Motor Control And Motor Learning Flashcards
When are motor abilities and skills acquired?
during motor
development
Do individuals perform movement the same each time?
Individuals rarely perform movement exactly the
same way each time
What must movement systems be able to do?
Movement systems must be able to adapt to
changing demands of the individual and the
environment
What is motor development affected by?
time (age),
maturation (genes), adaptation (physical constraints),
and learning
What contributes to an ongoing process of change throughout life?
Motor development, motor control, and motor
learning all contribute to an ongoing process of
change throughout life
What is motor control?
The ability to maintain and change posture and
movement
What is motor control a result of?
Result of complex neurologic and mechanical processes
including motor, cognitive, and perceptual development
What does motor control allow?
Allows the nervous system to direct what muscles should
be used, in what order, and how quickly, to solve a
movement problem
What is the first movement problem?
overcoming the effects of
gravity
What is the second movement problem?
how to move a larger head
compared to the smaller body (head control)
What are later movement problems?
controlling the
interaction between stability and mobility of the head,
trunk, and limbs
What dictates the type of movement solution needed?
Task to be carried out within
the environment dictates the
type of movement solution
needed
Motor abilities change over time, so _____ may also change.
Motor abilities change over
time so motor solutions to
motor problems may also
change
Motor control emerges from an interaction between _____.
between the
task, the individual, and the
environment
When does motor control occur?
occurs in fractions of seconds at the
cellular, tissue, and organ levels
How does physiologic process need to occur?
quickly to
produce timely and efficient movements
What produces a reflexive motor response?
Sensory or perceptual
information/stimulus
produces a reflexive
motor response
What is feedback?
Feedback is sensory or perceptual information
received as a result of movement
What do feedback and error signals provide?
means to
understand the process of self control and to learn
new motor skills
What does sensory or perceptual input provide?
feedback for
accuracy of movements and posture when
interacting with objects and maneuvering within an
environment
What is there a common element in?
motor control and motorlearning
theories
What is the hierarchic theory?
Top down perspective (most traditional theory) (everything controlled from brain)
What does the hierarchic theory include?
cortex, neural structures, reflexes, postural control
What is the cortex?
- Highest level of control
- All subcortical structures take orders from it
- Directs movement
- Controls voluntary movement
What are other neural structures that can initiate or control movement?
- Basal ganglia
- Cerebellum
- Spinal cord
What are reflexes?
- Gauges nervous system maturation
- Basic unit of movement in motor control
- A pairing of sensory stimulus with a motor response
- Can be simple or complex
What are primitive reflexes?
(simplest)
‒ Occur at spinal cord level
‒ Onset: 28 - 35 weeks gestation
‒ Example: Flexor Withdrawal
What are tonic reflexes?
‒ Occur at brainstem level
‒ Produce changes in muscle tone and posture
‒ Onset: Birth – 6 months
‒ Example: ATNR
What is postural control?
includes balance reactions, righting reactions, and equilibrium reactions
What are balance reactions?
with development, structures above
the spinal cord begin to control posture and movement
(righting, protective, and equilibrium)
What are righting and equilibrium reactions?
(postural responses)
Occur at midbrain and cortex levels
• Onset: Birth and persist throughout life
• Example: Landau Righting
What do these reactions involve?
• Involves head and trunk movements providing body with
an automatic way to respond to movement of COG
within and outside the body’s BOS
• Involves extremity movements to movement of COG
outside the body’s BOS (protective responses – serve as
back up system)
What do tonic reflexes inhibit?
spinal cord reflexes, and
righting reactions inhibit tonic reflexes
What does inhibition allow?
previously demonstrated
stimulus response patterns of movement to be
integrated or modified into more voluntary
movements
What is the development of motor control?
Relationship of mobility/stability of body postures
and the acquisition of automatic postural responses
What is the progression of movement?
Initial random movements (mobility), followed by
maintenance of posture (stability), then movement
within a posture (controlled mobility), and finally,
movement from one posture to another (skill)
What happens with each new posture?
With acquisition of each new posture comes
development of control within that posture
What is stage 1?
(mobility) – Initiation of movement – First 3 months of development – Movements are erratic and often lack purpose – Reflex based
What is stage 2?
(stability) Ability to maintain a steady position in weight bearing,
anti-gravity position
How is stage 2 divided?
Divided into tonic holding and co-contraction
What is tonic holding?
– Occurs at end of shortened ROM and usually involves an
isometric contraction of antigravity postural extensors
– Most evident with prone extension
– Prone: head is held asymmetrically, then held in midline, and
progresses to holding up past 90° from support surface
– Supine: head is turned to one side, then in midline, and
progresses to midline with chin tuck as infant is pulled up
What is co-contraction?
– Simultaneous static contraction of antagonistic muscles
around a joint to provide stability in midline or weight
bearing
– As task is learned co-contraction is decreased to allow the
joint to move more freely (degrees of freedom)
– Allows for holding postures of prone extension, prone on
elbows, all fours, and semi-squat
What is stage 3?
(controlled mobility)
– “Dynamic postural control”
– Once relationship between mobility and stability is
established in prone, all fours, and standing, then
controlled mobility can be superimposed on this
established stability
– If stability of proximal joints is not present then distal
performance may be impaired
When does stage 3 occur?
Occurs when extremities are weight bearing and body
moves (all fours or standing)
What is stage 4?
(skill)
– Mastered after controlled mobility within a posture
– Skilled movements involve manipulation and
exploration of the environment
When does stage 4 occur?
Occurs when mobility is superimposed on stability in
non-weight bearing, the proximal segments stabilize
while the distal segments are free to move, or the
trunk is upright or parallel to the force of gravity
What are examples of stage 4?
creeping and walking
How does postural control develop?
Develops in a cephalocaudal (top to bottom)
direction
What is needed for development of functional movement?
Variability in postural control is needed for
development of functional movement
How is postural control demonstrated?
Demonstrated by ability to maintain alignment of
body parts relative to each other and the
environment
What are functions that maintain alignment?
equilibrium or balance
What is the sequence of development of postural reactions?
righting reactions (head righting, trunk righting), followed by protective reactions (extremities), and finally, equilibrium reactions (starting in prone)
What are righting reactions?
• Responsible for orienting head in space and keeping
the eyes/mouth horizontal
• Involve head and trunk movements to maintain or
regain orientation or alignment
When do righting reactions begin?
Some righting reactions begin at birth but most are
evident at 4-6 months
What is cueing provided by?
gravity, change of head/body
position, vision, and abdominal touch
What does head control develop from?
head righting reactions
neck, optical, and labyrinthine
What does head turning produce?
neck-on-body righting (body
follows head movement)
What does upper or lower trunk turning produce?
body-on-body
righting (body follows upper or lower trunk
movement)
What can either righting produce?
log or segmental rolling
When does head and trunk righting occur?
when weight is
shifted within a BOS (amount of displacement
determines degree of response)
What are slower displacements more likely to elicit?
head
and trunk righting
Where can righting reactions occur?
Can occur in any posture and in response to anterior,
posterior, or lateral weight shifts
When do righting reactions have max influence on posture and movement?
Have maximum influence on posture and movement
between 10-12 months of age (can be present
through age 5)
When are righting reactions no longer present?
if child can come to standing
from supine position without using trunk rotation
(trunk rotation indicates righting around a long axis)
What are protective reactions?
Extremity movements that occur in response to rapid
displacement of the body by diagonal or horizontal
forces
How is the developmental sequence?
very predictable
What is the extension of extremities for?
to prepare for,
or to catch a fall
When is protective staggering of LEs evident?
by 15-17 months
What must an infant be able to do to exhibit protective extension?
to bear weight on extended arms
to exhibit protective extension
What is a useful treatment intervention?
Propping or pushing up can be a useful treatment
intervention
What are equilibrium reactions?
Most advanced postural reactions and last to
develop
What do equilibrium reactions allow the body to do?
Allows body to adapt to slow changes in relationship
to COG with the BOS
What do equilibrium reactions add?
Adds extremity responses to flexion, extension, or
lateral head and trunk movements to regain
equilibrium
When can equilibrium reactions occur?
if the body moves
relative to a support surface, or if the support moves
relative to the body (tilt reactions)
What are the three expected responses to lateral displacement of COG toward the periphery of BOS in standing?
– Lateral head and trunk righting away from weight shift
– Arm and leg opposite direction of weight shift abduct
– Trunk rotation away from weight shift
What happens when COG leaves the BOS?
protective arm extension
may occur, or a protective step or stagger may
reestablish a stable base
What is the developmental sequence and timetable for equilibrium reactions?
– Prone at 6 months
– Supine at 7-8 months
– Sitting at 7-8 months (creeping)
– All fours at 9-12 months (standing and cruising)
– Standing at 12-21 months (↑ walking speed)
What does the memory structure provide?
instructions for control of
actions for future use (nervous system does not have
to create each action from scratch – saves time when
initiating actions)
What is the motor program model theory associated with?
a set of muscle commands specified
at the time of action production which do not require
sensory input
What does this theory have the ability to do?
mentally represent an action as part of
developing motor control
What are the specific neural circuits?
Central pattern generators (CPGs) and stepping pattern generators (SPGs)
What are central pattern generators (CPGs)?
exist in the spinal cord and
are capable of producing a motor pattern (walking)
What are stepping pattern generators (SPGs)?
are located in each leg and
control stepping movements at the hip and knee
What does sensory feedback do?
Sensory feedback adjusts timing and reinforces muscle
activation
What does the systems model describe?
Describes relationship of various brain and spinal
centers working together to control posture and
movement
How is motor control accomplished?
Motor control is accomplished by the complex interaction of many systems of the body • Nervous system • Musculoskeletal system • Cardiopulmonary system • Postural system (considered a system)
What is self-organizing?
Posture and movement are thought to be selforganizing
What is the basic functional unit?
the movement pattern that
emerges from this complex interaction of the
changing body’s system
What are generated in the movement patterns?
Means of mobility (Rolling, creeping, erect standing, and walking)
What is another fundamental characteristic?
feedback (need to know if the movement has been successful)
What is the closed-loop model?
sensory information is used by
nervous system to provide assistance with next action
– Errors can be detected and corrected with practice
What is the open-loop model?
movement is cued by either a
central structure or by sensory information from
the periphery
– Movement is performed without feedback and errors
are detected after the fact
– Fast movements are controlled in this manner
What is the difference between closed-loop and open-loop models (playing a new piano piece)?
– Closed-loop: piece is played slowly, receiving feedback
while learning it (stop and fix errors along the way)
– Open-loop: piece is played quickly from beginning to end
(analyze errors at the end)
What are considered systems in the systems model?
both posture and movement are
considered systems
What is the relationship between posture and movement called?
postural control
What does posture imply?
a readiness to move, an ability to
react to threats to balance, and ability to anticipate
postural needs to support a motor plan
What is a motor plan?
a plan to move (stored in memory)
What kind of process is postural control?
ongoing complex process
What are the components of a postural control system? (7)
limits of stability, environmental adaptation,
musculoskeletal system, predictive central set, motor
coordination, eye-head stabilization, and sensory
organization
What are the limits of stability?
Boundaries of the BOS of any given posture
When is a person stable?
As long as the COG is within the BOS the person is
stable
What is an infant’s stability like?
Infant’s BOS is constantly changing relative to body
size and contact with support surface
What is the cone of stability?
In standing, the area that a person can move within
the limits of stability or BOS is called “cone of
stability”
What does posture adapt to?
Posture adapts to environment in which movement
takes place
What does the sensory system provide?
input that allows generation
of a movement pattern that dynamically adapts to
current condition
Is this movement pattern limited?
This movement pattern is not limited to the typical
postural reactions
What does the musculoskeletal system provide?
Musculoskeletal system provides mechanical
structure for any postural response
– Postural alignment and musculoskeletal flexibility of
all body segments
What does the neurologic system process?
vital sensory
information to choose correct posture and motor
response, to plan for response, and execute response
What do both systems need to do?
Both need to function optimally to appropriately and
accurately maintain balance and movement outcome
What is the predictive central set?
Sensation and cognition will anticipate postural
needs prior to movement as a state of “postural
readiness”
Why must postural readiness be present?
to support
movement and is critical to postural control
Who might lack this anticipatory preparation?
Many adults with neurologic deficits lack this
anticipatory preparation and children with
neurologic deficits may have never experienced this
sensation in this manner
What is motor coordination?
Ability to sequence muscle responses in a timely
fashion to respond to displacements of the COG
within the BOS
What does the CNS generate?
patterns of muscle activity required to
regulate the relationship between COG and BOS
What is an example of motor coordination?
postural sway
What are three common sway strategies in standing?
ankle
strategy, hip strategy, and stepping strategy
What is ankle sway?
Depends on having on having a solid surface in
contact with the feet and intact visual, vestibular, and
somatosensory systems
What is hip sway?
– Activated when BOS is narrower (balance beam)
– Muscles are activated in a proximal-to-distal sequence
(hips to ankles)
What is stepping strategy?
Speed and strength of balance disturbance is
sufficient enough to cause the individual to take a step
to prevent loss of balance or fall (same as LE
protective reaction)
What does the visual system provide?
accurate information about
the surrounding environment during movement or
gait
What does the vestibular system do?
coordinates with the visual system
to maintain a stable visual image of the environment
as the head moves with or without the body
What happens if the head or eyes can’t be stable?
movement can
be impaired
What are three sensory systems used for posture, balance, and motor control?
visual, vestibular, and
somatosensory
What is vision for?
critical for development of balance during
first three years
What happens with inaccurate visual input?
Development of head control is impeded with inaccurate
visual input
What do eyes need to be able to do?
Eyes need to be able to move separately from head, to
dissociate, and to scan surroundings to assess environment
What is vestibular input?
relayed by labyrinths within the
middle ear that detect the head’s relation to gravity
What do early motor behaviors do?
Early motor behaviors stimulate vestibular receptors
What is somatosensory?
the combination of touch and
proprioceptive information received from being in
contact with a supporting surface and from joint
position
When does somatosensory occur first?
Occurs first in form of reflexes and then later from
input from movement of weight-bearing joints in
contact with supporting surface
When is this used for balance?
Not until middle to late childhood is this source of
information consistently used for balance
What is motor control?
Motor control is the control of posture and movement that
supports the initial acquisition of motor abilities and the
continual adaptation to the changing physical demands
encountered
What would happen without motor control?
Without appropriate motor control, motor development would not
proceed normally
What are some constraints?
Constraints could be lack of strength, endurance, and ROM
When does posture have a role in movement?
Posture has a role in movement before, during, and after
movement
– The body tries to anticipate the postural needs before movement
What must the PTA do when treating a person with a movement dysfunction?
When treating a person with a movement dysfunction, the PTA
must prepare them to move before movement is initiated
How can perfect fundamental motor skills be learned?
Automatic postural responses must be unlearned to learn perfect
fundamental motor skills
What is motor learning?
Process which a person learns the skills that make up the
developmental sequence and learns how to execute and
control movement, automatically and voluntarily bringing
about a permanent change in motor performance as a result
of practice or experience
What are two theories of motor learning?
Adam’s closed-loop theory and Schmidt’s schema theory
What is Adam’s closed-loop theory?
sensory information is funneled
back to the CNS for processing and control of motor behavior
(sensory feedback is used to produce accurate movements)
What is Schmidt’s schema theory?
four kinds of information are stored in
memory and analyzed to gain insight into the relationships
among them and form recall schema and recognition schema (relies on open-loop feedback to foster learning)
What are the four kinds of information stored?
- Initial condition under which performance took place
- Parameters assigned to the motor program
- Outcome of the performance
- Sensory consequences of the movement
What is recall schema?
used to select a method to complete a motor task (learner stores this schema and uses it the next time)
What is recognition schema?
helps assess how well motor behavior
performed (represents relationship among initial
conditions, outcome, and sensory consequences)
When does motor learning occur?
when the rules and tasks are
perfected
When is feedback not necessary?
when a motor program is
performed unless the external or internal conditions
pertaining to the movement change
When is open-loop control helpful?
when performing fast
movements in which there is little time for feedback
What are most actions after they are learned?
combinations
of open-loop and closed-loop control
How does the transfer of learning become better?
More closely the practice environment resembles the
actual environment, the better the transfer of
learning
When can broken-down tasks help learn the entire task?
If broken down components of a task are specific to
the entire task, then practicing components
individually can enhance learning the entire task
What does the time it takes to learn a motor task depend on?
– Difficulty of task
– Amount of practice and feedback received
– Motivation to learn task
When does motor learning take place?
Motor learning takes place over a span of hours, days,
weeks, and years
What is learned in infancy?
Task specific abilities of walking, self-feeding, and object
play
What is learned in childhood?
Fundamental motor patterns of running, hopping,
throwing, and catching
What is learned in adolescence/adulthood?
Motor tasks related to jobs and leisure
What are Fitt’s stages of motor learning?
cognitive,
associative, and autonomous
What is the cognitive stage?
• Task is completely new to learner (closed-loop model)
• Great deal of attention must be devoted to learning a new
motor task or relearn a previously known task
• Slightest distraction can interrupt concentration and result in
an unsuccessful attempt
What must learners understand in the cognitive stage?
Learner must understand “what to do” so visual guided
movements are helpfu
Why may the cognitive stage be difficult?
This may be difficult with individuals with cognitive deficits
(CVA, TBI, Down’s Syndrome)
What is the associative stage?
• Person associates aspects of the task’s motor performance
with success or failure
• Learning occurs with each new trial, errors are detected and
corrected with the next attempt
• As small details of the movement are perfected, speed and
efficiency of movement improve
• This phase lasts longer than cognitive
What does the learner concentrate on in the associative stage?
Learner is concentrating on “how to do” the task
Why may the associative stage be difficult?
Difficulties arise with person who have low frustration
tolerance for failure, or has difficulty detecting and
correcting errors due to sensory or motor deficits
What is the autonomous stage?
• Once the task is mastered it can be carried out with little to
no attention to details (walking)
• Once action is started it is completed without conscious
feedback (open-looped model)
• It is possible to make changes to performance but these
changes are slower since there is less attention to detail
What is the learner concentrating on in the autonomous stage?
Learner is concentrating on “how to succeed”
What happens once the autonomous stage is reached?
Once autonomous level is reached, attention can be directed
to other higher-order cognitive activities
What is the Neo-Bernsteinian Model?
Considers learner’s ability to master multiple degrees
of freedom while learning a new skill
What is the novice stage?
learner reduces degrees of freedom that
need to be controlled during the task (“fixes” some joints
so motion does not take place – constrains a joint)
What is the advanced stage?
learner allows more joints to participate
in task releasing some degrees of freedom (coordination
improves)
What is the expert stage?
all degrees of freedom necessary to perform
task in an efficient, coordinated manner are released
(learner adjusts performance to improve efficiency and
speed of movement)
When does movement result?
when an interaction exists among
the mover, the task, and the environment
What are open skills?
are done in environments that are
changing over time (walking on uneven surface)
– Requires the mover to update information constantly and
place attention on incoming information
What are closed skills?
have set parameters that do not change
(walking on level surface)
– Pose fewer problems
How are motor learning and motor development connected?
Motor learning is the functional connection between
motor control and motor development and is an
essential part of motor development
How are movements constrained?
Movements are constrained by the biomechanical
properties of the bones, joints, and muscles thereby
limiting motor development, motor control, and
motor learning
How does the brain function during motor development?
Brain does not function in a rigid top-down manner
during motor development but instead is flexible
allowing other parts of the nervous system that can
best direct and regulate the motor task to initiate
and direct movement (distributed control)
What is the common goal of therapy?
Goal of every intervention is to teach the patient how to
produce functional movements in the clinic, home, and
community
– Motor learning must always occur within the context of function
What do interventions focus on with the hierarch model?
interventions will focus on
inhibiting reflexes and facilitating higher-level postural
reactions in an effort to gain the highest level or cortical
control of movement
What do interventions focus on with the systems approach model?
interventions will focus on
performing a functional task in an appropriate setting
that will impact the quality of life rather than just
practicing a component of the movement thought to be
needed for that task
What must the interventions be?
Interventions must be relevant and meaningful to the
individual, interesting and engaging
– Active participation is required for motor learning
How do movements progress?
– Head control – Trunk control in rolling – Sitting – Trunk control in sitting – Hands and knees position – Upright standing – Walking
What do children learn during play?
During play activities a child learns how to move and also
valuable cause and effect lessons when observing how their
actions resulted in moving themselves or an object
What should be stressed early on?
Early on quality of movement patterns should be stressed
when trying to promote achievement of developmental
milestones
Where should emphasis be as the child grows?
As child grows more emphasis should be placed on functional
movement with less emphasis on quality of movement
Why stress normal movement early on?
Stressing normal movements early on encourages normal
movements
Why intervene early when infant exhibits motor dysfunction?
Intervening early when infant exhibits motor dysfunction
provides an opportunity to learn correct movements from the
start
What objective data should the PTA correct?
– Number of times the patient performed the activity
– What type of cues (verbal, tactile, pressure) result in
better or worse performance
– If the task can be successfully performed in more than
one setting
– Comment on consistency of patient’s motor behavior
what are the types of practice?
• Massed Practice: practice time > rest time
• Distributed Practice: rest time > practice time
• Blocked Practice: same task is repeated several times in a row
• Random Practice: variety of tasks practiced in random order
(rarely same task practiced twice in a row)
• Mixed Practice: combination of Blocked and Random
practiced in same session
• Constant Practice: one variation of motor skill practiced
several times in a row
• Variable Practice: several variations of motor skill practiced in
same session
• Whole Task Practice: task practiced as a complete action
• Part Practice: task broken up into its component parts
What is Constraint-Induced Movement Therapy (CIMT)?
– Involves constraint (restraining) of the noninvolved upper
extremity of a hemiplegic patient and repetitive practice of
skilled activities or functional tasks with the involved upper
extremity (more research needs to be done to establish dosage)
– CIMT increases upper extremity use by inducing cortical
reorganization and mapping which increases efficiency of task
performance in the hemiplegic upper extremity
What is Partial Body Weight Support Treadmill Training (PBWTT)?
– Form of gait practice that does not require person to have
postural control of trunk before attempting to walk
– Lower extremities are maximally loaded for weight bearing
while using a body weight support system and manual cues
– Significantly increased gait velocity and endurance, balance,
independence, and participants walked earlier
