Chp 13 and 14 Flashcards
What is a motor program?
What is a motor plan
What is motor control
What is motor control?, an area of study dealing with neural, physical and behavioral components of movement
What is a motor plan?, plan for purposeful movement made up of component motor programs
What is a motor program?, abstract representation that results in coordinated movement
Model of information processing stages
Stimulus selected, Stimulus ID (hearing a song reconginizing what the object is, feeling what the object is ETC) Response selection Response Programming, Movement output
Theories of Motor Control
Reflex theory - Movement is the result of a stimulus-response sequence of events or reflex based. Complex movements where nothing more than a chaining together of reflexes
Hiearchy theroy- High control centers that organize the movement like in the brain and lower control centers like the reflex pathways and reflex pathways take over when the higher centers are damaged. “top down approach”
Systems theory, Bernstein-cooperative actions of many interacting systems
Distributed control- large areas of the CNS may be engaged for
Degrees of freedom- number of independent motions that the CNS is responsible for,
Coordinative structures- used to simplfy control and used for coordinative patterns and synergys
Motor Programming Theory
abstract representation that, when initiated, results in the production of a coordinated movement sequence”, O’Sullivan & Schmidt
Allows for movement to occur in the absence of sensation or when the sensory info is not available due to the speed of the movement
ie. generalized schema: invariant characteristics, parameters Shcema - motor program which provides the info for a motor plan
what is motor learning
set of internal processes associated with practice or experience leading to relatively permanent changes in capabilities for skilled behaviors” O’Sullivan & Schmidt
How do we define Learning, Performance, rentention, generalizability, resistance to contextual change
Performance- result from practice or experience and are a frequesntly measurable thing
Learning- can measure or say that it wasn’t taught and can’t be affected by things such as medication, lack of sleep, poor motivation, or anxiety
Retention- the ability to demonstrate the skill over a certain period of time
Generalizability – ability to transfer one skill to another task. For instance transfering from a W/C to a car then trying W/C to a bed
Resistance to contextual change, transfer- once the skill is learned you should be able to do it in a variety of enviorments for example ( if you walk inside then you can then walk outside on uneven ground
Theories of Motor Learning
Historically,
Adams, closed loop theory/control (perceptual trace, reference of correctness)
Schmidt, schema theory (rule based with slow movements FB based and fast movements Program based)
Stages of Motor Learning & Training Strategies, review Table 13.1, p 476-7
Fitts & Posner
Cognitive, develop a map or plan, what to do
Associative, refine spatial & temporal aspects, coordinated pattern emerges, how to do
Autonomous, perform in both predictable environments closed skills and unpredictable open skills, how to succeed
4 categories of Motor skills this again :/ probadly going to be on test
Mobility
Static postural control – stability
Dynamic postural control – controlled mobility
Skill
review Table 13.2 p 481
Table 13.3 p 482 (transition lab)
So what is Recovery of Function?
Reacquisition of movement lost through injury, O’Sullivan & Schmidt
Which maybe compensatory in nature
Neural Plastisicity, ability of the brain to change & repair itself
Types of Recovery and Neuroplascity
Vicariance, focuses on the use of different and underutilized areas
Redundancy, fail-safe system/unmasking
Functional substitution, preprogrammed
2 types of recovery, Spontaneous= Diachisis, recovery immediately after temporary blocking factors Function-induced recovery= reorganize due to changes in activity (constraint-induced movement therapy Box 13.1, BWS) and environment
What influences recovery of function?
Age
Slow vs fast occurring injury
Enriched environments
Specific training vs non specific training
Frameworks for Intervention
Functional-task oriented training= behavioral shaping and motor learning principles are used Box 13.2 Neuromotor Development Training NDT Bobath’s, PNF Kabat,Knoot,Voss, Neuromuscular/Sensory Stim Tech Rood Movement Therapy, Brunnstrom Compensatory training
Neurodevelopmental treatment (NDT), Bobath’s Appendix A p512
Primary problem abnormal tone & coordination
Primary cause of control problems was release of abnormal postural reflexes (primitive spinal cord & brainstem reflexes)
Loss of higher level postural reactions (righting, equilibrium, protective extension)
Use developmental sequence to promote normal selective movements
Handling and key points of control are used to promote automatic higher level postural reactions
Dynamic reflex inhibiting patterns are used to inhibit excessive tone
Sensory stim used to facilitate normal movements
Compensatory training strategies are used
Movement therapy, Brunnstrom
Uses structured activities that promote normal function
Described recovery stages 7 stereotypical patterns of abnormal synergistic control
Gain basic limb synergies before out of synergy combinations (? Isolated control)
Uses sensory stimulation techniques
Proprioceptive Neuromuscular Facilitation (PNF), Kabat, Knoott, VossAppendix B p 514
Incorporates spiral & diagonal functional movement patterns that are based on normal movements
Proprioceptive techniques-facilitate movement (stretch, max resistance)
Use of precise manual contacts
Developmental emphasis was added
practices individual and combinations of patterns
Motor learning principles are incorporated
Sensory Stimulation, RoodAppendix C p 517
Stimulation was organized into Phasic or Tonic categories and applied based upon stage of control observed
Mobility, Stability, Mobility Superimposed on Stability, & Skill
Used Approximation & Steady Resistance (tonic stimuli) = STABILTY
Used Quick Ice & Quick Stretch (phasic stimuli) = MOBILIZING ACTIONS
Uses either facilitory or inhibitory stimuli
FUNCTIONAL TASK ORIENTED TRAINING APPROACH
Motor control motor learning approach
System theory & motor learning theory
“Interacting systems within the CNS are organized around essential functional tasks and the environment in which the task is performed”, O’Sullivan & Schmitz
Practice tasks that provide client with difficulty and practice in varying environments
Use cognitive, perceptual, motor learning, biomechanical strategies
Focuses on Active participation
Tone & Reflex Integrity how t decrease tone?
Decrease tone, prolonged icing, prolonged stretching, inhibitory pressure, neutral warmth, slow vestibular stim, rhythmic rotation = precede ROM/ACTIVE EXERCIES
Use constant firm manual contacts
Pressure splints, inhibitory serial casting
NMS, intrathecal baclofen , chemical blocks
biofeedback
how to increase tone
Increase tone Quick stretch, tapping, resistance, approximation, positioning Strengthen exercises Supportive devises Posture stability control Sensory stim NMES/functional training
Muscle Performance: Strength, Power, Endurance
Performance= capacity to do work (force x distance)
Strength= muscles ability to produce force to overcome one max effort
Power= work produced per unit of time (strength x speed)
Endurance= ability to contract muscle repeatedly over time
Specificity principle
PRE’S, PNF, FUNCTIONAL TRAINING PROGRAM, MUSCLE ENDURANCE EQUIPMENT
Postural Control & Balance
Postural alignment & weight distribution Limits of stability (lab experience) Functional balance strategies Manual perturbation, force displacing the COM Moveable surface that displaces BOS Sensory organization Somatosensory (proprioceptive/tactile), visual, vestibular Safety & fall prevention Maintain BOS Lower COM Environment
Gait & Locomotion requires what 3 types of training
Requires functioning of many interacting systems
Task specific training
BWSTT
Locomotor Training Ch 14 p 523 Successful walking includes what 5 things
Support of body mass Production of locomotor rhythm Dynamic balance control Direction/Propulsion adaptability
Lab exercisesLocomotor training Box 14.1 p 524Figure 14.6 p 532
Pre tasks Parallel bars Indoor overground Box 14.2 Outdoor overground BWST Indoor overground with BWS
Canes coming to standing and return to sitting ‘
Crutches
Walkers
coming to standing - patient moves forward in chair can is positoned on UL and use as arm rest.
sitting down - patient turns on UL backs up to fell the chair at back of knees reaches for armrest standard cane patient uses cane as arm rest
Crutches -
Come to standing - Pt. moves forward in the chair cruthces placed in a vertical position on the affected side one arm rest of crutch and the other arm rest of chair and push up then patient leans forward and push crutch under unaffected then under affected arm and maintains a tripod position
Return to sitting- patient turns in a small circle ditto to the cane procedure
Walkers
come to standing same way excpet use both arm rest as there is no armrests then pt. slowly reaches for walker one hand at a time
Return to sitting-
ditto as before
Stair Climbing
Box 14.5 “Up with the good down with the bad”?
Summary: Principles of Neural Adaptation“Neuroplasticity”
“With learning, the distributed cortical representations of inputs & brain actions “specialize” in their representations of behaviorally important inputs & actions for skill learning” O’S & S 2001
Neurons grow based on repetitive excitation from behaviorally important stimuli
Which leads to specificity of temporal and spatial dimensions
Leads to temporal coordination
Synapses are strengthened by selecting behaviorally important inputs
Skill learning is massive
Enduring cortical plasticity changes appear to be accounted for by local changes in neural anatomy
Cortical plasticity processes in child development represent mutli -staged learning
Cortical field specific differences in input create different representational structures
Temporal dimensions of behaviorally importa
Processing time is subject to learning based plasticity
Learning is modulated as a function of behavior state
Constraints limit the magnitude of plasticity
