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Motor Control and Learning > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

What 3 components make up Motor Behavior?

A

Motor Control
Motor Learning
Motor Development

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2
Q

What is motor control?

A

The study of the neural, physical, and behavioral aspects of movement (typically LE and gait)

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3
Q

What is motor learning?

A

Refers to the relatively permanent gains in motor skill capability associated with practice or experience (usually UE function; CVA)

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4
Q

What is motor development?

A

Refers to the continuous, age-related process of change in movement

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5
Q

Motor Control Definition

A

Ability to regulate or direct the mechanisms essential to movement

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6
Q

Benefits of Motor Control Theories?

A

Provides philosophy about how the brain controls movement (predicts how behavior should turn out)
Framework for interpreting behavior (use theory to hypothesize how it will develop)

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7
Q

What are the Motor Control Theories?

A 
Reflex Theory
Hierarchical Theory
Motor Programming Theories
Systems Theories
Ecological Theory
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8
Q

What are control parameters?

A

Factors that impact attractor state (speed that forces you to run)

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9
Q

Infant Behavior and Development Reflex

A

When submerged in water, stepping pattern reappears
Added fat mass prevents the step from occurring
Older infants stop stepping when weight is added to the limbs
As the mass is taken away in water, the stepping motion reappears

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10
Q

Dynamical Systems Theory

A

Movement emerges from the interactions between the individual, the task, and the environment in which the task is being carried out
Movement is not solely the result of the muscle - specific motor programs, or stereotyped reflexes, but results from a dynamic interplay between perceptual, cognitive, and actions systems (neuromuscular and musculoskeletal system)

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11
Q

Systems Theories Clinical Implications

A

Stresses understanding body as mechanical system
Movement is emergent property
Retraining movement in patients with neural pathology

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12
Q

What components make up the Nature of a Movement?

A

Task
Individual
Environment

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13
Q

What factors impact the Task?

A

Mobility
Postural Control
Upper Extremity Function

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14
Q

What factors impact the Individual?

A

Cognitive
Sensory/Perception: essential to
Motor/Action:

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15
Q

What factors impact the Environment?

A

Regulatory

Nonregulatory

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16
Q

Motor/Action (Individual)

A

Study of the neuromuscular and biomechanical systems that control functional movements

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17
Q

Sensory/Perceptual Systems (Individual)

A

Essential to control of functional movement
Perception: integration of sensory impressions into psychologically meaningful information
Provide information about the state of the body
Integral to ability to act effectively within an environment

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18
Q

Cognitive Systems (Individual)

A

Essential to motor control
Attention, planning, problem-solving, motivation, and emotional aspects of motor control that underlie establishment of intent or goals
Have patients walk and cross over an obstacle

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19
Q

Categories of Movement (The Task)

A

Discrete vs Continuous
Stability vs Mobility
Manipulation
Closed vs Open Movement Tasks

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20
Q

Categories of Movement (The Environment)

A

Regulatory Factors (ball, BOS)
Non-Regulatory Factors (lights, cheering)
Open vs Closed

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21
Q

What are the phases of the Integration of Movement Analysis?

A

Initial conditions: Posture; Ability to interact with the environment; Environmental Context
Preparation: Stimulus Identification; Response Selection; Response Programming
Initiation: Timing; Direction; Smoothness
Execution: Amplitude; Direction; Speed; Smoothness
Termination: Timing; Stability; Accuracy
Outcome: Outcome Achieved?

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22
Q

Body functions

A

Physiological functions of body systems

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23
Q

Body Structures

A

Anatomical parts of the body

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24
Q

Impairments

A

Problems in body function or structure such as a significant deviation or loss

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25
Q

Activity

A

Execution of a task or action

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26
Q

Participation

A

Involvement in a life situation

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27
Q

Activity Limitations

A

Difficulties in executing activities

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28
Q

Participation Restrictions

A

Problems in involvement in life situations

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29
Q

Environmental Factors

A

Make up the physical, social, and attitudinal environment in which they live

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30
Q

Phases of Motor Plan

A

Preparation for motor plan (somatosensory and visual system)
Customization of the motor plan (frontal lobe, basal ganglia, cerebellum which continuously communicates with the brain stem and thalamus)
Execution of the motor plan (Primary motor area of precentral gyrus, pyramidal cells in cortocospinal and corticobulbar tracts, skeletal muscles

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31
Q

What is a Task Oriented Approach?

A

Integrates a systems theory approach with concepts from rehabilitation science

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32
Q

What are the assumptions of a Task Oriented Approach?

A

Movement is organized around behavioral goal and environmental constraints
Movement is the result of interaction of different systems
Focus on functional task rather than on movement patterns just for the sake of movement
Patient should be involved in problem solving
Adaptability is key

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33
Q

Task Oriented Approach to Evaluation

A

Integrates with the ICF model to give a rounded view of the patient
Evaluate functional activities and participation restrictions
Describe the strategies used to accomplish the tasks
Quantify underlying impairments
Acknowledge contextual factors = environmental and personal factors

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34
Q

Task Oriented Approach to Intervention

A

Resolve, reduce or prevent impairments @ Body Structure/Functional Level
Effective and Efficient Task-Specific Strategies: find ways to really teach patients so they learn best
Change Task and Environmental Conditions to maximize participation and independence
All steps occur simultaneously

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35
Q

Task Oriented Approach to Exam

A

Evaluate functional activities and participation restrictions
Describe the strategies used to accomplish the tasks
Quantify underlying impairments
Acknowledge contextual factors: environmental and personal factors

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36
Q

What are the 4 main concepts of motor learning?

A

A process of acquiring the capability of skilled action
Results from experience or practice
Cannot be directly measured but is inferred from behavior
Produces permanent changes in behavior (short term changes are not thought of as learning)

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37
Q

Motor Learning vs Performance

A

Performance: temporary change in motor behavior following practice (needs more practice to be permanent changes)
Motor Learning: permanent changes in motor behavior

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38
Q

What is the Retention Test?

A

Slower treadmill belt has shorter step length compared to faster, but move to symmetrical strides when tempos are moved back to the norm

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39
Q

What is the Transfer Test?

A

Able to get symmetrical stride on the treadmill, but once they walk on the ground, they lose the symmetry

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40
Q

What are the two types of long-term memory?

A

Non-declarative (Implicit)

Declarative (Explicit)

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41
Q

What are the 3 types of non-declarative learning?

A

Non-associative
Associative
Procedural

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42
Q

Non-associative Learning

A

Animals given stimulus repeatedly
Habituations: decrease in responsiveness as result of repeated exposure to non-painful stimulus
Sensitization: increased responsiveness following threatening or noxious stimulus

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43
Q

Associative Learning

A

Predicts relationships through classical or operant conditioning
Classical and operant

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44
Q

Classical Conditioning

A

Learning to pair two stimuli (Pavlov’s Dog)

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45
Q

Operant (Instrumental) Conditioning

A

Trial-and-Error learning

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46
Q

Procedural Learning

A

Learning tasks automatically without attention or conscious thought

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47
Q

Declarative (Explicit) Learning

A

More reflexive, automatic, or habitual
Frequent repetition for its formation
Knowledge that can be consciously recalled
Processes as awareness, attention, and reflection
Ability to remember factual knowledge

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48
Q

4 Types of Declarative Learning Processing

A

Encoding
Consolidation
Storage
Retrieval

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49
Q

Schmidt’s Schema Theory

A

Emphasis on generalized motor programs
Based on Motor Programming Theory of Motor Control Theories
Focused on closed-loop processes

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50
Q

Newell’s Ecological Theory

A

Emphasis on integration of perceptual/motor systems
Based on Systems and Ecologic Theory
Focus on dynamic exploration workspace/task in order to create optimal movement strategies
Augmented feedback

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51
Q

What is a Schema?

A

An abstract representation stored in memory following multiple presentations

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52
Q

Schmidt’s Schema Theory Info Storage

A

Stored in short-term memory following completion of movement
Initial movement conditions (positions of the body, weight of the object)
Parameters used in the generalized motor programs (temporal and spatial information)
Outcome of movement (knowledge of results)
Sensory consequences

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53
Q

What are the 2 types of Schema?

A

Recall

Recognition

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54
Q

Recall Schema

A

Used to select movement responses

Adds parameters of movement as data point reference

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55
Q

Recognition Schema

A

Used to evaluate response
Focuses on sensory consequences
Schema is modified as a result of sensory feedback and knowledge of results

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56
Q

Schema Theory Clinical Implications

A

Optimal learning occurs with variable practice conditions

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57
Q

Schema Theory Limitations

A

Too vague to test
Inconsistent experimental support
Cannot account for one-trial learning (in the absence of schema)

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58
Q

What is practice?

A

Improved coordination between patient perception and action that is consistent with the task and the environment

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59
Q

What is the goal of Newell’s Ecological Theory?

A

Identify the optimal strategy: perceptual information or action-based

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60
Q

What is a Regulatory Cue?

A

Perceptual cue that is critical for completion of the task

Perceptual information includes feedback

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61
Q

Ways to augment learning?

A

Help learner understand nature of the workspace
Understand the normal search strategies utilized by performers
Provide the learner with information to facilitate the search of environment/task

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62
Q

Ecological Theory Clinical Implications

A

Patient must learn to distinguish perceptual cues important to organizing action
Visual cues: look at the environmental cues that help them with that task

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63
Q

Ecological Theory Limitations

A

New theory that is yet to be applied to specific examples of motor skill acquisition in any systematic way

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64
Q

Fitt’s and Posner 3 Stage Model of Motor Learning

A

Cognitive Stage: Requires high degree of cognitive activity (attention)
Associative Stage: less cognitive contributions as focus is on refining the movement
Autonomous Stage: Low degree of attention with skill being automatic

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65
Q

Bernstein’s 3 Stage Model of Motor Learning

A

Novice Stage: Learner constrains degrees of freedom in order to simplify task
Advanced Stage: Releasing degrees of freedom at additional joints
Expert Stage: All joints are released to produce the most efficient and coordinated movement

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66
Q

Bernstein’s Approach Clinical Implications

A

Explanation for presence of coactivation of muscles during early stages of acquiring motor skill
New rationale for using developmental stages in rehabilitation
Importance of providing external support during early phases of learning motor skill

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67
Q

Gentile’s 2 Stage Model of Motor Learning

A

Based the goal of the learner
Stage 1: understand the task dynamics
Stage 2 (fixation/diversification stage): refine movement

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68
Q

What is the Stage of Motor Program Formation?

A

Based on hierarchical control of motor programs
A lot of small motor programs: one large motor program
Early, middle, and late stages

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69
Q

Types of Feedback

A

Intrinsic

Extrinsic

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70
Q

Intrinsic Feedback

A

Received through various sensory systems during normal movement

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71
Q

Extrinsic Feedback

A

Provided from an external source

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72
Q

Knowledge of Results

A

Terminal feedback on outcome of the movement

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73
Q

Knowledge of Performance

A

Feedback related to movement patterns used to achieve the goal

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74
Q

Fading Schedule of Feedback

A

More knowledge of results early on followed by a gradual decrease in feedback

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75
Q

Summary Knowledge of Results

A

Feedback provided after a block of practice trials

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76
Q

Characteristics of Feedback and Learning

A

External feedback is good for impaired sensory systems
Performance is better with constant feedback
Learning is better with fading of feedback and summary knowledge of results
# of trials to include in a summary knowledge of results is based on complexity of task (Complex: 5 trials; Simple: 15 trials)

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77
Q

What are the 4 types of practice conditions?

A

Massed
Distributed
Constant
Variable

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78
Q

What is massed practice?

A

Amount of practice time is greater than rest time

Better learning on transfer test for continuous tasks

79
Q

What is Distributed Practice?

A

Rest time =/> practice time

80
Q

Constant Practice

A

Task practiced under constant conditions

81
Q

Variable Practice

A

Task practiced under variable conditions

Initially has a poorer performance but better able to generalize info

82
Q

Random Practice

A

Tasks practiced in random order
Better performance on transfer task
Contextual interference may be reason initial performance is poor

83
Q

Blocked Practice

A

Practice 1 task in a block trial before moving to next task

Better performance during skill acquisition

84
Q

Whole training

A

Practice entire task at once

Better for promoting carry over

85
Q

Part Training

A

Practice a part of the task

86
Q

Transfer Training

A

Training transfers to new skill or environment

87
Q

Mental Practice

A

Mentally practicing a skill using imagination and no active movement

88
Q

Guided Learning

A

Learner is physically guided through the task

89
Q

Discovery Learning

A

Allowing trial and error to learn the task

90
Q

What is the key for rehabilitation when it comes to learning?

A

Preparing the patient to perform the task in their home and community

91
Q

Recovery vs Compensation

A

Recovery: achieving the goal in the same way as pre-injury
Compensation: behavioral strategies learned to complete a task in an altered way

92
Q

Clinical factors to consider when developing a plan of care

A

Type and severity of injury
Age
Promoting independence vs forced use

93
Q

Chronological Age

A

Calendar age based on date of birth

94
Q

Corrected Age (Adjusted)

A

Calculated if the infant was earlier than 38 weeks gestation

Remember to use 40 weeks when determining prematurity

95
Q

Gestational Age

A

Number of weeks spent in utero

96
Q

Why would you do a screen?

A

Development follows a progressive timeline
Used with typically developing children (identify delays)
Quick and cost effective (no diagnosis, but hints at delays)

97
Q

Alberta Infant Motor Scale Snapshot

A

Purpose: identify delays in motor development and maturation over time
Age: 0-18 months
Test Components: Observation-based on 4 developmental motor categories (Prone, supine, sitting, standing)

98
Q

AIMS Strengths and Weaknesses

A

Strengths: Short test, no materials needed
Weaknesses: small age range

99
Q

AIMS Scoring

A

Less than 1 year old and was born before 38 weeks gestation
Window created for least and most mature
Write “O” or “NO” for items between the windwon

100
Q

What is the Developmental Direction?

A

Cephalocaudal
Proximodistal
Reflex => Cortical Control
Generalized => Localized

101
Q

Key Factors of Developmental Direction

A

Strength of key muscle groups

Anthropometric characteristics

102
Q

Stage Progression

A

Sensitive periods of development

Established ages and stages of development

103
Q

What are the stages of the 1st year of life?

A

1st Quarter: Head control
2nd Quarter: Arms and upper trunk
3rd Quarter: Lower trunk and pelvis
4th Quarter: Legs and feet

104
Q

0-4 Months Milestones

A

0-3 months: head control

3 months: prone on elbows

105
Q

4-6 months milestones

A

4-6 months: log rolling

5-7 months: segmental rolling

106
Q

7-9 months milestones

A

7 months: belly crawling
8 months: sitting
9 months: creeping

107
Q

9-12 months milestones

A

9 months: pull-to-stand
10 months: cruising
9-13 months: independent standing

108
Q

12-24 months milestones

A 
8-14 months: creeping UP stairs
15-23 months: creeping DOWN stairs
16 months: walking UP stairs with help
18 months: walking DOWN stairs with help
18 months: jump DOWN with help
24 months: jump FORWARD
109
Q

2-3 years milestones

A

30 months: run

3 years: walking UP stairs (alternating)

110
Q

3-5 years milestones

A

3-4 years: walking down stairs (alternating)

3-5 years: jumping OVER

111
Q

5-6 years milestones

A

5-6 years: skip

112
Q

0-4 months typical development

A

Fine: swipes, closed hands, midline
Cognitions: listens, smile, cries
Toys: mirrors, rattles, links, blankets, tactile books

113
Q

4-6 months typical development

A

Fine: reaches, grasps rattle, hands open
Cognition: laughs, babbles, turns head, eats cheerios
Toys: play gym, prop sitting, large blocks, toys with music, press buttons

114
Q

7-9 months typical development

A

Fine: prone reaching, rakes/scoops
Cognition: babbles, responds to familiar people, responds to name, shouts
Toys: take items out of container, bang blocks, board books, balls to push, cause/effect toys

115
Q

9-12 months typical development

A

Fine: hold bottle/cup, picks up small objects, fine pincer grasp
Cognition: Patty cake, bye-bye, fear of strangers, “mama/dada”
Toys: Cruising toys, peek a boo, container play, kitchen items

116
Q

12-24 months typical development

A

Fine: holds crayon in fist
Cognition: understands and follows simple commands, 3 body parts
Toys: catch, throw, kick ball, push toys, stepping games, jumping

117
Q

2-3 years typical development

A

Fine: holds crayon in fingers, dress/undress
Cognition: states name, few vocab words, knows some colors
Toys: Beads, scissors, play-doh, puzzles, obstacle course

118
Q

3-4 years typical development

A

Fine: cuts with scissors, puts shoes/pants on
Cognition: Speech clear, first and last name, recognize letters and numbers
Toys: obstacle course, trikes/bike

119
Q

4-5 years typical development

A

Fine: independent dressing, comb hair, ties shoes, brush teeth
Cognition: address, full sentences, alphabet, 1-20, write name/words, read
Toys: bikes, simon says, hokey pokey, tag, kickball

120
Q

6-8 years typical development

A

Fine: print name, cut food with fork and knife
Cognition: read, write, addition, subtraction, spell words
Toys: bikes, jump rope, hopscotch, rocker board, therapy ball, sports

121
Q

Right Reactions

A

Orientation of head in space

Orientation of body in relationship to the head and ground

122
Q

Balance and Protective Reactions

A

Equilibrium reactions that occur sequentially

123
Q

What are the 3 developmental reflexes?

A

Primitive Reflexes
Righting Reactions
Balance and Protective Reactions

124
Q

Rooting

A

Touch peri-oral area, turn head toward stimulus
Appears: 28 weeks gestation
Integrates: 3 months

125
Q

Suck-Swallow

A

Touch inside of mouth; tongue rolls around mouth and then swallow
Appears: 28-34 weeks gestation
Integrates: 5 months
Concerns: problem for nutrition, CNS or sensorimotor dysfunction

126
Q

Plantar Grasp

A

Pressure on plantar aspect of foot; flex toes
Appears: 28 weeks gestation
Integrates: 9 months

127
Q

Palmar Grasp

A

Pressure on palm; flex fingers
Appears: 28 weeks gestations
Integrates: 4-7 months
Concerns: neurological problem (spasticity)

128
Q

Moro

A

Arms abduct and extend, fingers splay when head tilted back
Appears: 28 weeks gestation
Integrates: 3-5 months
Concerns: CNS dysfunction, sensory motor problem if persisting, delay sitting and head control, injury to one side if assymetric

129
Q

Symmetric Tonic Neck Reflex (STNR)

A

Flexion in UE and extension in LE when head flexed; extension of UE and flexion of LE when head extended
Appears: 4-6 months
Integrates: 8-12 months
Concerns: Persistence may impede other motor skills and cause spinal flexion deformities

130
Q

Asymmetric Tonic Neck Reflex (ATNR)

A

Extension in face and arm, flexion in the skull, arm when head is turned
Appears: 20 weeks gestation
Integrates: 4-5 months

131
Q

What are the 3 Righting Reactions?

A

Head Orientation
Landau Reaction
Body Orientation

132
Q

Head Orientation

A

Optical righting reaction
Labyrinthine righting reaction
Body-on-head righting reaction

133
Q

Landau Reaction

A

Head, upper trunk, and legs extend when suspended in prone
Appears at 3-4 months
Integrates at 12-24 months

134
Q

Body Orientation

A

Neck-on-body righting reaction

Body-on-body righting reaction

135
Q

Prone Balance Reflex

A

Spine curves so head and pelvis move in opposite direction
Appears: 5-6 months
Integrates: persists

136
Q

Sitting Balance Reflex

A

Spine curves so head and pelvis move in opposite direction
Appears: 7-8 months
Integrates: persists

137
Q

Forward Balance reflex

A

Infant reaches toward surface with elbows extended and bears weight on arms on surface in response to forward plunge
Appears: 6-9 months
Integrates: persists

138
Q

Sideways Balance Reflex

A

Shoulder abduction and elbow extension to put hand down in response
Appears: 7 months
Integrates: persists

139
Q

Backward Balance Reflex

A

Hands placed behind to prevent fall backward
Appears: 9 months
Integrates: persists

140
Q

0-3 months atypical development

A

Unable to lift head
Stiff legs with little movement
Pushes back with head
Keeps hands fisted with little arm movement

141
Q

6 months atypical development

A

Poor head control
Rounded back
Arches back/arms held back and stiffens legs

142
Q

9 months atypical development

A

Uses only one hand
Poor use of arms sitting
Difficulty crawling
Only one side of body

143
Q

12 months atypical development

A

Difficulty standing due to stiff legs
Needs to use hands to sit
Sits with weight to one side

144
Q

15 months atypical development

A

Unable to take steps independently
Falls frequently/poor standing balance
Walks on toes

145
Q

Components of sensorimotor processing

A

Constraints to the individual: age; experience with the task; presence/absence of pathology
Type of task: degrees of freedom; complexity
Environmental Constraints: properties of the object, standing/sitting surface

146
Q

Key Elements of Reach/Grasp

A

Locating a target/visual regard
Reaching
Grasping
In-hand Manipulation

147
Q

Musculoskeletal Contributions

A

ROM
Spinal flexibility
Muscle Properties
Biomechanical relationships among linked segments
Motor aspects (muscle tone, strength, coordination)

148
Q

Neurological Contributions

A

Motor processes
Sensory processes (visual, somatosensory, cognitive/motivation)
Internal Representations
Higher level processes

149
Q

Components of Target locating

A

Eye-Head-Trunk coordination
Interactions between eye movements and hand movements
Kinematics: pointing and reaching

150
Q

Reach vs Grasp

A

Reach: reach and point/bat at an object
Grasp: reach and then grasp the object (shorter duration)

151
Q

Types of control

A

Anticipatory

Reactive

152
Q

Anticipatory

A

Feed-forward: plan for future action

153
Q

Reactive

A

Feedback: regulate in order to create a successful catch

154
Q

Roles of the brain in a reach and grasp

A

Parietal lobes and pre-motor cortex: develop motor plan

Cerebellum and basal ganglia: modification and refinement of movement

155
Q

Grip types

A

Power (hook, spherical, cylindrical)

Precision (pinch type)

156
Q

4 hand shapes

A

Poke
Pinch
Clench
Palm (raking, post-CVA)

157
Q

Succesful Grasp

A

Hand adaptation

Times finger movements

158
Q

Development of Reach and Grasp

A

Continues through 8-10 years compared to manipulation development at 10-12 years
Move from less efficient and slow pathways for reach/grasp to more efficient and faster grasps

159
Q

Reach and Grasp in aging

A

Reduction in reach velocity

Increased time to manipulate small objects

160
Q

Reasons for decreased reach/grasp ability

A

Vision changes
Musculoskeletal changes: OA, joint changes
Able to stop/slow with strength and fine motor control

161
Q

Purdue Pegboard

A

50 holes; 2 columns
Pegs, washers, collars
3 times, score averaged
PD

162
Q

9 Hold Peg Test

A

Put pegs in one at a time and remove
3 trials, best analyzed
CVA, RA, JA

163
Q

Minnesota Rate of Manipulation Test

A

2 boards, 60 pegs
Placing, Turning, Displacing, One-hand turning/placing, Two-hand turning/placing
Not highly sensitive for fine dexterity

164
Q

Chedoke Arm and Hand Inventory

A

More functional, 13 skills with encouragement for bilateral

165
Q

Peabody Developmental Motor Skills

A

Ages: 0-6
Norm-referenced
0-2 rating scale
Gross and fine motor (grasping and visual motor integration)

166
Q

Task analysis for reach/grasp/manipulation

A

Internal factors: patient’s perspective (ROM, strength, postural control)
External Factors
Task complexity
Postural effects

167
Q

Exceptions to typical reach/grasp/manipulation

A 
Neuromuscular dysfunction
Musculoskeletal dysfunction (robotic technology)
168
Q

Future reach/grasp considerations

A

Children with DS aged 6-12
Anticipatory deceleration of hand transport
Orientation of the hand in preparation for object contact
Onset of preparatory grasp
Reach trajectories

169
Q

What is vestibular rehabilitation?

A

Exercise-based program primarily designed to reduce vertigo and dizziness, gaze instability, and/or imbalance and falls

170
Q

What are the components of balance?

A

Sensory input
Integration of Input
Motor Output

171
Q

What systems make up sensory input?

A

Vestibular: equilibrium, spatial awareness, rotation, linear movement
Visual: sight
Proprioceptive: touch

172
Q

What components make up Integration of Input?

A

Cerebellum: coordinates and regulates posture, movement, and memory
Cerebral cortex: contributes higher level thinking and memory
Brainstem: integrates and sorts sensory information

173
Q

What components make up Motor Output?

A

Vestibulo-ocular Reflex
Motor Impulses: control eye movements
Motor Impulses: to make postural adjustments

174
Q

What are the roles of the internal ear?

A

Process signals in the middle ear
Detection of position and motion
Utricle: vertical acceleration
Saccule: acceleration in planes

175
Q

3 Semicircular Canals

A

Anterior/Superior: nodding
Posterior: frontal-plane rotation (lateral flexion)
Horizontal: horizontal plane rotation (30° upwards)

176
Q

What is included in the Peripheral Vestibular System?

A

Anything distal to the vestibular nerve

177
Q

What is the ampulla?

A

Hair cells activated and move within the semicircular canals
Contain the cupula
Detect angular velocity

178
Q

Neuroanatomy of canals

A

Horizontal canal tilted 30° superiorly

Clinical implications for testing positions (dynamic acuity)

179
Q

Utricle and Saccule

A

Otoliths

Detects acceleration and static tilt

180
Q

CN VIII

A

Vestibulocochlear Nerve

181
Q

What all is involved with central vestibular processing?

A

Vestibular Nuclear Complex
Cerebellum
Integrates with the somatosensory and visual systems

182
Q

Children at risk for vestibular dysfunction

A

Sensorineural Hearing Loss (SNHL)
Learning Disabilities
Recurrent and chronic ear infections

183
Q

What complaints are common in Vestibular dysfunctions?

A

Non-specific (hard to get to explain headache/dizziness as a 3 y/o)
May have nausea and some vomiting, but hard to describe those feelings
Often seen as clumsy (yellow flag)

184
Q

What are the signs of vestibular involvement?

A

“Trails” the wall: run hand along wall while walking
unable to separate head/eyes/body: everything moves as a unit and can’t disassociate
Eye strain/fatigue: child rubs eyes, push eyes, close eyes more often, headaches
Headaches
Unsteady gait/Clumsy
Nystagmus
Avoids/Seeks out movement activity: goal is to be in the middle

185
Q

Behaviors associated with Hypo-functioning Vestibular Systems

A

May seek out/limit movements that stimulate the vestibular system
Patient response more slowly/with delays to movements that stimulate the vestibular system
Instability with or without dizziness
Tripping, “clumsiness”, poor coordination

186
Q

Behaviors associated with Hyper-Functioning Vestibular Systems

A

Sensitivity to sensory input: light, sound, motion
Increase negative behaviors
Headaches
Avoidance of movements that stimulate the vestibular system

187
Q

What are the 3 categories of vestibular interventions?

A

Vestibulo-ocular exercises
Postural Control
Combo of the two

188
Q

What is a grading activity in vestibular dysfunctions?

A

Working only within the patient’s limits of tolerance

189
Q

What are the signs of over stimulation?

A

Worsening of symptoms
Decreased quality of exercises
Increased behavioral issues

190
Q

What are other environments/surfaces to utilize for individuals with vestibular dysfunctions?

A 
Sand
Grass
Stairs/Steps/Curbs
Scooters/Bikes/Skates
Water
191
Q

What is the Sensory Profile?

A

Assess how well they process various senses
Completed by the caregiver/teacher
Allows identification of strengths and challenges
Looks at: auditory, visual, touch, vestibular, multisensory, oral, modulation, and behavioral/emotional

192
Q

Appropriate screening for 6 month old

A

Touch: response to tickle, carpet vs. hardwood
Taste: ask caregiver what they like
Sound: Rattles, do loud sounds startle them, do any sounds bother them
Vision: tracking a toy/parent, contrasts (reds and yellows)

193
Q

What is the goal of activities for individuals with vestibular dysfunctions?

A 
Improve awareness of body in space
Improve ability to process visual information
Improve safety
Improve independence with mobility
Improve participation with family/peers

Motor Control and Learning (2 decks)

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