Exam 1 Review

Question 1

Classification of Movement Tasks: Discrete Tasks

Answer 1

Tasks that have a definite beginning and end (ex. transfers, child kicking a ball).

Question 2

Classification of Movement Tasks: Continuous Tasks

Answer 2

Tasks that do not have a definite end; the person performing a task must decide when to stop (ex. running or riding a bike) Tasks that requires momentum and speed

Question 3

Reflex-Hierarchical Theory

Answer 3

This theory suggests that motor control is a hierarchical process, where higher brain centers exert control over lower reflexive centers. Therapy aims to re-establish motor control by promoting higher-level voluntary movements. Organization control is top-down, each level can act on other levels.

Ex. A child with developmental delays works on crawling and walking activities. The therapist uses techniques to inhibit primitive reflexes and encourage voluntary movements that are more typical of higher developmental stages.

Question 4

Environmental Theory

Answer 4

Ecological theory emphasizes the role of the environment in shaping motor behavior. It posits that motor control is a process of perceiving and acting within a specific context.

Example: A senior recovering from hip surgery practices walking in different environments such as indoors, outdoors, and on uneven terrain. The therapist adjusts the environmental context to help the patient adapt their movement strategies to various real-world situations.

Question 5

Cognitive Motor Learning

Answer 5

This theory integrates cognitive strategies with motor learning principles. It involves using cognitive processes such as planning, problem-solving, and memory to facilitate motor performance.

Example: A person with multiple sclerosis practices dressing themselves using a strategy of verbalizing each step (e.g., “First, I will put my right arm through the sleeve”). This verbal self-guidance helps them plan and execute the movements more effectively.

Question 6

Motor Learning Theory

Answer 6

Motor learning theory focuses on the processes involved in acquiring and refining motor skills. It emphasizes practice, feedback, and the importance of repetition to achieve motor skill proficiency.

Example: A client with a CVA (stroke) diagnosis practices reaching for and grasping various objects (cups, pens, books) with their affected hand. The therapist provides immediate feedback and gradually increases the complexity of tasks to enhance motor learning and functional use of the hand.

Question 7

Dynamic Systems Theory

Answer 7

This theory posits that motor control is the result of dynamic interactions between various subsystems including the neurological, musculoskeletal, and environmental factors. It emphasizes the importance of adaptability and variability in motor tasks.

Example: A child with cerebral palsy is encouraged to play on different types of surfaces (grass, sand, pavement) to improve their balance and gait. The changing surface conditions challenge the child’s motor system to adapt and find new ways to maintain stability and movement.

Question 8

Task-Oriented Approach

Answer 8

This approach emphasizes the importance of practicing functional tasks that are meaningful to the individual. It integrates cognitive and perceptual processes with motor actions.

Example: An adult recovering from an acquired brain injury practices making a sandwich. The therapist breaks down the task into smaller steps (e.g., opening the bread bag, spreading the peanut butter) and provides cues as needed, gradually reducing assistance as the patient becomes more proficient.

Question 9

Biomechanical Frame of Reference

Answer 9

This approach focuses on the mechanical aspects of movement, including muscle strength, joint range of motion, and physical endurance. It uses principles of physics and anatomy to improve motor function.

Example: An individual with arthritis performs a series of hand exercises using putty or hand grippers to increase strength and flexibility. The exercises are designed to improve the mechanics of grip and hand function necessary for tasks like opening jars and writing.

Question 10

Neurodevelopmental Therapy (NDT)

Answer 10

NDT is based on the premise that abnormal postural reflex activity and abnormal muscle tone are the primary problems in motor control. The goal is to facilitate normal movement patterns and inhibit abnormal ones.

Example: An occupational therapist helps a child with spastic quadriplegia practice sitting up and reaching for toys. The therapist uses hand-over-hand techniques and weight-bearing exercises to promote proper alignment and muscle activation.

Question 11

Constraint-Induced Movement Therapy (CIMT)

Answer 11

CIMT is based on the principle of “learned non-use,” where an individual with a unilateral impairment (e.g., stroke) learns to rely on the unaffected limb, leading to further disuse of the affected limb. This therapy involves restraining the unaffected limb to encourage use of the affected limb.

Example: A stroke survivor wears a mitt on their unaffected hand while performing daily activities such as eating, dressing, and brushing teeth. This forces the use of the affected hand, promoting neuroplasticity and improving its functional ability.

Question 12

Sensory Integration Theory

Answer 12

Developed by A. Jean Ayres, this theory posits that difficulties in processing sensory information can affect motor control. Therapy aims to improve sensory processing and integration to enhance motor skills.

Example: A child with sensory processing disorder engages in activities like swinging, bouncing on a therapy ball, and playing in a sensory bin filled with rice and beans. These activities help the child better process sensory input and improve their coordination and motor planning.

Question 13

Movement Control

Answer 13

Determined by interactions between an individual, a task, and the environment

Question 14

Movement Control: Individual

Answer 14

Systems that affect a person’s functional motor control include. Deficits on these affect occupational performance and OT can help:
1. Motor/action systems - coordination between biomechanical and neuromuscular systems (ex. movement of joints and muscles involved
2. Sensory/perceptual systems
3. Cognitive systems - attention, planning, problem solving, motivation, and emotion

Question 15

Movement Control: Environmental

Answer 15

2 types of movements.
1. Regulatory - include things such as size, shape, and weight of an object
being lifted or the type of terrain on which a person is walking. Movements MUST conform to regulatory environmental factors in order to participate in activities/occupations

2. Non-regulatory - include distractions such as background noise and
   changing lighting. Performance may be affected but movement does not need to conform to them.

Question 16

Movement Control: Task

Answer 16

Affects the neurological organization of the
motor plan being executed. The degree of monitoring necessary by the individual is determined
by the type of task being performed
1. Mobility
2. Upper-Extremity Function
3. Postural Control

Question 17

Classification of Movement Tasks: Closed Tasks

Answer 17

Occurs in a fixed and predictable environment. There is a consistency of movement - a person performing tasks uses a limited number of movement patterns. The skills can be planned in advance.

ex. Playing golf - hitting a ball: same target and same ball

Question 18

Classification of Movement Tasks: Open Tasks

Answer 18

Requires movement diversity - a person performing tasks uses many movement patterns. Participant adapts to an unpredictable environment.

Ex. Playing volleyball

Question 19

Classification of Movement Tasks: Stability Task

Answer 19

Tasks performed while the individual is sitting or standing with a non-moving base of support

Question 20

Classification of Movement Tasks: Mobility Task

Answer 20

Tasks performed with a moving base of support

ex. Jogging

Question 21

Manipulation of tasks

Answer 21

Involves an individual using their upper extremities to achieve a goal

Question 22

Motor Control

Answer 22

the study of how movement is controlled or how an individual may not be able to control
movement due to an illness or injury or other factors

Question 23

Reflex Theory

Answer 23

Described by Sir Charles Sherrington in his 1906 book titled the Integrative Action of the Nervous System. Complex behavior could be
explained through the combined action of individual reflexes chained together. A Reflex is initiated by an outside stimulus (ex. person touching a hot stove stimulates withdrawal reflex); it has a receptor, a conductor, and a muscle effector. Does not account for rapid movements where there isn’t enough time for sensory information to activate the next move (ex playing piano). Does not account for the translation of skills to new situations. Reflex testing allow therapists to predict function; client’s movement behaviors may be interpreted in terms of the presence or absence of controlling reflexes (you may want to enhance or reduce the effect of reflexes during motor tasks). As clinicians, it’s important that we note the presence, absence or persistence
of reflexes. And consider whether the presentation is developmentally appropriate for the client with
whom we’re working.

Question 24

Top down approach

Answer 24

Focuses on the skills necessary to participate in daily activities. This method is more compensatory based on maximizing existing skills and adapting activities to allow independence in occupation.

T = Task to approach the goal

Question 25

Systems Theory

Answer 25

The most current way of looking at motor control and motor learning. Involves understanding:
1. the system you’re moving
2. External forces acting on the body
3. Internal forces acting on the body

Involves: Dynamic systems theory, non-linear system (output is not equal to input)

Limitation: Considers the nervous system less important than all of the other factors combined

Question 26

Attractor states

Answer 26

Highly stable preferred patterns of movement used to participate in occupations

Question 27

Motor Learning

Answer 27

Involves skill acquisition and skill reacquisition or learn a modification to a skill.

Involves interaction between the body, sensory feedback, and the environment

Question 28

Recovery of function

Answer 28

Reacquisition of movement skills lost through injury - can occur with motor recovery (ex. stroke patients) or through the use of adaptive equipment and compensatory strategies

Question 29

Prosthesis

Answer 29

artificial substitute for a missing part of the body

Question 30

Motor Performance

Answer 30

Temporary change in motor behavior seen during a practice session.

Sometimes an improvement in motor performance is seen but not learning. Therapists must always look for the carryover of learning to ensure client safety when performing tasks.

Question 31

Learning

Answer 31

Skills have been generalized and have become automatic.

Question 32

Long term memory

Answer 32

Consists of 2 types:
1. Nondeclarative (implicit) - where most of motor learning occurs and it can be intact even if declarative memory is impaired. Clients have the capacity for motor learning even if explicit memory is poor.
- Nonassociative learning - results from repeated exposure to a single stimulus (habituation and sensitization)
- Associative learning - includes classical (ex. Pavlov’s dog) and operant/instrumental conditioning (trial and error learning)
- Procedural learning - learning tasks automatically without attention or conscious thought.

2. Declarative (Explicit) - what we typically think about when talk about memory. Recall.
   - Facts, events, people

Question 33

Intrinsic Feedback (Inherent)

Answer 33

Physical feel of the movement as it is being performed.

Question 34

Extrinsic Feedback (Augmented)

Answer 34

External sources providing verbal or tactile cues

Question 35

Knowledge of results vs. Knowledge of performance

Answer 35

Knowledge of results - knowing your shirt is on

Knowledge of performance - outcome of movement in terms of a movement’s goal

Question 36

Massed practice

Answer 36

amount of practice time in a trial greater than the amount of rest between trials. Most likely to cause fatigue and increase chance of falls or injury

practice > rest

Question 37

Distributed practice

Answer 37

amount of rest between trials equal to or greater than the amount of time for a trial. More appropriate since it is less likely to cause injury or falls

Question 38

Variable vs Constant Practice

Answer 38

Variable practice is more effective than constant practice for long-term learning and the generalization
of learning. Generally, if appropriate for your client, variable practice in different environments is most
effective for learning a task. However, constant practice is appropriate to start with, or if an individual
isn’t able to participate in variable practice and will always perform a task in the same environment.

Question 39

Blocked Practice

Answer 39

one task is practiced repeatedly and mastered before moving on. There are repeated trials and learning opportunities

the best choice during the skills acquisition phase

Question 40

Random Practice

Answer 40

different tasks or variations of tasks may be practiced randomly before they are mastered.

most effective when used with skills that
require different patterns of coordination.

Question 41

Guidance learning

Answer 41

Leaner physically guided through a task to be learned

Question 42

Discovery learning

Answer 42

Involves trial and error

Question 43

Spared function

Answer 43

When a function is not lost despite a brain injury

Question 44

Recovery

Answer 44

2 categories;
1. Spontaneous
2. Forced - obtained through specific interventions designed to have an impact on neural mechanisms

Question 45

Motor Learning: Schmidt’s Schema Theory

Answer 45

Described an open loop control process and generalized motor program concept. Motor programs contain generalized rules for classes of movements that can be applied to

Schema: abstract representation stored in memory following multiple presentations

The following information is stored in short-term memory and abstracted into either a motor (recall) or sensory (recognition) schema.
- Initial movement conditions
- Parameters used in generalized motor program
- Outcome of movement in terms of knowledge of results
- Sensory consequences of movement

Clinical Implications
Learning will occur if the task is practiced under many different conditions as the recall and recognition schemas grow.

Limitations
Results of research are mixed for typically functioning adults. There has been strong support with children. Why do you think this may be the case?
It lacks specificity. It does not explain how initial movement occurs prior to schema formation.

Question 46

Three Stage Model

Answer 46

1. Cognitive - learning what needs to be done/understand the requirements
2. Associative - learning how to perform and adapt the skill. Client attempts to translate declarative knowledge into procedural knowledge
3. Autonomous - skills is automatic and requires minimal thought

Question 47

Bottom Up Approach

Answer 47

Focuses on the cause of deficits in foundational skills and treatment is designed to address the deficits to increase performance in daily activities. The approach is more restorative to improve functional skills (ex ROM and MMT). Traditional medical model.

B = Body functions, Biomechanical to approach goal