Lecture 1: Neuroplasticity and Motor control

Question 1

What Is Neuroplasticity?

Answer 1

Adaptive capacity of the central nervous system
• Mechanism by which the brain encodes experience and learns new behaviors
• Mechanism by which the damaged brain relearns lost behavior in response to rehabilitation

Question 2

How Is Neuroplasticity Measured?

Answer 2

Animal Studies

• Cortical map reorganization
• -intracortical microstimulation
• Morphological markers of plasticity
• -Synaptogenesis

Human Studies

• Cortical excitability and cortical map reorganization
• -Transcranial magnetic stimulation

Question 3

What Are Exercise-Dependent Plasticity Practice Variables?

Answer 3

1) Use it or lose it (task complexity)
2) Use it and improve it
3) Specificity
4) Repetition Matters
5) Intensity Matters (task difficulty)
6) Salience Matters
7) Age matters
8) Transference
9) Interference
10) Time

Question 4

Use it or lose it

Answer 4

failure to drive specific brain functions can lead to functional degradation

Question 5

Use it and improve it*

Answer 5

Training that drives a specific brain function can lead to enhancement of that function

Question 6

Specificity*

Answer 6

the nature of training experience dictates the nature of the plasticity

Question 7

Repetition Matters*

Answer 7

induction of plasticity requires sufficient repetition

Question 8

Intensity Matters

Answer 8

induction of plasticity requires sufficient training intensity

Question 9

Salience Matters*

Answer 9

The training experience must be sufficiently salient to induce plasticity

Question 10

Use it or lose it

Answer 10

failure to drive specific brain functions can lead to functional degradation

Question 11

Transference

Answer 11

plasticity in response to one training experience can enhance the acquisition of similar behaviors

Question 12

Interference

Answer 12

Plasticity in response to ones experience can interfere with the acquisition of other behaviors

Question 13

Time

Answer 13

different forms of plasticity occurs at different times during training

Question 14

Intensity Matters/ task difficulty

Answer 14

induction of plasticity requires sufficient training intensity

Question 15

Salience Matters*

Answer 15

The training experience must be sufficiently salient to induce plasticity

must matter to the person

Question 16

Interference

Answer 16

Plasticity in response to one’s experience can interfere with the acquisition of other behaviors

Question 17

Functional reorganization of the motor cortex is dependent on

Answer 17

Task complexity
• Skill dependent rather than use dependent
• Skill acquisition is more important than movement repetition
• Skill acquisition is more important than strengthening

Question 18

What induces cortical reorganization, strength training or skill learning

Answer 18

Skill learning

Question 19

What is TMS

Answer 19

Transcranial Magnetic Stimulation
• Non-invasive method to cause depolarization in neurons of the brain
• Current through the primary coil induces a magnetic field
• TMS applied over Stimulus-response curve motor cortex → contraction of contralateral muscles
• Electrode over muscle in the periphery (biceps) measures motor evoked potentials (MEPs)

Question 20

Neuroplasticity in the damaged brain

Answer 20

• Spontaneous neural recovery
• Mechanism for spontaneous recovery
• Recovery from diaschisis

Question 21

Spontaneous neural recovery

Answer 21

plastic response to injury that demonstrate functional restoration independent of rehabilitation experience

Question 22

Mechanism for spontaneous recovery:

Answer 22

Reversal of acute physiologic changes that occurred from injury
• Lessening of edema
• Reestablishment of pre-morbid neurotransmitter levels
• Reabsorption of blood in cases of hemorrhage

Question 23

What does diaschisis mean

Answer 23

Diaschisis: the selective disruptive effect of a focal lesion on the operations of areas with which it was structurally and functionally connected; associated with the acute injury events

(idea of penumbra around a stroke)

Question 24

Windows of ‘Spontaneous Recovery’

Answer 24

~1 year for brain injury

~6 months for CVA

Question 25

Neuroplasticity and compensation

Answer 25

your neuroanatomy changes to reflect compensatory movements. worsens the repair on affected side because that side is getting lazy. plasticity of dendrites and synapses was seen in the contralesional motor co

Question 26

What is Motor Control?

Answer 26

The scientific field of study concerned with: - How all kinds of movements (genetically defined or learned through practice) are controlled - How the CNS is organized so that many individual muscles and joints become coordinated - How sensory information from the environment and/or from the body is used in the control of movement and how such information allows a person to select and plan an action

Question 27

Movement emerges from:

Answer 27

TIME •Task •Individual •Environment The individual generates movement to meet the demands of the task being performed within a specific environment.

Question 28

What do we as therapists manipulate to help pt with movement

Answer 28

The task

Question 29

What do we as therapists manipulate to help pt with movement

Answer 29

The task

Question 30

What is an Open Movement Task

Answer 30

task is ever changing and unpredictable i.e. Soccer • Requires constant monitoring of the sensory system to alter the motor plan

Question 31

What is a Closed Movement Tasks

Answer 31

fixed and relatively predictable environments • Requires less constant sensory monitoring

Question 32

Movement emerges from :The Environment

Answer 32

Tasks are performed in a wide range of environments. CNS must take into consideration the environment

Question 33

What is a Closed Movement Tasks

Answer 33

fixed and relatively predictable environments • Requires less constant sensory monitoring

Question 34

What are Regulatory features and examples

Answer 34

affects the performance i.e. the size, shape, and weight of a cup to be picked up and the type of surface on which we walk

Question 35

What are Non -Regulatory features

Answer 35

affects performance on a small margin i.e. background noise and the presence of distractions. Shumway-Cook

Question 36

What systems are apart of motor control

Answer 36

``` Coordination Perception, Cognition ROM Muscle Tone Sensation Synergy Strength ```

Question 37

What is meant by Movement emerges from The Individual:

Answer 37

Motor/Action Systems • Both the neuromuscular and biomechanical system contribute to functional movement control. • Strength, balance, coordination, range of motion • There are a number of joints and muscles that must all be controlled referred as “degrees of freedom problem”

Question 38

What is the relationship between balance and perception?

Answer 38

Balance is related to strength and holding tone but also using the visual inputs and proprioception.

Question 39

What is meant by Movement emerges from The Individual:

Answer 39

1) Cognitive System | 2) Sensory, Perceptual Systems

Question 40

Why must the study of motor control include the study of cognitive processes as they relate to perception and action.

Answer 40

There are different ways we process and perceive information

Question 41

Cognitive system includes

Answer 41

``` includes: • attention • planning • problem solving • motivation ``` * All above must be considered as it relates to the patient’s intent or goals (Subjective) * Study of motor control must include the study of cognitive processes as they relate to perception and action.

Question 42

Why is sensation and perception are essential to the control of functional movement.

Answer 42

Perception is the integration of sensory impressions into psychologically meaningful information. • Perception is subject to interpretation • Sensory/perceptual proprioception critical to the regulation of movement.

Question 43

What is the ventral stream processing

Answer 43

"What pathway" / Perception pathway | From the striate cortex to the inferior temporal cortex

Question 44

What is dorsal stream processing

Answer 44

"Where pathway"/ Action | projects form the parietal region and mediates the sensory motor

Question 45

What is visual agnosia and which pathway would be affected

Answer 45

inability to recognize the size, shape and orientation of visual objects affects the "what pathway"