Lecture 4: POC for neuroMSK diagnoses

Question 1

treatment plans are based on:

Answer 1

-Plan of care
-Treatment approach
-Motor control theory
-Patient’s personality
-Setting

Question 2

POC is based on:

Answer 2

-Diagnosis
-CLINICAL PICTURE
-Evaluation results
-Reason for referral
-Patient/family goals

Question 3

a well developed plan of care is the vehicle to to greater ___ and _____for children with neurological and non-
neurological disorders

Answer 3

functional
independence and participation

Question 4

what are two early theories of motor control (major in late 1950s to early 1970s)

Answer 4

reflex theory
heirarchical theory

Question 5

What is reflex theory?

Answer 5

-Sensory (afferent) input causes motor (efferent) output between the peripheral

**Reflex is the basic unit of movement

Question 6

What is hierarchical theory?

Answer 6

-Considers the reflex a primitive behavior

-Motor control is achieved from a top-down fashion
from the cerebral cortex to the spinal cord

***Primitive reflexes were thought to be
suppressed with the development of higher
control

Question 7

Where did NDT, PNF, SI (main neurofacilitation approaches) originate?

Answer 7

from the early theories (reflex and hierarchical theory)

Question 8

What is Motor Programming Theory?

Answer 8

-Networks of neurons within the spinal cord-
central pattern generators (CPGs)
work together as a whole to produce
rhythmic, patterned motor commands, such as
commands for repetitive stepping
(locomotion)

-More complex programs developed at the cortex level result from motor
learning and are used to simplify the production of movement

Question 9

What is systems theory?

Answer 9

movements emerged from interaction of many systems (not just reflexes or centrally/peripherally driven…)

emphasizes CONSTRAINTS of msk system and environment on movement

*contractures, maybe the environment, etc.

Question 10

systems theories says that the control shifts among systems depending on ___, ___, and ____

Answer 10

internal state (fear?)
specific motor task (ice skate, walking?)
environmental conditions (dark, bumpy road?)

Question 11

What are the 3 automatic postural responses to perturbations when standing?

Answer 11

1. ankle
2. hip strategy
3. stepping strategy

Question 12

ankle strategy involves what muscles?

Answer 12

Gastrocsoleus, hamstrings, paraspinals

Question 13

hip strategy involves what muscles?

Answer 13

abs, quads, tib ant
(prox to distal activation)

Question 14

What is the dynamic systems theory?

Answer 14

variability within and
between individuals is considered an
essential component of motor
development

control shifts among among systems following principle of self organization between components that make up individual and surrounding environment

Question 15

automatic postural responses to backwards perturbations of floor surface occur at ____ milliseconds from perturbation

Answer 15

80-100 milliseconds
*as opposed to spinal reflex response time of 30 milliseconds

Question 16

What are the control parameters of dynamic systems theory?

Answer 16

-factors that promote change in movements produced (internal/external)

ex. speed of mvmt, degree of hip and pelvic stiffness

Question 17

What are control parameters for example with toe walking?

Answer 17

-speed
-mm stiffness
- ROM
-surface
-selective motor control (swim fins)

Question 18

example of control parameters with grip

Answer 18

1. number of fingers
2. size of objects

Question 19

What are the three parts of the “triad of constraints?”

Answer 19

1. person
2. environment
3. task

Question 20

What is the difference between movement and action?

Answer 20

action: accomplished task, strategy to achieve goal

movement: change at mvmt level, involves coordination of mvmt patterns, allowing action goal to be achieved

CHANGE AT MVMT LEVEL ALONE IS NOT SUFFICIENT FOR ACTION

Question 21

palmar grasp vs pincer grasp
qualitative or quantitative change?

Answer 21

qualitative

Question 22

what is the difference between dynamic systems and information processing perspective?

Answer 22

dynamic: how mvmt behavior is organized and how it changes with ACTIVITY FOCUSED INTERVENTIONS

information-processing: emphasizes cognitive systems role in motor learning

Question 23

motor learning is a _____ associated with practice or experience leading to a relatively permanent change in capability for a motor skill

Answer 23

set of internal processes

*repeated motions without active participation and info processing does not cause motor learning!!!

Question 24

What are the cognitive aspects important to motor learning?

Answer 24

attention
memory
mental representation

Question 25

stages of information processing

Answer 25

1. stimulus identification 2. response selection 3. response programming *memory and attention involved

Question 26

Name the framework that has been used to explain the slow information processing times, poor visual, and spatial ability, and timing deficits seen in children with DCD

Answer 26

information processing

Question 27

children with DCD depend heavily on ____ bc they don't have effective ______

Answer 27

depend on visual feedback *not good anticipatory control *also have force production deficits

Question 28

it takes __ children longer to process feedback information

Answer 28

younger! (time to process info is age related) *precision of info that can be used for feedback ALSO varies with age

Question 29

What is the memory representation of a movement that can be retrieved when needed for a functional action?

Answer 29

motor program * this is the main homie, but also interaction with sensory processes to refine movement and adapt it to environment!

Question 30

What are the three motor learning principles?

Answer 30

1. performance 2. learning 3. attention

Question 31

Name the motor learning principle: change may or may not be permanent

Answer 31

performance

Question 32

the variant or changeable features of a motor program

Answer 32

parameters *variable practice of multi parameters is important!

Question 33

name the motor learning principle: permanent change

Answer 33

learning

Question 34

name the motor learning principle: allocation and focusing of info processing resources

Answer 34

attention

Question 35

The decrement in performance associated with __ ___ is significantly greater for children with neuro conditions, such as DCD and CP

Answer 35

dual tasks

Question 36

What are three strategies for attention?

Answer 36

1. taking child to a high level of primary task performance before introducing competing tasks 2. using dual tasks to evaluate level of learning of a primary task or development of postural control 3. Practicing functional tasks in the natural environment, which attention is divided

Question 37

Kleim and Jones Principles of Plasticity!

Answer 37

1. Use it or Lose it 2. Use it and Improve it 3. Specificity 4. Repetition 5. Training Intensity 6. Time 7. Salience 8. Age 9. Transference 10. Interference

Question 38

activity focused interventions stress ___ and ___ associated with practice to foster brain reorganization!

Answer 38

repetition and problem solving

Question 39

3 steps for activity focused interventions

Answer 39

1. develop activity related goals and objectives 2. plan activity focused interventions 3. integrate impairment focused interventions

Question 40

Hippotherapy Aquatic therapy Manual guidance Biofeedback Partial weight-bearing treadmill training Proprioceptive Neuromuscular Facilitation (PNF) These are examples of...._____ focused interventions

Answer 40

activity impairment focused interventions!

Question 41

joint mobs passive ROM orthoses these are examples of

Answer 41

passive impairment focused interventions

Question 42

Four stages of development of motor control: sensorimotor approach by margaret rood

Answer 42

◦ Reciprocal Innervation ◦ Co-contraction ◦ Stability superimposed on mobility ◦ Mobility superimposed on stability