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PTA 204 > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

Which theory suggests that development of motor control relates to the level of integration of the nervous system and the level of neural functioning corresponds to the level of reflex and motor skill development.

A

Hierarchic Theory

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2
Q

What are the CNS levels of integration in order from first developed to last developed?

A

-Spinal Cord
-Brain Stem
-Mid-Brain
-Cortical

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3
Q

What are the levels of Reflex Development in order from first developed to last developed?

A
  • Phasic Primitive Reactions
    -Postural Tonic Reflexes
    -Righting Reactions
    -Equilibrium Reactions
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4
Q

What are the levels of Positional Motor Development in order from first developed to last developed?

A

-Prone/Supine
-Prone/Supine
-Crawling/Sitting
-Standing/Walking

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5
Q

What is the difference to De-cerebrate and De-corticate Regidity?

A

-De-cerebrate Rigidity happens when there is a lesion to the cerebrum, reverting the patient back to Brainstem level reflexes
-De-corticate Rigidity happens when there is a lesion to the cortex, reverting the patient back to Midbrain level reflexes

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6
Q

What are the Stages of Motor Control?

A

-Mobility: the ability to move
-Stability: the ability to be stable
-Controlled Mobility: the ability to be stable while moving
-Skill: Highly coordinated movement

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7
Q

Which theory suggests that several systems working together achieve motor control
-A complex interaction of several systems
-Posture and movement are self-organizing
-Use of feedback provides self-control of movement

A

The Systems Theory

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8
Q

What are the 7 Components of the Postural Control System?

A

-Limits of stability
-Environment adaptation
-Musculoskeletal system
-Predictive central set
-Motor coordination
-Eye-head stabilization
-Sensory organization

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9
Q

What are “Limits of Stability” in terms of Postural Control

A

Boundaries of the base of support

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10
Q

What are “Limits of Stability” in terms of Postural Control

A

Boundaries of the base of support

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11
Q

What does the Musculoskeletal System have to do with Postural Control?

A

It provides the infrastructure for movement

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12
Q

What is “Predictive Central Set” in terms of Postural Control

A

Postural readiness for movement

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13
Q

What does Motor Coordination have to do with Postural Control

A

It is the ability to sequence a motor response

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14
Q

What does Eye-Head Stabilization have to do with Postural Control

A

It is the ability to take in visual information while moving

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15
Q

What is “Sensory Organization” in terms of Postural Control

A

It is the interaction between all senses to influence movement

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16
Q

What is the difference between the Hierarchical Theory and the Systems Theory?

A

Hierarchical Theory:
-states that one level of motor development must function before the next level of motor development functions
-Does not explain how we create movement
-Does not explain how we store movement
-Does not explain the role of feedback and feedforward mechanisms
-Does not explain environmental influences on movement

Systems Theory:
-states that if one system fails, it will affect all other systems when controlling movement

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17
Q

What are the 3 Systems which are responsible for Sway Strategies, contribute to postural control, provide feedback about current environment, and contribute to “schema” for anticipated movement?

A

-Visual
-Vestibular
-Somatosensory

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18
Q

Which theory suggests there is an “open loop” motor program that uses abstract memory to prepare the body for a specific movement?
-muscle commands are pre-programmed
-feedback may not be needed unless external or internal conditions change

A

Schmidt’s Schema Theory

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19
Q

What are the steps in which Schmidt’s Schema Theory suggests people motor plan?

A

The person analyzes:
-Initial conditions: what is going on now
-Past outcomes: similar experiences in memory
-Desired outcomes: what would you like to happen

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20
Q

What are “Expected Sensory Consequences”?

A

A person’s expectation that repeating a past movement which resulted in a specific outcome will hopefully result in a similar outcome again.

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21
Q

What happens if a person realizes, through feedback, that there Expected Sensory Consequences did not match up with the Actual Outcome?

A

Their brain will make an adjustment to the motor program

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22
Q

What is the difference between Feed-forward and Feedback Mechanisms?

A

-Feedback: the information gathered during or after the movement which lets the person know if they are performing or did perform the movement correctly

-Feed-forward: the initial motor planning of how the person is going to perform the movement

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23
Q

What is the difference between the Open Loop and Closed Loop Theorys?

A

Open Loop: Adjustments are made after the movement is accomplished
-Mostly for quick movements or skills

Closed Loop: Adjustments are made while the movement is being performed

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24
Q

Definition: Ability of the brain to reorganize its structure

A

Neuroplasticity

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25
Q

What does “Use it or Lose it” mean in terms of neuroplasticity?

A

Failure to stimulate brain function can lead to functional degradation

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26
Q

What does “Use it and Improve it” mean in terms of neuroplasticity?

A

Training targeting a specific brain function can help enhance that function.

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27
Q

What does “Specificity” mean in terms of neuroplasticity?

A

-Nature of training dictates nature of plasticity
-Task-oriented will have greater effect on neuroplasticity
-e.g., to work on grasping, use everyday items like fruit or utensils, instead of weights or gym equipment

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28
Q

What does “Repetition” mean in terms of neuroplasticity?

A

-

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29
Q

What does “Repetition” have to do with neuroplasticity?

A

-VERY IMPORTANT for neuroplasticity
-The more you practice something, the better you get at it

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30
Q

What does “Intensity” have to do with neuroplasticity?

A

-It has a major effect on the induction of neuroplasticity
-High intensity strengthens synaptic response and vise versa

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31
Q

What does “Intensity” have to do with neuroplasticity?

A

-It has a major effect on the induction of neuroplasticity
-High intensity strengthens synaptic response and vice versa

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32
Q

What does “Saliency/Attention” mean in terms of neuroplasticity?

A

The more engaged the patient is with the activity, the more positive neural reorganization will occur

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33
Q

What does “Age” have to do with neuroplasticity?

A

-Neuroplasticity is greater in younger patients
-Cortical map re-organization declines with age

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34
Q

What does “Transference” mean in terms of neuroplasticity?

A

Transferability of exercises to desired functional movement helps with neuroplasticity.
-e.g., having a pt. do bridges to strengthen muscles used for sit to stands

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35
Q

What factors influence neuroplasticity?

A

-Injury/disease
-Activity/practice
-Sleep
-Attention/Arousal
-Mood/stress
-Exercise
-Pharmacologic Interventions
-Cardiovascular Exercise
-Brain stimulation
-Nutrition
-Age

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36
Q

What is “Priming” in terms of neuroplasticity and what are the different methods of priming?

A

Priming is a type of implicit learning wherein a stimulus prompts a change in behavior. (Something to get the pt. ready for exercise or treatment)
-Active-passive bilateral therapy: Pt. actively moves strong side, while PTA moves week side (supine alternating heel slides to simulate walking
-Aerobic exercise: E.g., warm up on bike
-Sensory stimulation: E.g., bouncing on a ball to give pt. sensation of weight bearing through feet
-Nerve stimulation: to wake up nerves

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37
Q

Definition: Control of posture and movement

A

Motor Control

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38
Q

Definition: Acquisition of skill through maturation of control systems

A

Motor Development

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39
Q

Definition: Process that brings about a permanent change in performance as a result of practice or experience

A

Motor Learning

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40
Q

Definition: The process by which a learner develops a set of motor responses into an integrated, organized movement pattern

A

Skill

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41
Q

Spatial Skill vs. Temporal Skill

A

-Spatial: correct muscles are recruited
-Temporal: correct timing of the movement response

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42
Q

Definition: The learned capability for reproducing something

A

Memory

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43
Q

What is the meaning of Registration Function in terms of neuroplasticity?

A

External and internal stimuli detected and coded

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44
Q

What is the meaning of Storage Function in terms of neuroplasticity?

A

Coded data is stored

45
Q

What is the meaning of Retrieval Function in terms of neuroplasticity?

A

Access to coded information

46
Q

What is the meaning of Readout Function in terms of neuroplasticity?

A

Retrieved information is recoded for use

47
Q

Which Factors effect Learning?

A

-Proficiency of Base Skills
-Transfer
-Intelligence
-Practice
-Arousal
-Fatigue
-Serial Position
-Familiarity with task
-Feedback

48
Q

How does Proficiency of Base Skills effect learning?

A

Proficiency of simple skills help to develop more complex skills

49
Q

What is “Transfer” in terms of learning?

A

The effect of one skill on the learning of subsequent skills
-The learning of one skill may have a positive OR negative effect on the learning of another skill

50
Q

How does Intelligence effect learning?

A

Relates to memory and ability to learn new skills

51
Q

What are the different components of Practice in terms of learning?

A

-Type: Massed vs. Distributed
-Sequence: Blocked vs. Random
-Order: Blocked Order (repeating the same task over and over; e.g., AAAA, BBBB, CCCC), Serial Order (different tasks performed in a sequence; e.g., ABC), or Random Order (exactly how it sounds; e.g., CAB)
-Strategies: Part-whole (practicing part of the skill), Mental Practice (imagining the steps, or quizzing the pt. on the steps), and Transfer Training (practicing simpler skills which carry over to the desired skill)

52
Q

How does Arousal effect learning?

A

Different skills require different levels of arousal or attention

53
Q

How does Fatigue effect learning?

A

Greater fatigue will erode performance

54
Q

What does “Serial Position” mean in terms of learning?

A

-The first and last parts of a sequence are most often engrained the most in a person’s memory (Primacy-Recency Effect)
-They are the parts of a sequence which are most readily learned

55
Q

What does Familiarity With Tasks have to do with learning?

A

The more familiar the learner is with the task, the greater the learning.
-This is the GREATEST effect on learning a new task

56
Q

What does Feedback have to do with learning?

A

-Timing and type of feedback will influence learning
-Depends upon phase of learning (to follow)
-Use of intrinsic feedback will be more beneficial to learner as motor program develops

57
Q

What are the Stages of Learning?

A

-Cognitive Phase
-Associative Phase
-Autonomous Phase

58
Q

What usually happens in the Cognitive Phase of Learning?

A

-Attention demand is high
-Greater reliance on visual input
-Reliance on verbal learning
-Early attempts at skill lack coordination and efficiency
-More supervision required for feedback
-Motivation is high

59
Q

What usually happens in the Associative Phase of Learning?

A

-Increased temporal and spatial organization
-Greatest affect of transfer
-Increased reliance on proprioceptive feedback
-Improved error detection from learner

60
Q

What usually happens in the Autonomous Phase of Learning?

A

-Spatial and temporal aspects of skill highly organized
-Decreased attention need
-Can focus on other stimuli in environment
-Learner can discriminate between relevant and irrelevant information

61
Q

Instructional Factors to consider with which Phase of Learning?
-Identify the goal of the task
-Environment: optimize learner’s attention
-Provide meaning/familiarity to task
-Provide visual demonstration
-Ask learner to verbalize understanding
-Provide adequate practice trials
-Provide adequate rest periods
-Reduce complexity of task

A

Cognitive Phase

62
Q

Instruction Factors to consider with which Phase of Learning?
-“Movement Diagnostics”
-Self-evaluation
-Introduce concept of Mental Rehearsal
-Continue visual and verbal instructions to reinforce correct pattern
-May need to increase motivation of learner (remind them of why they are practicing this skill)

A

Associative Phase

63
Q

Instruction Factors to consider with which Phase of Learning?
-Larger units of practice tolerated
-Focus on timing of skill
-Organize session to increase motivation
-Simulate new practice conditions
-Teach learner to anticipate in environment
-Emphasize self-evaluation
-Less supervision required

A

Autonomous Phase

64
Q

Components of which Theory?
-use of mass movement patterns
-use of spiral diagonal movements
-movements are rhythmic and reversing
-use of a developmental sequence
-learning should be promoted

A

PNF

65
Q

Why are Manual Contacts important for PNF?

A

-Hand placement informs patient about desired direction of movement
-Minimizes substitutions

66
Q

What kind of Body Position and Body Mechanics are important for PNF?

A

Therapists should ideally be positioned in the diagonal of movement and close enough to the patient to maintain good body mechanics and be ready to provide appropriate guidance or resistance to movement

67
Q

What things are key to good Verbal Commands for PNF?

A

-Keep commands simple
-“Push”, “Pull”, “Hold”, “Relax”
-Should be timed with patient’s effort

68
Q

Why is Visual Input important for PNF?

A

-Helps provide directional and postural control
-Helps provide patient feedback
-Should follow diagonal pattern

69
Q

What does “Stretch” have to do with PNF?

A

Quick Stretch:
-facilitates muscular response
-most effective in elongated position

Prolonged Stretch:
-inhibits muscular response
-also most effective in elongated position

70
Q

What kind of Manual Resistance should be applied with PNF?

A

-Resistance can be provided manually, mechanically, gravitationally
-Amount of resistance depends on patient’s abilities

71
Q

What is “Irradiation” in terms of PNF?

A

-The spread of muscle activity in response to resistance
-“Overflow”
-E.g., Action of unilateral or bilateral patterns on trunk

72
Q

What are the different ways to provide Joint Facilitation for PNF?

A

-Approximation: compression of joint surfaces promotes stability (e.g., weight bearing position)
-Traction: Inhibits muscular response, promotes mobility

73
Q

Name the Components of UE D1 Flexion

A

“Snatching up a baton in a relay”
Starting Position:
-Scapular: Retraction/Depression
-Shoulder: Ext/Abd/IR
-Forearm: Pronation
-Wrist/Finger: Ext

Ending Position:
-Scapular: Protraction/ Elevation
-Shoulder: Flex/Add/ER
-Forearm: Supination
-Wrist/Finger: Flex

74
Q

Name the Components of UE D1 Extension

A

“Reaching back for a baton in a relay”
Starting Position:
-Scapular: Protraction/ Elevation
-Shoulder: Flex/Add/ER
-Forearm: Supination
-Wrist/Finger: Flex

Ending Position:
-Scapular: Retraction/Depression
-Shoulder: Ext/Abd/IR
-Forearm: Pronation
-Wrist/Finger: Ext

75
Q

Name the Components of UE D2 Flexion

A

“Returning a seatbelt to above your shoulder”
Starting Position:
-Scapular: Protraction/Elevation
-Shoulder: Ext/Add/IR
-Forearm: Pronation
-Wrist/Finger: Flex

Ending Position:
-Scapular: Retraction/Elevation
-Shoulder: Flex/Abd/ER
-Forearm: Supination
-Wrist/Finger: Ext

76
Q

Name the Components of UE D2 Extension

A

“Grabbing a seatbelt above your shoulder and putting it on”
Starting Position:
-Scapular: Retraction/Elevation
-Shoulder: Flex/Abd/ER
-Forearm: Supination
-Wrist/Finger: Ext

Ending Position:
-Scapular: Protraction/Elevation
-Shoulder: Ext/Add/IR
-Forearm: Pronation
-Wrist/Finger: Flex

77
Q

Name the Components of LE D1 Flexion

A

“Looking at gum on the bottom of your shoe”
Starting Position:
-Hip: Ext/Abd/IR
-Knee: Ext
-Ankle: PF/EV

Ending Position:
-Hip: Flex/Add/ER
-Knee: Flex
-Ankle: DF/IV

78
Q

Name the Components of LE D1 Extension

A

“Putting your foot down after looking at gum on the bottom of your shoe”
Starting Position:
-Hip: Flex/Add/ER
-Knee: Flex
-Ankle: DF/IV

Ending Position:
-Hip: Ext/Abd/IR
-Knee: Ext
-Ankle: PF/EV

79
Q

Name the Components of LE D2 Flexion

A

“Kicking a door closed to the side”
Starting Position:
-Hip: Ext/Add/ER
-Knee: Ext
-Ankle: PF/IV

Ending Position:
-Hip: Flex/Abd/IR
-Knee: Flex
-Ankle: DF/EV

80
Q

Name the Components of LE D2 Extension

A

“Putting your foot back down after kicking a door closed to the side”
Starting Position:
-Hip: Flex/Abd/IR
-Knee: Flex
-Ankle: DF/EV

Ending Position:
-Hip: Ext/Add/ER
-Knee: Ext
-Ankle: PF/IV

81
Q

What does “Bilateral” mean in terms of PNF Combinations?

A

Same starting positions (flex/ext)

82
Q

What does “Reciprocal” mean in terms of PNF Combinations?

A

Different starting positions (flex/ext)

83
Q

What does “Symmetrical” mean in terms of PNF Combinations?

A

Same pattern (D1/D2)

84
Q

What does “Asymmetrical” mean in terms of PNF Combinations?

A

Different pattern (D1/D2)

85
Q

What are the different PNF Combinations?

A

-Unilateral
-Bilateral Symmetrical (for trunk flex/ext)
-Bilateral Asymmetrical (lifts and chops)
-Symmetrical Reciprocal (for trunk rotation)
-Asymmetrical Reciprocal (for trunk stability)

86
Q

What is Rhythmic Initiation in terms of PNF and what is it used for?

A
  1. PROM
  2. AAROM then PROM back to starting position
  3. Resisted ROM them PROM back to starting position

(Do not engage antagonist by having the pt. actively go back to starting position)

This builds strength

87
Q

What is “Hold Relax Active Motion” in terms of PNF and what is it used for?

A

The same as Rhythmic Initiation, but with an Isometric hold at the top of the movement

  1. PROM with Isometric hold at the top
  2. AAROM with Isometric hold at the top, then PROM back to starting position
  3. Resisted ROM with Isometric hold at the top, then PROM back to starting position

(Do not engage antagonist by having the pt. actively go back to starting position)

This builds strength

88
Q

What is “Combination of Isotonics” or “Agonist Reversal” in terms of PNF and what is it used for?

A
  1. Concentric
  2. Isometric
  3. Eccentric

This builds strength

89
Q

What is “Slow Reversal” in terms of PNF and what is it used for?

A

Apply light resistance into and out of motion

This builds strength and stability

90
Q

What is “Slow Reversal Hold” in terms of PNF and what is it used for?

A
  1. Apply light resistance into motion
  2. Isometric hold
  3. Apply light resistance out of motion

This builds strength and stability

91
Q

What is “Alternating Isometrics” in terms of PNF and what is it used for?

A

Alternating isometrics in the sagital and frontal planes

This builds stability

92
Q

What is “Rhythmic Stabilization” in terms of PNF and what is it used for?

A

Alternating isometrics in the transverse plane

This builds stability

93
Q

What is “Rhythmic Rotation” in terms of PNF and what is it used for?

A

Lengthen muscle to point of limitation, then passively circumduct joint

This increases flexibility

94
Q

What is “Hold Relax” in terms of PNF and what is it used for?

A

A type of Autogenic Inhibition with isometric contraction of muscle to be lengthened

This increases flexibility

95
Q

What is “Contract Relax” in terms of PNF and what is it used for?

A

Same as Autogenic in

This increases flexibility

96
Q

What is “Reciprocal Inhibition” in terms of PNF and what is it used for?

A
  1. Lengthen muscle to point of limitation
  2. Isometric contraction of opposite muscle
  3. Stretch further

This increases flexibility

97
Q

What does NDT stand for?

A

Neurodevelopmental Treatment

98
Q

Which Theory states:
-Postural reflex mechanisms are an indicator of how a person can grade and regulate movement
-Movement is characterized by weight shifting, and the ability of a person to shift weight is an indicator of their movement abilities
-If righting and equilibrium responses are intact, the person can make choices about voluntary movements

A

The NDT theory

99
Q

According to the NDT theory, which 3 things influence motor development?

A

-CNS maturation
-Genetic coding
-Handling

100
Q

According to the NDT theory, what is the importance of normal and abnormal movement?

A

By inhibiting what is abnormal, you can facilitate normal movement
-Normal postural reflexes can be elicited
-Sensation of normal movement can be facilitated
-Normal movement patterns can be facilitated

Focus on normal posturing before settling for substitutions

101
Q

According to the NDT theory, how does Therapeutic Handling promote motor development?

A

Helps to influence the quality of the motor response via inhibition and facilitation
-should match patient’s abilities
-movement responses should be functional, task-oriented
-handling should promote movement, not control it

102
Q

What are the Key Points of Control?

A

-Help to give the pt. necessary control and stability to initiate movement
-May assist with normal postural alignment
-Amount of control should be modified as patient gains self-control

103
Q

Which Theory states that there are stereotyped motor behaviors which happen with stroke recovery?

A

The Brunnstrom Theory

104
Q

What is the strongest component of the UE Flexion Synergy?

A

Elbow flexion

105
Q

What is the strongest component of the UE Extension Synergy?

A

Shoulder Add/IR

106
Q

What is the strongest component of the LE Flexion Synergy?

A

Hip flexion

107
Q

What are the strongest components of the LE Extension Synergy?

A

Hip Ext/IR and ankle PF

108
Q

What are examples of Associated Reactions in terms of Synergies and what are their characteristics?

A

Examples: Tonic reflexes, Symmetrical, Crossed Reciprocal, Ramiste, Homolateral Synkinesis
-They are involuntary
-They are elicited by voluntary effort
-They are controlled by lower levels of neural control

109
Q

Summarize the Brunnstrom stages of Stroke recovery

A

Stage 1: Flaccid/Hypotonic
Stage 2-3: Spasticity develops and synergies are seen
Stage 4-6: Spasticity decreases and isolated movement develops
Stage 7: Return to normal function

PTA 204 (4 decks)

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