self-organization: movement emerges from an interaction of multiple systems—no need for “higher centers” or “central motor program”
Nonlinearity: motor output is not proportional to input—variability expected and needed in the system Control parameters: a variable that regulates a change in behavior (e.g., velocity may be considered the control parameter that shifts the action of walking to running) Attractor states: preferred patterns of movements that are highly stable Attractor wells: the degree of flexibility to change an attractor state: shallow well—unstable pattern that is easy to change; deep well—stable pattern that is difficult to change
ecological theory for motor control
Motor control evolved so that animals can cope with their environment: perception–action coupling. Gibson’s theory of affordances—perception of environmental factors that are critical to the task
Schmidt’s schema theory for motor learning
Draws heavily on motor programming theory of motor control Emphasize on open-loop control processes and the development of the generalized motor program (GMP), which contains the rules for creating the pattern of muscle activity needed to perform the movement After a movement is made, there are four elements available for short-term memory storage: (1) initial movement conditions, (2) parameters used in the GMP, (3) outcome of the movement (knowledge of results), and (4) sensory consequences of the movement (knowledge of performance). This information is stored as two schemas: recall schema (motor) and recognition schema (sensory). Recall schema is used to select a specific set of responses and the response schema is used to evaluate the responses.
Learning occurs as a result of the updating of the two schemas each time a movement is attempted, and it is augmented by the amount of practice and variability of practice.
ecological theory for motor learning
During practice, there is a search for optimal strategy to solve the task problem—search for most salient perceptual cues and optimal motor response.
Fits and Posners 3 stage model for motor learning
Cognitive stage: learner is figuring out what is to be done; determining appropriate strategies to complete the task. Effective strategies are maintained and ineffective ones are discarded. Performance is variable, but improvements are large. High cognitive demands are placed on the learner. The therapist uses instructions, models, feedback, etc., to assist in learning the task at hand.
Associative stage: learner determines the best strategy for the task and is now refining it. Performance is less variable and improvements are slower. Cognitive demands decrease.
Autonomous stage: skill is performed automatically requiring little attention.
Bernstein’s three-stage model for motor learning
Draws heavily on the systems theory of motor control and solving the degrees of freedom problem
Stage 1: reduction in the number of degrees of freedom that must be controlled—learner will constrain the degrees of freedom and develop an effective strategy for task performance, but the strategy is not energy-efficient or flexible. Stage 2: release of additional degrees of freedom and muscle synergies are used across multiple joints resulting in well-coordinated movement that is more efficient and flexible. Stage 3: release of all the degrees of freedom needed for task performance; performer has learned to exploit external and internal forces acting on the system to produce the most coordinated and efficient movement pattern.
Gentile’s two-stage model learning
Initial stage: learner develops an understanding of the task and generates a movement pattern that
enables some degree of success; key element of this stage is learning to discriminate between regulatory features (characteristic of environment that determine movement requirements) and nonregulatory features in the environment; high cognitive load. Later stage: (aka: fixation/diversification) learner is refining the movement so that it can be performed to meet the demands of any situation, and so that it is performed consistently and efficiently. Closed tasks: environmental conditions are stable and little variability is needed—fixation. Open tasks: environmental conditions are changing requiring multiple movement patterns—diversification.
OPTIMAL (optimizing performance through intrinsic motivation and attention for motor theory)
Goal-action coupling: learning is associated with structural brain changes and task-specific neural connections across brain regions (functional connectivity). Evidence demonstrates strong motivational and attentional focus influences motor performance and learning—enhances goal-action coupling. Key motivational variables include enhanced expectancies for future performance (need high expectancies of success) and learner autonomy (choices and a sense of control). External focus of attention (concentration on task goal) is critical during practice.
what is irradiation
allow the stronger muscles in a functional pattern to influence the weaker ones.
in PNF all patterns have a
reversing pattern
What is the continuum of care for PNF
ROM, stability, controlled movement
slow rolling of hips and pelvis helps to
reduce tone
what is sensory motor control
is vibration used for low tone or high tone?
typically it is for someone with low tone.
how do you balance agonist with antagonist muscles?
Here in lies the problem solving
Rood approaches
has a combination of balance control within a movement pattern. used in the context of ADLs and functional activities.
Rood deals heavily with
sensory
NDT deals heavily with
postural shifts and core strength for functional movement and balance. It’s a hands on approach to help enhance movement
Rood pioneered what key concepts?
The use of a frame of reference to guide practice
meaningful activities to promote motor function
importance of repetition
deep connection between sensory system and skilled movement
therapeutic use of self
that therpists can influence the variable that effect tone
Stability, mobility, postural control and skill
What the key concepts pioneered by Brunnstrom
Motor return is proximal to distal
Progress goes through stages and can stall at any stage
Flexion comes back first of primitive movement patterns then extension
Gross motor comes back first then selective fine motor
Stages may overlap
Movement patterns are practiced within the context of daily activities
PNF contraindication
crepidis of the shoulder.
Ways to facilitate muscle tone:
brief rapid icing, high frequency vibration, fast stroking over skin, joint approximation
Ways to inhibit muscle tone:
Prolonged ice, low frequency vibration, slow stroking over the skin
coordination disorders that are hyperkinetic
ataxia, hemiballismus, chorea, tremor, tics
coordination disorders that are hypokinetic
Bradykinesia, parkinsons
ataxia
without motor control
hemiballismus
intermittent, sudden, violent, involuntary, flinging, or ballistic high amplitude movements
what is bradykinesia
slowness of movement
What are some motor interventions to help ataxia
static balance (e.g., standing on one leg) dynamic balance (e.g., sidesteps, climbing stairs) whole-body movements to train trunk–limb coordination steps to prevent falling and falling strategies, movements to treat or prevent contracture
Different presentation of MS and what they mean
Primary progressive
relapsing remitting
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relapse remitting
most new cases. Mostly stable, periods of relapse followed by remission where improvement occurs
secondary progressive
Initial relapse remitting that converts to slow, steady decline without periods of remission
primary progressive
when diagnosed later in life. continuous worsening in disease symptoms. disability without exacerbation.
How would you assess a pt with MS
visual screens, sensory assessment if it’s indicated after asking, upper quarter screen, fine motor (9hole peg), MMT, hand strength (grip and pinch), cognition (informal or cognitive assessment - Mini-mental or moca), ADLs and IADLs
