Motor Control and Coordination Flashcards
Motor Deficits include
- Motor control/coordination (“Motor Contol”)
- Balance/Proprioception (“Motor Control”)
- Muscle Strength (“Force”)
- Muscle Endurance (“Energy”)
abarrent movement
abnormal movement
Phase 1 we don’t gain motion but improve ____. We maintain muscle atrophy by providing ____.
quality of movement
isometric exercises.
These will all help in maintaining proximal and distal function.
Phase 1 Presentation
Poor motor coordination/activation
Use functional movement screens
Phase 1 Goal
- Improve movement coordination and muscle activation
- Prevent muscle atrophy
- Movement strategies to decrease pain
Exercises for Phase 1
Submax isometrics
Phase 2 Presentation
Strength and endurance deficits (Impaired muscle force production)
MMT, Set weight and do as many reps as possible, VO2max
Phase 2 Goals
- Restore/improve motion, strength, balance and function
- Enhance ideal movement patterns by enhancing force production of muscle
- Progress to performing more advanced ADL’s
Phase 3 Presentation
Strength and Endurance deficits of mm and limited ability to perform specific FUNCTIONS
Phase 3 Goals
- Enhance neuromuscular control during “high level activities” (based on pt’s goals)
- Enhance endurance, dynamic stability, power, speed, etc.
Phase 3 Strengthening Exercises
- Functional strengthening
- Higher level isotonics
- Exercise to enhance endurance
- OKC and CKC Rhythmic Stabilization
- Continued core stabilization
- Endurance
Usual Examination findings associated with Early Poor Motor Control/Coordination
Subjective:
* History of either acute or chronic pain or any other condition that affects quality of motion (ex: surgery)
* Or: neurological condition affecting motor control (Ex: Stroke, Peripheral Nerve injury, Concussion)
AROM:(CASSS: Control, Amount, Symmetry, Speed, Symptom reproduction)
* QUANITY of motion is variable
* QUALITY of motion especially with functional motions is altered. “ABERRANT MOTION”
Motor:
* Compensations noted during any motor assessment.
Dissociated (“Fractioned”) Movement
Break down motor patterns by facilitating body segments moving independently.
Loss of dissociated movement examples
Examples of abnormality:
* Upper quarter: Dissociated scapular movement; scapular and humeral move in conjunction together such as when they can’t properly do a lateral raise
* Lower quarter: Dissociated pelvic movement
Why do changes occur in acute pain with motor control?
- Protective mechanism; preventing joints to prevent further injury or pain
- Short term benefits by minimizing movement but can lead to long term consequences if it becomes habitual which leads to abberant movement
Examples:
* Antalgic gait; sprained ankle or knee injury
* observe someone turning head with acute neck pain (rotate through their trunk vs. their neck)
Why do changes occur in CHRONIC pain with motor control?
- Pain leads to redistribution of activity within and between muscles
– Increase activation of large superficial, biarticular muscles (leads to muscle tone “tightness”)
– Decrease activation of deep stabilizing muscles (multifidus, gluteus medius, piriformis, deep hip flexors, lower trapezius, transverse abdominis) - Pain and redistribution muscle activity leads to biomechanical changes. In other words…People move differently (more subtle than acute)
- Occurs centrally in the cortical levels in the brain
New theory of motor adaptation to pain
variability: amount of segments moving
Phases 1-3 Triangle Progress
Start in the red and build into strength and endurance
Scapula Dissociation Exercise
Moving the Scapula in isolation
(ex: Scapular clocks)
Humeral Dissociation Exercise
Moving the humerus in isolation of a fixed scapula
(Ex: Prone Horizontal Extension “T”)
Implication of Inadequate Pelvic Dissociation
Rounded: Leads to over loading erector spinae
Hyperextended: Puts too much pressure on facets joints
