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Motor Control Flashcards

1
Q

what is motor control?

A

the ability to regulate or direct the mechanisms essential to movement

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2
Q

how does the individual impact movement?

A
  • requires cooperative effort of many brain structures and processes
    – sensory perception system: proprioception, environment, input from sensory systems
    – cognitive: attention, motivation, planning, memory, problem solving
    – motor system: muscles, joints, ROM, strength, tone, coordination, sequencing (NM and MS systems)
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3
Q

is reflex theory a stimulus or thought driven system?

A

stimulus driven, no conscious thought
- stimulus in –> response out

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4
Q

is reflex theory a top down or bottom up approach?

A

peripheral system dominant –> bottom up approach (distal to proximal)

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5
Q

how are complex movements explained with reflex theory?

A

combination of reflexes/reactions that were chained together (lower –> higher CNS development)

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6
Q

what are limitations to reflex model?

A
  • what about voluntary movement
  • a single stimulus can result in more than one response; we can override a reflex using higher brain centers (pulling a hand away from hot fire vs touching fire to save a child)
  • doesn’t explain movement that occurs in absence of sensory stim
  • what about fast and quick movements/movements that are too rapid to allow new sensory information to impact them (ex. fast typer)
  • what bout new movements/applications of movement in new situations
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7
Q

is hierarchical theory a top down or bottom up approach?

A

top down, overlaps with reflex theory
- higher cortex motor association areas –> motor cortex –> spinal levels –> limbs move

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8
Q

according to hierarchical theory, what is the primary agent for change in development?

A

CNS maturation (reflexes decrease as we age and we use higher levels of the brain as we develop)

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9
Q

what does hierarchical theory say about damage to the CNS

A

results in a release of control by higher centers (release of inhibition) and results in spasticity or other movement dysfunction (and return of primitive reflexes), which causes movement disorders

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10
Q

what does hierarchical theory say about recovery of CNS dysfunction?

A

is a process of CNS regaining control (inhibition) over the lower centers

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11
Q

what does hierarchical theory say when the brain is damaged?

A

there will be an expression of lower-level reflexes

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12
Q

what are some examples of lower level reflexes?

A

patellar tendon, infant reflexes (moro, rooting, palmar grasp, etc), motor response: flexor withdrawal or extensor response, pupillary dilation/constriction, close eyes in response to something coming to your face

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13
Q

what is considered a higher level reflex?

A
  • when the cortex impacts movement
  • low level auditory startle vs movement to a command
  • low level visual tracking vs object recognition
  • low level flexor withdrawal to pain vs functional object use
  • low level eyes opening with stimulation only vs maintaining attention
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14
Q

what are the limitations to hierarchal theory?

A
  • does not explain dominance of reflex behavior in certain situations (flexor withdrawal - stepping on a pin results in immediate withdrawal of the leg; the lower level of the hierarchy dominates motor function)
  • our response to the environment
  • biomechanics factors not taken into account
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15
Q

what are some clinical implications of reflex and hierarchal theories?

A
  • noting evolution of reflexes in pediatrics
  • gait training based on limb position
  • PNF
  • interventions are aimed at gaining or regaining higher level reflexes and movements in a step wise approach
  • tend to focus on resolving reflexes –> with limited evidence that this improves function
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16
Q

how does motor control theory suggest motor programs are activated?

A
  • looks at both peripheral and central pieces to permit motor control
  • a motor program can be activated by sensory input or central processes (a sensory input can alter a motor program)
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17
Q

what does motor control theory say about how typical movements are created?

A

synergy - typical movements are created by specific patterns

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18
Q

according to motor programming theory, what are central pattern generators (CPGs)?

A
  • neural circuits that influence movement
  • rhythmic input (quick stretch) can create a chain of events that permits walking, breathing, etc
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19
Q

how do central pattern generators function?

A
  • without help from the cortex (driven by the spinal cord, not the brain)
  • reaching: cervical spine CPGs
  • walking: lumbar spine CPGs
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20
Q

what are some limitations to motor programming theory?

A
  • this theory does not replace the impact of environmental or musculoskeletal variable, but instead helps to expand our understanding of movement
  • a central motor program cannot be the sole determinate of action (ex. holding weights w/ shoulder flexed to 0 and 90: gravity impacts the movement)
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21
Q

what are some clinical implications of motor programming theory?

A
  • don’t just train a single motion or isolated muscle; the problem may be from a higher motor center - stroke vs biceps tear
  • this theory emphasized the importance of training the task and helping pts relearn the action
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22
Q

does dynamic systems theory focus on one system or multiple?

A
  • focused on the interactions of MULTIPLE body systems
  • interacting systems work cooperatively to achieve movement
  • nervous system is a team, not a hierarchy
23
Q

according to dynamic systems theory, how is movement considered?

A
  • movement is flexible: motor equivalence (not just one way to complete a movement)
  • also other control parameters that impact movement (ex velocity)
24
Q

how does dynamic systems theory allow for motor variability?

A
  • not an error (as described in motor processing theory) but as a necessary factor in optimizing movement
  • low variability = highly stable movement pattern
    – walking pace: not always easier to move slow –> variability in speed alters movement patterns
    – ingrained movement patterns in our pts are harder to change; adjusting to a new movement pattern has more variability
25
Q

what are degrees of freedom in dynamic systems theory?

A
  • coordination of movement is the process of mastering the redundant degrees of freedom of the moving organism
  • all of the independent variables of movement (join may fix/ext, abd/add, etc)
  • work to gain control of degrees of freedom over time with movement refinement
26
Q

what are synergies in dynamic systems theory?

A
  • flexible and adaptive nature of movement patterns to gain control over degrees of freedom
  • constraining certain mm to work together to control the movement
27
Q

what is the use of sensory information in dynamic systems theory?

A
  • initially can cue movement in a feedforward manner (prepare prior to moving)
  • use somatosensory, visual, and vestibular systems
28
Q

what 4 items does dynamic systems theory take into account?

A
  • musculoskeletal systen
  • nervous system
  • forces of gravity and inertia along with the environment
  • developmental status of the mover’s nervous system
29
Q

what is seen when we define an atypical movement pattern in dynamic systems theory?

A
  • result of the lesion in one system
  • the result of other systems working to compensate for the damage to that system
30
Q

what are some limitations to dynamic systems theory?

A
  • predicts actual behavior much better than previous theories
  • prior theories only looked at the nervous system: that alone will not predict movement
  • one limitation is that it may be presumed the nervous system doesn’t play a big enough role
31
Q

what are some clinical implications to dynamic systems theory?

A
  • PT needs to consider neurons and MS impairments as reasons for a loss of motor control
  • exam and intervention must focus on interaction of multiple systems
  • variability is a good thing
32
Q

how is movement controlled according to ecological theory?

A
  • detecting information in our environment that is relevant to our actions and how we use this info to control our movements
33
Q

how is perception involved in ecological theory?

A

perception focuses on detecting information in the environment that will support the actions necessary to achieve the goal

34
Q

what are the limitations to ecological theory?

A
  • focused less on the nervous system and how the organism produces that given movement
  • focused more on the organisms’ interactions with the environment
35
Q

what are the clinical implications of ecological theory?

A
  • adaptability: lots of ways to achieve a goal
  • we can control and manipulate the environment to challenge the learner to regain/retain/develop motor control and achieve a goal
  • help the pt perceive components of different environments
36
Q

what are the clinical implications of present theory?

A
  • move away from traditional therapies (PNF, NDT, bobath, sensory integration
  • embrace evidence based practice: task specificity, encourage variability, dosage parameters –> high intensity, increase the challenge, consider practice conditions, more hands off
37
Q

what is the purpose of task analysis?

A
  • determine if the functional task is being optimally performed
  • observe the problems that may be present with the task performance
  • generate hypotheses about underlying impairments that may be contributing to movement dysfunction
  • determine appropriate tests and measures
38
Q

when considering movement analysis, what two things are we looking at?

A
  • level of assistance required (if any)
  • quality of movement
39
Q

what is independent (assistance)?

A

safe w/ no one present, no verbal cues

40
Q

what is modified independent?

A

independent but required an assistive device or extra time

41
Q

what is distant supervision?

A

line of sight supervision; helper could be across the room and provide verbal cues

42
Q

what is close supervision?

A

within arms reach, not touching, but there for safety and/or provide verbal cues

43
Q

what is minimum assistance?

A

pt able to do >75%, PT need <25%

44
Q

what is moderate assistance?

A

pt able to do 50-75%, PT need 25-50%

45
Q

what is maximum assistance?

A

pt able to do 25-49%, PT need 51-75%

46
Q

what is total assistance?

A

pt performs <25%

47
Q

what are the observable motor control constructs?

A
  • symmetry, speed, amplitude, alignment, symptom provocation
  • postural control: verticality, stability
  • coordination: smoothness, sequencing, timing, accuracy
48
Q

what are the six core tasks ANPT recommends for movement analysis?

A

sit, stand, sit to stand, step, walk, reach/grasp/manipulate

49
Q

what are the initial conditions in the movement continuum?

A

posture and environment

50
Q

what are the 3 phases to observe for dynamic tasks?

A

initiation, execution, termination

51
Q

what is initiation (movement continuum)?

A

those changes that occur to overcome inertia of the body at rest (timing, direction, smoothness)

52
Q

what is execution (movement continuum)?

A

intersegmental movements that allow for the movement of COM into a new position (amplitude, direction, speed, smoothness)

53
Q

what is termination (movement continuum)?

A

those changes that occur to decelerate the movement of the COM as the body stabilizes into a new position (timing, stability, accuracy)

54
Q

what are the ask constraints on movement control?

A
  • discrete vs continuous (have beginning and end vs end point determined by performed)
  • closed vs open (relatively fixed/predictable environment vs constantly changing environment)
  • stability tasks vs mobility tasks (static vs moving BOS)
  • non manipulation vs manipulation (not using UEs during movement vs movement of UEs)

mtr ctrl & lrn (9 decks)

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