Lesson 1 Flashcards
Enablement model
focus on what patient can do in a holistic approach
Function
dynamic interaction between health condition and contextual factors, environment and personal
Disablement model centered on
pathology, impairment, functional limitation and disability
Enablement model focused on:
individual abilities
influence of internal and external factors
Body functions and structures:
impairments at the physiological or anatomical levels in ROM, strength, endurance, etc
Activitiy:
task or action execution; mobility on the floor, object manipulation, self care
Participation:
involvement in meaningful life situations in home, school, community
Environmental:
physical, social, attitudinal aspects of the environment (family, stress, etc)
Personal
individual characteristics of child/family, cultural background, etc.
Functional movement
self-initiated, goal-directed and meaningful
Play
practice of functional activities for motor development, motor learning and environmental mastery
Repetition of motor behaviors
trial and error, strengthening, postural control, response to reactive forces
Intensity of purpose
practice emerging skills until mastered
Neuromaturationist Theory
hierarchical CNS development
appearance of predetermined behavior patterns with nervous system maturation
not altered by environment
tests of motor milestone and reflex development
Early focus of NDT treatment:
inhibition of abnormal muscle tone and movement patterns
manual facilitation of more normal patterns using key points of control
Later focus of NDT treatment
more dynamic
emphasis on child-directed movements supported by therapist
less use of static postures in adaptive equipment
Dynamical Systems Theory
motor behavior emerges from self-organization of multiple subsystems in a task-specific environmental context
Berstein
degrees of freedom in muscles and joints organize into synergies to produce coordinated movement patterns
Motor Learning
acquisition of motor skills or requisition of motor skills impaired by injury or disease
Sensitive Periods
experience-dependent plasticity during which interventions might be more effective
2-4 months
grasp a toy within reach
7-8 months
visually guided manipulation comparison of multiple objects
12-13 months
coordination of multiple actions, putting shape into box
18-21 months
symbolic representation- object memory activates action
By 18 months:
upright head posture prone on elbows rolling supine to prone independent sitting belly crawling, attaining all 4's, reciprocal crawling pulling to stand cruising crawling up and down stairs independent standing and walking
Gross motor development:
cephalo-caudal and proximal to distal
spiraling pattern
Gross motor development
0-3 months
head control
Gross motor development
3-6 months
postural control of the trunk and arms
Gross motor development
6-9 months
upright control of lower trunk, pelvis
Gross motor development
9-12 months
postural control in standing, walking
Object manipulation
0-4 months
rotation, translation, vibration of objects
Object manipulation
4-6.5 months
two handed hold, bilateral holding, hand to hand transfer, single object manipulation
Object manipulation
6-9.5 months
banging objects together, deforming objects, coordinated hand use for sequential actions
Object manipulation
7-13 months
stable hand preference
What drives development?
neural maturation
exploration
solving the task at hand
Functional head control
Birth:
unable to sustain a stable vertical head
position > 1-2 seconds
Functional head control
6 weeks
supine head turning elicited by visual stimulus
Functional head control
2 months
ability to sustain head in midline in frontal plane during supported sitting but may appear to be gazing downward
Functional head control
3 months
finer synergistic control of neck flexors and extensors allows stable head position
