L13 - Coordination Flashcards
What is motor coordination?
Motor coordination refers to the ability to perform a motor task in an accurate, rapid, and controlled manner. It is characterized by appropriate speed, distance, direction, timing, and muscular tension.
What are the types of motor coordination?
- Fine Motor (e.g., intricate hand tasks)
- Gross Motor (e.g., walking, dancing)
- Hand-Eye Coordination (e.g., racket sports)
What factors may impact coordinated movement?
- Central Nervous System (e.g., cerebellum, motor/sensory functions)
- Peripheral Nervous System (motor and sensory pathways)
- Muscle strength and neuromuscular factors
- Proprioception and sensory systems (pain, touch, temperature)
- Vision, vestibular systems, and joint ROM
What is the role of the motor cortex in coordination?
The motor cortex plans and executes voluntary movement, stores motor programs for skilled movement, and adjusts movements based on feedback for motor learning and refinement.
What is the function of the thalamus in motor coordination?
The thalamus acts as a sensory relay center, communicating with the cerebrum, cerebellum, and basal ganglia. It is involved in memory, emotions, and pain.
What is the role of the basal ganglia in motor coordination?
The basal ganglia are involved in planning and controlling complex motor behavior, initiating movement, preventing unwanted movement, and regulating motor symptoms.
What are the main functions of the cerebellum in coordination?
The cerebellum is responsible for balance, proximal control, coordination, movement correction, and acts as a comparator to initiate corrective measures for accurate movement.
How do impairments in the cerebellum affect coordination?
If the cerebellum is damaged, it cannot process incoming sensory information properly, leading to uncoordinated movements and difficulty in refining motor tasks.
What are some pathologies that can affect coordination?
- Stroke (CVA)
- Multiple Sclerosis (MS)
- Parkinson’s Disease (PD)
- Dyspraxia
- Traumatic brain injuries
- Peripheral nerve injuries
- Hereditary ataxia (e.g., Friedrich’s ataxia)
What tests are used to assess coordination?
- Gait observation (wide BOS, staggered steps)
- Romberg’s test (assessing proprioception/vestibular function)
- Nystagmus test (rapid eye movements)
- Finger-to-nose and Heel-to-shin tests
How does impaired coordination commonly present?
- Wide base of support
- Leaning back while walking
- Unequal step lengths
- Poor facial muscle coordination (slurred speech)
- Nystagmus (eye flickering)
What is proprioception?
Proprioception is the awareness of the body in space, using joint position and motion sense to respond to changes in posture and movement.
What are the different types of proprioception?
- Joint Position Sense (perceiving joint angles)
- Kinaesthesia (awareness of body movement)
- Sense of Force (ability to match force levels)
- Sense of Change in Velocity (ability to detect vibration)
What are the key sensory receptors involved in proprioception?
- Muscle spindles (detect muscle length changes)
- Golgi tendon organs (detect muscle tension changes)
- Vestibular apparatus (senses head position)
- Vision (orients body to environment)
- Somatosensory receptors (detect pressure and tactile information)
Why is proprioception important?
- Injury prevention
- Motor control and coordination
- Balance and dexterity
- Adaptation to external stimuli
- Maintaining posture and stability
How might proprioceptive impairments present in musculoskeletal (MSK) conditions?
- Recurrent injuries (e.g., strains, sprains)
- Associated pain, stiffness, oedema
- Decreased performance in activities
- Difficulty in dual-tasking
What causes proprioceptive impairments?
- Alcohol (acute or chronic)
- Vitamin deficiencies (e.g., B12)
- Neurological damage (stroke, brain injury, MS)
- Age-related changes
- Musculoskeletal injuries (e.g., ligament tears)
How is Romberg’s test performed, and what does it assess?
Romberg’s test is performed by asking the patient to stand with their eyes closed. It tests for loss of proprioceptive or vestibular function. Difficulty in maintaining balance indicates an over-reliance on visual input to balance.
How is the Nystagmus test performed, and what does it assess?
The Nystagmus test is performed by asking the patient to look at the examiner and then follow their finger in various directions. It assesses for rapid eye movements, which can indicate neurological impairments related to coordination and balance.
What is the finger-to-nose test, and what might an abnormal result indicate?
The finger-to-nose test requires the patient to touch their nose and then the examiner’s finger repeatedly as fast as they can. Missing the target or showing an intention tremor may indicate cerebellar dysfunction or coordination impairments.
How is the heel-to-shin test performed, and what does it assess?
The heel-to-shin test asks the patient to place their heel on the opposite knee and run it down their shin in a straight line. Difficulty in performing the test smoothly may indicate cerebellar ataxia or coordination impairments.
How might impaired coordination present during gait observation?
During gait observation, impaired coordination may present as:
- Wide base of support (BOS)
- Staggering or unequal step lengths
- Ataxic or unsteady gait
- Difficulty turning
- Inability to walk in a tandem (heel-to-toe) gait pattern
What are common signs of impaired coordination?
Common signs include:
- Wide base of support
- Leaning backward
- Difficulty interpreting feedback and refining movements
- Nystagmus (flickering eyes)
- Poor coordination of facial muscles, leading to slurred speech
What is an ataxic gait, and what are its characteristics?
Ataxic gait is a type of unsteady, staggering walk caused by poor motor coordination. Characteristics include a wide base of support, irregular step patterns, and difficulties with balance and turning.
What is proprioception (Joint Position Sense), and how is it measured?
Proprioception (Joint Position Sense) refers to the body’s sense of joint and limb positioning. It is measured by assessing the ability to perceive and reproduce joint angles, either actively (AJPS) or passively (PJPS).
What is kinaesthesia, and what does it involve?
Kinaesthesia, or motion sense, is the awareness of the body’s movement. It involves sensing joint movement, including the speed, direction, amplitude, and timing of movements.
What is the Sense of Force, and what structures contribute to it?
Sense of Force (SoF), also called the sense of effort or heaviness, is the ability to match or reproduce a desired level of force. It involves afferent feedback from the Golgi Tendon Organs, muscle spindles, and skin proprioceptors.
What is the Sense of Change in Velocity (SoV), and how is it detected?
The Sense of Change in Velocity (SoV) refers to the ability to detect vibration from oscillating objects placed on the skin. It is detected through large afferent nerve fibers (Aαβ), similar to proprioception.
What are muscle spindles, and what do they detect?
Muscle spindles are sensory receptors within muscles that detect the rate of change in muscle length, providing feedback about muscle stretch and aiding in proprioception.
What are Golgi Tendon Organs (GTOs), and what do they sense?
Golgi Tendon Organs are sensory receptors located in tendons that detect changes in muscle tension. They help regulate muscle force and prevent overexertion or injury.
What role does the vestibular apparatus play in proprioception?
The vestibular apparatus, located in the inner ear, senses the position of the head in space and detects sudden changes in direction or movement of the head, contributing to balance and spatial orientation.
What types of sensory receptors are found in the skin and muscles, and what information do they detect?
Sensory receptors found in the skin and muscles include:
- Mechanoreceptors (detect mechanical pressure)
- Nociceptors (detect pain)
- Thermoreceptors (detect temperature)
How does proprioception contribute to injury prevention?
Proprioception helps prevent injuries by enabling the body to sense changes in joint position and muscle tension, allowing for quick adjustments in posture and movement to avoid harmful stress or strain.
What are common musculoskeletal (MSK) presentations of proprioceptive impairment?
MSK presentations of proprioceptive impairment include:
- Recurrent injuries (e.g., strains, sprains)
- Associated pain, stiffness, and oedema
- Difficulty with dual-tasking and reduced performance in activities
How might proprioceptive impairments present in neurological conditions?
In neurological conditions, proprioceptive impairments may present as:
- Altered midline awareness
- Difficulty maintaining postural control
- Poor balance and clumsiness
- Uneven step length and height
- Difficulty with functional tasks (e.g., reaching, gait)
What are common causes of proprioceptive impairments?
Causes of proprioceptive impairments include:
- Alcohol use (acute or chronic)
- Vitamin B12 deficiency
- Medical conditions (e.g., syphilis)
- Posterior column damage (spinal injury/degeneration)
- Musculoskeletal injuries (e.g., ankle/knee ligament injuries)
How does age affect proprioception?
Age-related changes can affect proprioception, as the natural degeneration of nerves, joints, and muscles with age increases the risk of proprioceptive loss and impairs balance and motor control.
