Lecture 4 Flashcards
Performance Outcome Measures
Measure outcome or results of performing a motor skill
- time to complete a task
- reaction time
- distance covered
- errors
- standardized functional tests
Performance Production Measures
measures the performance charcteristces that produced the outcome
- specific aspects of motor control sysytem
- velocity, acceleration, joint angle, force
- how nervous system is functioning (fmri, pet)
- how muscular system is function (emg)
Kinematics
the description of pure motion withou regard for forces and masses
describe movement of limbs and entire body
Components of kinematics
spatial & temporal
apraxia
loss of motor planning- person will understand your command but cannot generate motor plan to do that
Sptaila Planning Decifict Study
healthy control vs patient with parietal lobe stroke and apraxia
slice loaf of bread
apraxic person- pathway was circular, not in one plane of movment
control group= pathway was linear in saggital plane
Spatial planning deficits with command, object and tool study
patients with apraxia
Command- miming,
Object- just had bread, miming knife
Tool- knife no bread
Both- both bread and knife
Worked best with both object and tools
We can work to amerlioate difference in spatial planning if we give them actual real tools we want them to use
Constant Error
average magntidue of error in movement performance
takes direction into account
absolute error
measures magnitude but not direction
variable error
measures consistency or inconsistency of responses
discrete task
specific start and end point
continuous task
repetitive task
ex. gait
error for discrete tasks
- constant error
absolute error
variable error
error for continuous taks
root mean square error
root mean square error
measures both deviation and consistency
measures difference between target trajectory and actual trajectory over time
can be used to create a performance curve
simple reaction time
one stimulus, one repsonse
choice reaction
multiple stimuli, each has a specific response
discrimination
multiple stimuli but only respond to one type of stimuli
example- task to hit red everytime you see blue
both stimulated and inhibited
Response time
reaction time + movment time
reaction- between start signal and intiation of response
movement0 intiation to termination
premotor time
planning of movement
EMG - response time?
can measure motor time but not premotor time
Parkinson’s Reaction time
PD early onset- normal reaction time
actual onset of muscle recruitment is normal but time it takes to complete movement is slow
Muscle Performance + EMG
measures involvement of muscles by recording electrical activity in the muscle during movement
provides info about the identity of active muscles
provides info about temporal patterning
provides info about intensity of concentration(signal amplitude)
activation pattern between several muscles- antagonists and synergists
Children with CP co contraction
CP kids- muscle firing at same time
ability to recover over base of support is impaired
no reicprocal inhibition
Performance production- how is a movement performed?
Looks at the component parts of the movement AND at the neurologic and musculoskeletal components of movement creation
What do Performance Production Measures Tell Us?
How the nervous system is functioning
How the muscular system is operating
How limbs or joints are acting before, during, and after a person performs a skill
Performance Outcomes
outcome and end result of a movement
Performance Outcome Measures Tell Us?
Task Complete vs. Incomplete
Error
Accuracy
Consistency
Production Measures- Spatial
Location of limb segments Joint Angle Location of limb in space Movement Shape Joint Coordination Pathway of Trajectory Displacement Range and Control (fractionation) Measured Via: Cinematography, Optoelectric Camera, or Motion Analysis
Production Measures- Temproal
Velocity Acceleration Movement Duration Force Measured via: EMG, EEG, PET, fMRI
Outcome Measures examples
Time to Complete Task Reaction Time Amount of Error Absolute, Constant, Variable, RMSE Number or %age of errors Number of successful attempts Time on/off target Time on/off balance Distance Trials or Repetitions to Completion
EMG is used for
– identification of active muscles, intensity, temporal patterning
PET SCans, fMRI are used to
visualize the working brain
Positive Neuroplasticity
functional recovery
Negative Neuroplasticity
behavioral compensation
behavioral Compensation
definiton
response to damage and behavioral attempts to compenstae for effects of damage
negative plasticity
Functional Recovery defintion
response to a behavioral experience that enhances functional outcome and promotes functional reorganization
positive neuroplasticity
Functional recovery- operational definiton
reacquisiton of elemental motor patterns present prior to CNS injury
Functional recovery occurs as a result of
sponaneous recovery
experience dependent motor training
increased involvement of contralateral hemisphere
axonal remodeling of corticopinal system
Compensation
appearance of new motor patterns from the adaptation of remaining motor elements
substitution
integration of alternative motor elements form different end effectors
Writing example of functional recovery, compensation and subsitituion
functional recoveru- write the way you did before
compensation- adapt pen, utilize different stratefy, change posture
subtitution- learn how to use other hand
% of gains due to spontanous recovery
70%
What goes on in rehab?
Patients are coming in from acute care sicker
Patients are being discharged from rehab quicker
Many treatment models are not 1:1
How do we respond?
Make them “functional” as quickly as possible
Decrease burden of care
Maximize independence
In essence, we teach compensatory and substitution strategies
Constraints why we can’t acheive neural plasticity
Red lines- constraints why we cant achieve neural plasticity: fatigue, spasticity, attention, depression, limited time
How can we attempt to target functional recovery
“Set up practice to enable patient to use affected system in a limited setting”
Design interventions to allow patient to use their affected extremities safely in an environment that fosters success
Functional Reorganization
Skill dependent not use dependent
repitition is not enough- must be emphasis on skill acquisition
