Examination of Motor Control Flashcards
What does motor function consist of?
Includes motor control and motor learning
What is motor control
the control of posture and movements. Ability to regulate or direct the mechanisms essential to movement.
What three things interact for movement to occur?
The motor task, the individual, and the environment
What is muscle performance?
The capacity of the muscle to do work or generate force. Includes muscle strength, muscle power and muscle endurance
What is synergy?
Cooperative action of muscles working together to produce movement
What is fractionated movement?
The ability to selectively move one joint
What is the problem with using MMT in pts with CNS lesions?
MMT tests ability of individual muscles to actively produce force. Pts with CNS lesions may not be able to produce isolated movements, may still have primitive reflexes
How is active movement initiated?
Voluntary movement to command
Spontaneous movement
Reflexive movement
1,2 or all 3 may be impaired after CNS injury
What is voluntary movement to command?
Asking pt to perform certain movements, MMT
What is spontaneous movement?
Movement without an EXTERNAL stimulus. may be purposeful or non-purposeful.
What is reflexive movement?
Stereotyped response to a stumulus. EG babinski, flexor withdrawal to pain
What is plasticity?
“Natural recovery” refering to recovery that occurs as a result of physillogical healing properties in the body.
What is motor recovery?
The gradual return to the ability to move in simple to increasingly more complex ways.
What is the general flexion synergy seen after CNS lesion?
Flexion, abduction and ER
What is the general extension synergy seen after CNS lesion?
Extension, adduction, IR
When are limb synergies highly predictable?
Only after Cortical CVA’s. Also very characteristic of the stage of recovery
What is the Flexion synergy seen in the UE after cortical CVA?
Scapula -retraction, elevation Shoulder -abduction, ER Elbow -Flexion Forearm -supination Wrist/finger -Flexion
What is the extension synergy seen in the UE after cortical CVA?
Scapula -protraction Shoulder -horizontal adduction, IR Elbow -extension Forearm -pronation Wrist/finger -Flexion
What is the Flexion synergy seen in the LE after cortical CVA?
Hip -flexion, abduction, ER Knee -Flexion Ankle -DF, inversion Toes -Flexion
What is the extension synergy seen in the LE after cortical CVA?
Hip -extension, adduction, IR Knee -Extension Ankle -PF, inversion Toes -Extension
How do you grade Motor control?
Pt performs movement without facilitation by therapist/ Estimate the AROM that can be performed (% or fraction) at each joint without any synergistic movements
What do you make sure you include when documenting motor control?
The % or AROM as well as description: which joint, which direction and the testing position
What do you need to consider when grading/documenting trunk/head motor control?
Can the pt isolate trunk and head from limbs?
Can they isolate pelvic movements from limb and trunk?
What is a good way at assessing motor control?
Functional tasks IE: HIp extension in supine-pt can bridge 1/2 range 5 times but B knees move into extension
Fugl-Meyer
see ppt
Stage 1 of the Brunnstrom Stages of Motor Recovery
flacidity, no movement present (reflex or voluntary
Stage 2 of the Brunnstrom Stages of Motor Recovery
Weak associated reactions appear or minimal voluntary movement responses are present in limb synergies. Spasticity begins to develop
Stage 3 of the Brunnstrom Stages of Motor Recovery
All movements are in synergy although synergies may not be through full ROM. Spasticity peaks
Stage 4 of the Brunnstrom Stages of Motor Recovery
Some movement combinations out of synergy are possible and mastered with difficulty. Spasticity is decreasing
Stage 5 of the Brunnstrom Stages of Motor Recovery
Synergies lose their dominance; more difficult movement combinations can be mastered. Spasticity further decreases
Stage 6 of the Brunnstrom Stages of Motor Recovery
No synergies; full isolated joint movements are possible but decreased coordination present. Spasticity present only during active rapid movements.
Stage 7 of the Brunnstrom Stages of Motor Recovery
Normal movements performed; normal muscle tone