Motor Control Flashcards
Motor Control
- The ability to regulate or direct the mechanisms essential to movement
- Seek basic principles of controlling voluntary movements.
- How the nervous system interacts with the rest of the body and the environment
Multi-System Control of Movement
- Integrated, distributed, and interactive system of elements and operations comprised of all sub-systems that may contribute to movement function, together with the features of the external environment within which one moves and the physical laws governing the natural world
- Thus, movement dysfunction is attributable to changes in normative multi-system control for a given health condition
3 types of constraints:
Individual, task, and environment
Individual Constraints
- What systems needed?
* What does the person bring to bear on the task? Their ability and/or health condition(s)?
Task Constraints
- How do you do it?
* Why do you do it?
Environmental Constraints
- Surface features
* Lighting
What are Some Sub-Systems in the Nervous System Needed for Movement?
• Sensory and Motor Systems
• Cognitive Systems –attention, planning, problem-solving
• Motivational/Emotional Systems –important for intent and goal-
achievement
Sensory and Motor Systems in the nervous system needed for movement
- descending systems (CST, VST, RST, etc)
- spinal elements (Ia, Ib, II, Renshaw, interneurons, the various reflexes)
- Somatosensory systems (ALS, DCML)
- Perceptual systems and processes (eg, visual system but also the processes associated with interpretation and meaning
Other systems needed for movement?
- The CNS/PNS don’t act in isolation
- Biomechanical systems
- Cardiorespiratory, endocrine, lymphatic, renal, reproductive, etc
What are all of these systems a part of?
- The individual –> individual constraints
• Components of movement and the underlying systems that make them up
• Body structures and functions
Types of Task Constraints
- Discrete / serial / continuous
- Closed / open
- Stationary / moving
Environmental Constraints
- Regulatory and non-regulatory features of the environment
- Those things that should be attended to (weight, shape, size of an object to be grasped; height, width, conformability of an obstacle).
- Those things that don’t require attention (color of cup)
Explain how constraints limit choice
They help turn a seemingly massive and uncontrollable system into a manageable one –> Think of it as if boundaries have been placed on all the elements and their interactions needed for a movement
How to think about movement-
in a complex, multi-system organism, while embedded in a physical environment with structure and energy in the form of load, light, and sound (physical laws)
Forward Internal Model
- Model of what you sent into the world
- We don’t represent the world directly, we represent a model of all of the information we’ve taken in
Reflex Theory
- Reflex was the basic unit of movement.
- Reflex: “stereotypical response to some stimulus.” Need stimulus, receptor, afferent and efferent pathway, effector (motor response)
- Sensory input drives (is required for) movement
- Closed-loop system: a feedback system
Reflex Chain Hypothesis
- notion that each of a series of movements may be linked through the sensory results of prior movements
- developed to explain the observation that successive movements could be linked together into a contiguous sequence
- Complex movements are a result of a chaining together of elemental reflexes (chain hypothesis)
Therapeutic Implications of Reflex Theory
- PT can alter patient’s movement pattern by applying specific patterns of sensory stimulation (eg., proprioceptive path) –> Use of sensory inputs to facilitate (or inhibit) movement –> access CNS via sensory system
- Emphasis on eliciting reactions (particularly postural -equilibrium/righting)
- Treat spasticity before facilitating “normal” movement –> Don’t strengthen because forceful movements will increase spasticity
Limitations of Reflex Theory
- Patient not a spinal animal (not just a bundle of reflexes to be stimulated or suppressed)
- No concept of intention in this process
- Can override reflexes (delaying dropping a hot cup of tea in order not to spill it) –> “reflex chaining” is not obligatory
- Sensory input not “required” for movement –> Deafferented animal studies
More limitations of Reflex Theory
- Only “postural reflex mechanism” –> No APA in this model
* Feedback systems require too much time to account for fast (ballistic) movements –> Triphasic EMG pattern
Hierarchical Theory
- Structural-functional relationship in CNS is hierarchical
- CNS has higher and lower “centers”
- Strict top-down control model
Explain how structural-functional relationship in CNS is hierarchical
- Identification of the “Motor Strip” –The cerebrum is involved in movement
- Movements are controlled not muscles
Explain the CNS has higher and lower “centers”
- Higher centers are associated with cortical structures and are responsible for complex volitional movement (structure-function relationship).
- Lower centers are associated with brainstem and spinal structures and are responsible for primitive reflexes and other automatic movements.
- Higher centers suppress reflexes at lower centers
If higher centers control and/or inhibit lower centers’ reflexes, then ….
there is a close observational link to developmental/ maturational process
- In development it was thought higher centers gain control over lower primitive centers (an increasing corticalization of the CNS) –> Emergence of higher-level control over lower-level reflexes
What does the assumption was brain damage to cortex mimic?
- development
- Damage leads to a persistence of primitive lower-level reflexes.
- Recovery is observed through a progressive inhibition of lower level automatic / reflex responses
what does neuro-maturational Theory of Development
Depends on?
a Hierarchical (and Reflex) Model of Control
Therapeutic Implications of the Hierarchical Theory
- Positive and negative symptoms
- Recovery is hierarchical and moves in a predictable sequence.
- Move through inhibition of abnormal patterns before facilitation of normal patterns
- Then stimulate (via sensory systems) equilibrium and righting reactions in supine and sitting before moving to higher developmental positions –> This combines reflex and hierarchical theories
Hierarchical Theory- Positive and negative symptoms
- Brain damage to higher centers results in decreased volitional control –> There is a release of reflex patterns
- Lesion (cause) = abnormal response/pattern (effect)
Hierarchical Theory- Limitations
- Movement is not governed by a strictcontrol hierarchy in the CNS
- Need subcortical circuits to assist in planning and initiating complex movements –> There are no privileged levels of the nervous system
- Spinal cord is not just a relay station between cortical control and so-called primitive reflexes at the spinal level
Spinal level “control” signals
- not formulated in terms of contractions of individual muscles or even movements in individual joints
- Otherwise, loading a segment or blocking a joint would have led to inaccurate movements
- Second, the results imply the existence of very fast corrections of movement patterns, built into the “program” for wiping
Additional Limitations of Hierarchical Theories
• Primitive reflexes do not disappear due to neural maturation alone.
Environment, task and biomechanical factors explain much in the
emergence of complex movements
• Strict adherence to a hierarchical viewpoint resulted in a rigid
application of developmental sequence in physical therapy
Reflex and Hierarchical Control
Both were used to develop the traditional neurotherapeutic
approaches of:
• Bobath –Neurodevelopmental Treatment (NDT)
• Rood –sensory stimulation
• Knot and Voss –Proprioceptive Neuromuscular Facilitation (PNF) reflexes to
pattern
• Brunnstrom –reflexes to synergies