Intro to Neuromuscular Re-education Flashcards
what is motor control?
the ability of the neuromuscular system to regulate or redirect the mechanisms essential to move
ability of the system to produce output
what is motor learning?
set of processes associated with practice or experience which leads to relatively permanent changes in the capability of producing skilled action
way in which we adapt/change/relearn
motor learning is a direct result of what?
neuroplastic change
what is neuroplastic change?
the expansion and/or reorganization of the cortical map
what drives fxnal recovery after a stroke?
cortical plasticity and reorganization mechanisms
how long can reorganization take?
years
t/f: reorganization after a stroke can be positive or negative
true
what are the 3 mechanisms of neuroplasticity?
1) injury driven change
2) neuronal modification
3) experience driven change
what is involved in injury driven change in neuroplasticity?
cellular level changes
recovery following CNS injury
what is involved in neuronal modification in neuroplasticity?
stimulus driven change
synaptogenesis for the development of new neural pathways
activation of parallel neural pathways (opposite hemisphere)
activation of silent and redundant neural pathways
what is involved in experience driven change in neuroplasticity?
experience-expectant plasticity
experience-dependent plasticity
what is experience-expectant plasticity?
in reference to critical periods of developmental change (important in growing babies)
what is experience-dependent plasticity?
motor learning is an example of this
use-dependent, fxn-dependent, task-dependent
t/f: in the performance of a motor task/activity, brain activity is linked to the phase of motor learning
true
during the initial phases of neuroplastic changes (skill acquisition), what is happening in the brain?
there are large and diffuse areas of the brain that are active
immediate reorganization due to unmasking of previously nonfxnal synaptic connections in neighboring areas.
during the autonomous phases, what is happening in the brain?
when tasks are repeated, the # of active areas of the brain are reduced
during the skilled phase, when tasks are learned, what is happening in the brain?
smaller, more distinct areas of the brain show an increased activity
brain areas neighboring the lesion take over those parts of the map that were occupied by damaged cells
during what phase of neuroplasticity is less attention required to perform the task resulting in the brain regions becoming more focal as skilled performance increases?
during skilled phases
what is dendritic aborization?
branching out of dendrites to take over damaged parts of the brain
what are regenerative and reactive synaptogenesis?
ways of neurons taking over damaged parts of the brain
neuro rehab should result in _____ ______
brain change
TMS or fMRI shows that what kind of training and environment produces long-lasting cortical reorganization?
task-specific training in enriched environments
t/f: the tasks need to be fxnal to lay down a fxnal map
true
recovery of neuronal fxn after brain injury is influenced by what?
the type, intensity, and timing of rehab relative to surgery
t/f: early rehab is necessary for improved outcomes
true
t/f: during days 1-5, intensity needs to be monitored carefully
true
would you want to do forced use for the involved UE at day 3? why or why not?
nope bc it is probably too intense and will be counterproductive
t/f: being too rigorous too early can be counterproductive
true
what are the 10 neuroplastic principles?
1) use it or lose it
2) use it and improve it
3) specificity
4) repetition matters
5) intensity matters
6) time matters
7) salience matters
8) age matters
9) transference
10) interference
what does the neuroplastic principle of use it or lose it mean?
failure to drive specific brain fxns can lead to fxnal degradation
what does the neuroplastic principle of use it and improve it mean?
training that drives a specific brain fxn can lead to an enhancement of that fxn
what does the neuroplastic principle of specificity mean?
the nature of the training experience dictates the nature of the plasticity
what does the neuroplastic principle of repetition matters mean?
induction of plasticity requires sufficient reps
what does the neuroplastic principle of intensity matters mean?
induction of plasticity requires sufficient training intensity
what does the neuroplastic principle of time matters mean?
different forms of plasticity occur at different times during training
what does the neuroplastic principle of salience matters mean?
the training experience must be sufficiently salient to produce plasticity
what does the neuroplastic principle of age matters mean?
training-induced plasticity occurs more readily in younger brains
what does the neuroplastic principle of transference mean?
plasticity in response to one training experience can enhance the acquisition of similar behaviors
what does the neuroplastic principle of interference mean?
plasticity in response to one training experience can interfere w/acquisition of other behaviors
what is motor recovery?
the re-acquisition of mov’t skills lost through injury
variable and individualized
cortical representation of mov’t can be changed in what 3 ways?
1) spontaneous recovery
2) task/fxn-induced recovery
3) learned non-use recovery
what is spontaneous recovery?
the initial neural repair processes that occurs immediately after injury
what is task/fxn-induced recovery?
use of dependent cortical reorganization
the NS modifies itself
includes forced paradigms such as CIMT
what is learned non-use recovery?
non-use resulting in faulty/poor mov’t patterns
complete recovery may not be possible, but rather skills may be modified in what 2 ways?
compensation and substitution
what is compensation/substitution?
adaptation of remodeling motor or use of alternative motor elements
adoption of alternative strategies to complete a task
t/f: motor relearning is impaired w/sensory impairments
true
while motor and sensory processing are independently adaptive, what is the driving factor of fxnal neural adaptation?
the interaction bw them
what is an important input to motor learning and skill acquisition?
proper sensory input
what is the Brunnstrom theory to motor recovery?
heirarchical
using primitive, synergistic patterns to facilitate mov’t
a damaged CNS regresses to an older pattern of mov’t
which approach to motor recovery theorizes that primitive reflexes, synergies, and abnormal mov’ts are a part of recovery b4 normal mov’t occurs?
Brunnstrom
what is the technique for Brunnstrom’s approach?
facilitate synergies and primitive reflexes
progress through developmental (fxnal) positions
walking delayed
what is the NDT (Bobath) theory to motor recovery?
normalize tone, inhibit primitive patterns of mov’t, facilitate automatic , voluntary motor responses and subsequent normal patterns
what approach is the opposite to Brunnstrom?
NDT
what are the techniques of NDT?
therapeutic handling
key points of control to stop reflexes
facilitate normal and inhibit abnormal inputs
what is the Rood approach theory to motor recovery?
sensorimotor
modify muscles tone and motor activity using cutaneous sensorimotor stimulation
what is the technique of the Rood approach?
proprioceptive, exteroceptive, vestibular, vision, auditory, olfactory, gustatory inputs selected
what is the PNF theory of motor recovery?
stimulation of nerve, muscle, and sensory receptors through manual stimulation
what approach to motor recovery uses diagonal mov’t patterns that are fxnally relevant?
PNF (Kabat, Knott, and Voss)
what are the techniques of PNF?
facilitation of mov’t patterns using key manual contact and techniques
resistance, irradiation/reinforcement, stretch, verbal commands, traction/approximation, timing, body position/mechanics
what is the MRP (motor relearning programme) approach to motor recovery?
task-oriented approach
dynamical systems
ecological model
what is the theory of the MRP approach to motor recovery?
appropriate sensory input will modulate motor output
eliminate all unwanted motor activity w/in a task performance
NO developmental positions
want mov’t as normal as possible