Lecture 1-Intro to Rehab and Motor Control Flashcards

1
Q

What are the 3 components of the biopsychosocial model?

A

Biology, social environment, psychology.

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2
Q

What is motor control?

A

An area of study dealing with the understanding of the neural, physical, and behavioral aspects of biological (human) movement.

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3
Q

What is a motor program?

A

an abstract representation that , when initiated, results in the production of a coordinated movement sequence.

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4
Q

What are important parameters for structuring a motor program?

A

You need to pay attention to the specific parameters depending on the task, the individual, and the environment.

  • synergistic component parts
  • Force
  • Direction
  • Extent of movement
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5
Q

What is feedforward control?

A

Sending of signals in advance of movement to ready a part of the system for incoming sensory feedback or for a future motor command. Allows for anitcipatory adjustments in postural activity.

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6
Q

What is feedback control?

A

Response produced sensory information received during or after the movement. Used to monitor movement for output for corrective actions.

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7
Q

What is the belief of the Hierarchical theory?

A

Control occurs in descending (top down) direction with the brain always in control to produce output in the body.

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8
Q

What are the beliefs of the Systems theory?

A
  • Distributed model of control (shifting center of control). Various brain and spinal centers work cooperatively to meet the demands of body. Both internal and external factors are taken into consideration when planning movements.
  • Degrees of freedom- separate independent demensions of movement.
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9
Q

Describe an open -looped system and give an example.

A

Pre-programmed instructions to a set of effectors ( motor program) run virtually without the influence of peripheral feedback or error detection processes. ex.) playing the piano, you are playing out the song or notes without the feedback from each one individually because it occurs too rapidly.

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10
Q

Describe a closed- loop system and give an example.

A

Employs feedback and a reference for correctness to compute error and initiate subsequent corrections. Feedback and closed loop processes play a critical role in the learning of new motor skills and in the shaping or correction of ongoing movements. Feedback is essential for the ongoing maintenance of body posture and balance.
ex.) Standing in tandem.

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11
Q

T/F Open and closed loop systems operate together?

A

T- either may assume the dominant role depending on the task at hand
-feedback is used to refine and perfect movements

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12
Q

What are invariant characteristics?

A

The stored code. (force, order)

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13
Q

What are parameters?

A

Changeable features. ex.) speeding up or slowing down (parameters) cna change walking performance while the basic order of stepping cycle and relative timing of the components (invariant) are maintained.

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14
Q

What are muscle synergies?

A

Functionally linked muscles that act cooperatively to produce and intended motor action.

  • Control is flexible with cerebellum acting to generate the appropriate sequence of precise force, timing, and direction.
  • synergies can act in isolation
  • most commonly they combine for functional tasks ex.) sequence of actions required for transfer.
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15
Q

T/F Synergies are learned through practice, are flexible, and can be adapted to changes in the task or environment?

A

T- for postural control and balance: ankle, hip, and stepping strategies (synergies) are well defined. utilization varies from quiet stance to perturbed stance and unstable positions.

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16
Q

What leads to relatively permanent changes in the capability for motor skill?

A

A set of internal processes associated with practice or experience.

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17
Q

T/F learning a motor skill is a complex process?

A

True

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18
Q

How are non-observable changes in the CNS monitored?

A

From changes in motor behavior.

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19
Q

T/F Understanding of the task and practice lead to improvements in performance?

A

True

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20
Q

What is retention?

A

Teh ability of the learner to demonstrated the skill over time and after a period of no practice. This is a better measure of learning, rather than performance. ex.) hitting a 7 iron accurately on a golf course a week after practicing it last.

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21
Q

What is adaptability?

A

The ability to adapt and refine a learned skill to changing task and environmental demands. ex.) hitting a 7 iron on the golf course from the rough with 25mph winds.

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22
Q

T/F an individual who has learned a skill should be ale to apply that learning to new and variable situations?

A

True- ex.) a patient learns to use a cane during fait training in therapy sessions: can ambulate 150 ft using the SPC, independently. Can the patient use the SPC outside over uneven surfaces? At home in tight spaces with changing flooring surfaces and young children running around making noise?

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23
Q

Motor learning is the direct result of practice and is highly dependent on?

A

Sensory information and feedback processes.

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24
Q

What is Adam’s theory of motor learning?

A

Based on closed loop theory
feedback provides reference of error or correctness
Sensory feedback from ongoing movment is compared with stored memory to provide the CNS with a reference of correctness
(This theory cannot explain open loop rapid motor programs or learning that occurs when there is no sensory feedback.)

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25
Q

What is a schema?

A
  • A defined rule, concept, or relationship formed on the basis of experience.
  • Allows storage into short term memory
  • Initial conditions, relationships between movement elements, outcomes, sensory consequences of movement.
  • Information is then abstracted into motor memory (procedural memory)
  • The memory for movement or motor information.
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26
Q

What is the schema theory of motor learning?

A

A generalized motor program that contains the rules for creating the spatial and temporal patterns of muscle activity needed to carry out a given movement.

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27
Q

What 2 schema does the schema theory contain?

A
  • Recall Schema (motor)- used to select and define the relationship among past parameters, past initial conditions and past movement outcomes produced by these combinations.
  • Recognition schema (sensory)- used to evaluate movement responses.
  • Are based on information of the relationships among past initial conditions, past movement outcomes, and the sensory consequences produced by these combinations.
28
Q

Learning consists of the ongoing process of updating the _____ and _____ schemas with each movement that is made?

A

Recognition and recall.

29
Q

Variability of ______ should improve motor learning?

A

practice

30
Q

Can movement be produced accurately if it has never been made before?

A

yes, if it is based on a rule that has been previously created as part of an earlier movement practice.

31
Q

How do we learn skills?

A

By learning rules about the functioning of our bodies, forming relationships between how our muscles are activated, what they actually do, and how these actions feel.

32
Q

What are the 3 stages of motor learning? Describe each.

A
  • Cognitive- development of basic movement pattern.
  • Associative- refinement of movement pattern.
  • Autonomous- performance of movement virtually automatic.
33
Q

What happens during the cognitive stage?

A
  • Develop understanding of the task
  • Assess abilities, task demands
  • Identify stimuli
  • Contact memory
  • Select response
  • “what to do”
34
Q

What are some training strategies for the cognitive stage?

A
  • Highlight the purpose of the task
  • make it functional
  • demonstrate ideal performance
  • have patient verbalize components and requirements
  • for feedback use intact sensory systems, high dependence on vision, use praise for correct performance
  • controlled movement/ minimize errors
  • use guidance to assist
  • provide adequate rest periods
  • Block (repeated) practice of same task, mental practice
  • Structure the environment reduce distractions to ensure attention.
35
Q

What happens during the associative stage?

A
  • practice movements
  • refines motor program
  • spatial and temporal organization
  • decreases errors and extraneous movements
  • dependence on visual feedback decreases, proprioceptive feedback increases, cognitive monitoring decreases.
  • “how to do”
36
Q

What are training strategies for the associative stage?

A
  • for feedback, intervene when errors are consistent emphasize proprioceptive feedback “feel the movement”
  • stress relevance of functional outcomes
  • encourage self evaluation
  • avoid excessive augmented feedback focus on variable
  • encourage consistency in performance, focus on variable practice order
  • progress toward more open, changing environments
  • start to prepare for home, community, work.
37
Q

What happens during the autonomous stage?

A
  • practice movements
  • refine motor responses
  • spatial and temporal highly organized
  • movements are mostly error free
  • minimal level of cognitive monitoring
  • “how to succeed”
38
Q

What are autonomous stage training strategies?

A
  • provide only occasional feedback when errors are evident
  • learner does self evaluation, decision making
  • stress consistency of performance, practice in variable environments and variation of tasks.
  • high levels of (massed) practice
  • challenge the learner with varied environments to be ready for home, community, or work.
39
Q

What are the 4 categories of motor skills?

A

Transitional mobility- getting from one posture to another BOS and COM are moving
Static postural control or stability- Maintaining a posture -body is at rest-COM over BOS; BOS is fixed.
Dynamic postural control or controlled mobility- maintaining a posture while parts of body are moving COM over BOS while parts of the body are in motion; BOS is fixed
Skill-Highly coordinated movement patterns COM is in motion; BOS is changing

40
Q

What is an action that has a specific goal and requires coordinated movement sequence to achieve the goal?

A

Motor skill

41
Q

What are skilled movements characterized by?

A

Consistency, fluency, precise timing, and economy of effort in achieving the target goal

42
Q

How are skills acquired?

A

The direct result of practice and experience.

43
Q

what is the general capacity of an individual to perform a skill or task and is based on stable characteristics or traits that are genetically defined and not influenced by practice?

A

Motor ability

44
Q

What is the re-acquisition of motor patterns that were present before CNS injury?

A

Recovery of motor performance.

45
Q

What kind of recovery results in neural changes that result from the repair processes occurring within the CNS immediately after the insult, resulting in function being restored in neural tissue initially lost?

A

Spontaneous recovery

46
Q

What type of recovery is the restoration of the ability to perform a movement in the same or similar manner as it was performed before the injury; occurring in response to activity and the environment?

A

Function induced recovery

47
Q

What is the appearance of new motor patterns resulting from the adaptation of remaining motor elements or substitution of alternative motor strategies?

A

Compensation

48
Q

What takes place physiologically during spontaneous recovery?

A

With the injury there is immediate cascade of events, producing depression of brain activity

  • edema
  • Release of neurotransmitters, glutamate, and calcium activated enzymes associated with neuron death and neuronal degeneration.
  • free radical damage from toxic particles of oxygen and iron associated with cell death.
  • Blood flow changes suggestive of depressed neural activity have been found to exist on both sides of the brain and in both cortical and sub-cortical structures, areas that are remote from the injured site.
49
Q

When does initial spontaneous recovery occur?

A

over a relatively short time frame, typically withing 3-4 weeks

50
Q

Is there evidence of return to function of undamaged parts of the brain with the resolution of temporary blocking factors (shock, edema, decreased blood flow?

A

Yes

51
Q

Does neuroplasticity exist?

A

Yes, it is the ability of the brain to change and repair itself.

52
Q

What are the mechanisms of neuroplasticity?

A
  • Anatomical changes- nerve growth and regeneration, activation of areas previously not active
  • Neurochemical changes- nerve growth factor, improved neurotransmitter release and improved receptor sensitivity.
  • Neuroceptive changes- nerves change their interaction with each other, sprouting of injured axons to reclaim previously innervated synapses.
53
Q

How is the brain organized?

A

with parallel and distributed circuits that provide multiple inputs to many areas with overlapping functions.
Different and underutilized areas of the brain can take over functions of damaged tissue (cortical remapping)

54
Q

What is the theory behind cortical reorganization?

A

Possibly the CNS has backup systems that become operational when primary system breaks down

55
Q

T/F Different areas of the brain are capable of becoming reprogrammed?

A

T substitution ex.) increased sensitivity of the hands as a sensory info system for a person who becomes blind.

56
Q

Why does neuroplasticity happen?

A
  • law of supply and demand
  • the brain must need to survive, protect, compete, improve in order to make changes
  • if there is no challenge, no chance, no expectation, no success then there is no stimulus or demand to improve
57
Q

What is function induced recovery?

A

the ability of the nervous system to modify itself in response to changes in activity and the environment.
-Uses dependent cortical reorganization

58
Q

How does functional recovery work?

A

repetitive learning behaviors have been shown to prevent degradation and atrophy, enable growth of neurons, strengthen synaptic connections, alter cortical field representations and expand topographical areas of teh motor activity.

  • Receptive fields are altered, processing time is improved, and evoked responses demonstrate increased strength and consistency with improved synchronicity.
  • The brain has potential to change at any stage in life.
59
Q

What are the principles of promoting function induced recovery?

A
  • Focus on active practice (use it or lose it)
  • Repetition is important (HEP is vital
  • intensity is important (pt needs to be actively involved)
  • Focus on modifying motor skills (use it and shape it to patients ability and allow for success- challenging but achievable)
60
Q

How can you enhance selection of behaviorally important stimuli?

A

create the best possible environment for learning.

61
Q

How can you enhance attention and feedback

A

actively involve the patient in evaluating their performance and progress and make adjustments based on feedback

62
Q

How do you improve goal directed skills?

A

make goals that are important to the patient and actively involve the pt in goal setting

63
Q

Why is timing important?

A

Early intense training in acute after stroke or TBI can cause further cellular damage.
Rest is important for healing
delayed training can limit recovery and result in neural degradation and learned non use or bad habits

64
Q

Why is age important?

A

plasticity and adaptive brain changes are strongest in the young, may be slower in older adults.

65
Q

What are a couple of examples of function induced recovery?

A

locomotor training using partial body weight supported treadmill training
constraint induced movement therapy