Motor Control and Motor Learning

Question 1

Motor Control

Answer 1

• Movement is a product of the contributions of many systems working together within their own maturational level to produce movement tailored for that particular individual at that particular time, within that unique environment, to perform a specific task.

Question 2

Motor output from CNS produces “action” through the following mechanisms

Answer 2

• Body’s effector system
• Muscles and joints
• Degrees of freedom

Question 3

Tasks grouped according to functional categories: (3)

Answer 3

• Bed mobility tasks
• Transfer tasks
• Walking and ADL’s

Question 4

Tasks grouped according to critical attributes that regulate neural control mechanisms: (2)

Answer 4

• Discrete
  
  • Beginning and end
• Continuous
  
  • End point is not inherent characteristic of task
  • e.g., running-ending decided by performer

Question 5

Tasks grouped according to whether the base of support is stable or in motion: (2)

Answer 5

• Stability
  
  • Stable base of support
  • Sitting, standing
• Mobility
  
  • Moving base of support
  • Running, walking

Question 6

Tasks grouped according to whether object manipulation is required

Answer 6

• Adding a manipulation component increases the demand for stability during task performance

Question 7

Tasks grouped according to movement variability: (2)

Answer 7

• Open movements
  
  • Performer adapts behavior within constantly changing environment
  • Tennis, soccer
• Closed movements
  
  • Stereotyped, fixed, predictable

Question 8

Environmental Constraints on Movement: Regulatory

Answer 8

• Movement must conform to regulatory features for goal achievement
• These features shape the movement itself
• Size, shape, weight of object to pick up or surface on which to be stable
• Examples: differently-sized cups require different grasping patterns; walking on an uneven grassy surface impacts the gait pattern differently than walking on a smooth floor

Question 9

Environmental Constraints on Movement: Non-regulatory

Answer 9

• Movement does not have to conform to these features
• May or may not affect movement
• Examples: noise, lighting

Question 10

THEORIES OF DEVELOPMENT

Answer 10

• Theories describe various patterns of behavior and why those behaviors occur

Question 11

Theoretical Views (5)

Answer 11

• Neural-Maturationist
• Cognitive-Behavioral
• Cognitive-Developmental
• Motor Learning
• Dynamical Systems

Question 12

Neural-Maturationist (theoretical view)

Answer 12

• Stages of motor development occur as a result of CNS maturation
• Organizational, top-down control, wherein higher levels exert an influence over lower levels
• These higher levels contain motor programs that store rules for generating movements.
• Appearance/disappearance of reflexes occurs with maturation of the CNS

***Neural-Maturationist Model attributes progressively Sophisticated movements to neurological maturation

Question 13

Neural-Maturationist Theory Limitations (theoretic view)

Answer 13

• Presumes that reflexes still play a role in all movement/ Where do spontaneous/voluntary movements fit in?
• Doesn’t answer question of how novel movements occur

Question 14

Neural Maturationist Theory Clinical Implications

Answer 14

• Function could be predicted by presence/absence of reflexes
• Pediatric PT developed based on this model: exam of reflex development and motor milestones dominate neurological testing
• clinical interventions based on increasing or decreasing reflex effects still used today
• Many current therapeutic exercise approaches have their basis in this model

Question 15

Neural-Maturationist Summary

Answer 15

• Nervous system drives change
• Motor milestones in a predictable, sequential order over time
• What skills change and when
• Useful to tell us if a child is progressing in a typical fashion over time

But there is no How and Why of motor skill change

Question 16

Cognitive Theories

Answer 16

• Focus is on the advancement of the development of thinking (motor skill interaction with other areas of development and the experience of acting on the world

Question 17

Cognitive -Behavioral

Answer 17

• No identifiable stages
• Development occurs through interaction with the environment
• The building blocks are associated pairings in the environment (classical conditioning) and the behavioral consequences of reward and punishment (operant conditioning)

Question 18

Cognitive -Developmental

Answer 18

• Development occurs as a result of sensory and motor interactions with environment at the different stages
• 4 stages of development with cognitive milestones
• first actions use reflexes and progress to voluntary actions

Question 19

Cognitive theories limitations

Answer 19

• The interrelatedness of movement skill to cognition was not described

Question 20

Cognitive theories clinical implications

Answer 20

• Therapist needs to provide a variety of sensory experiences to encourage the child to interact with the environment
• Use direct hand over hand if necessary to provide interaction with objects

Question 21

Motor Learning theory

Answer 21

• Movement conditions, parameters of the motor program, outcome of the movement, and how the movement felt are stored in short-term memory until the following 2 schema can be extracted
  
  • Recall schema (motor components)
    • Movement conditions
    • Motor program parameters (trial and error practice
  • Recognition schema (sensory components)
    • Knowledge of results
    • Sensory feedback from movement

Question 22

Motor Learning from a temporal perspective in 3 stages

Answer 22

• Cognitive Stage - Early stage involves understanding the task, selecting a strategy, and constraining degrees of freedom to make the task easier. Characterized by large number of errors, but important to let patient be an active participant.
• Associative Stage - Intermediate stage allows task refinement, allowing more degrees of freedom with less muscle co-contraction, increasing coordination and decreasing variability of performance
• Autonomous Stage – Final stage wherein speed and efficiency of performance improves and automatic skills emerge. Patients ready for advanced challenges via distraction or new combinations of skills

***Learning is the ongoing process of updating the recognition and recall schema with each movement that is made (during each of the 3 stages):

Repetition Important!

Question 23

Dynamical Systems Theory

Answer 23

• All systems will demonstrate a change over time, & thus are dynamic
• Self-organization of the interaction of systems is the main dynamical action principle
• Collection of individual parts come together as a unit without commands from a higher center
• Non-linear behavioral change occurs in response to a single control parameter of that behavior
• New movements emerge because of readiness within the system

Question 24

Dynamic Systems Theory- Limitations

Answer 24

• De-emphasized neural contributions at both individual and environment levels

Question 25

Dynamic Systems Theory- Clinical implications

Question 26

Which theory is the best???

Answer 26

• One that incorporates best concepts of all previous theories

AND

• One that leaves room for growth as new evidence identifies new insights into motor control

Question 27

What is Motor Learning?

Answer 27

• Acquisition or modification of movement in normal subjects that is relatively permanent
  
  • Result of practice or experience
• Recovery of function: reacquisition of movement skills lost through injury/illness

Question 28

Relating Motor Training vs. Performance vs. Learning

Answer 28

• Training – performer provided with solutions to problems
• Performance – temporary change in behavior observed during practice
• Learning – permanent change in behavior based on the learner’s ability to actively problem solve and derive the solution in a variety of circumstances

Question 29

Stages of Motor Learning/Patient Progress – 2 distinct phases

Answer 29

• Acquisition or practice phase (1)
  
  • Initial fumbling attempts
  • Skills are learned or relearned
  • Indicates performance
• Retention & Transfer phase (2)
  
  • Mastery of a skill
  • Information stored for retrieval and application to novel situations
  • Indicates learning

Question 30

Is training or learning more important in therapy session?

Question 31

• Training is necessary if a client doesn’t know the performance parameters of a task (e.g., walking with crutches)
• But emphasis on Learning is essential to allow client to function without your constant input (e.g. managing obstacles in their environment that were not specifically practiced)

***Only individuals who are involved in their learning are willing

to make the effort to change their behaviors accordingly

Question 32

Practive levels

Answer 32

• Practice is the continuing and repetitive effort to become proficient in a skill
  
  • Practice should be accurate, since faulty practice may lead to development of bad habits and inefficient postures
  • Practice should be active, not passive, and initiated by the patient
  • Practice should incorporate enough variability to allow the patient to explore the perceptual motor workspace and to discover solution to movement dilemmas
  • Practice should be task specific

Question 33

Practice conditions- Transfer

Answer 33

Transfer: amount of transfer is dependent on similarity between two tasks/environments so that the neural processing would be similar {random and variability in practice= greater transfer}

Question 34

Practice conditions- Mental Practice

Answer 34

Mental Practice: enhances skill acquisition-stimulates brain {visualizing motor skill creates electrical activity in the nerves and muscles involved in performing skill}

Question 35

Practice conditions- Guidance vs Discovery

Question 36

Feedback

Answer 36

• Feedback – refers to the use of sensory information for the control of action in the process of skill acquisition. It’s a powerful variable affecting learning.
  
  • Provides guidance, a reference for correction, and motivation
  • Types of feedback
    
    • Intrinsic feedback
    • Extrinsic feedback

Question 37

Intrinsic feedback

Answer 37

• Intrinsic feedback
  
  • Comes from within one’s body via sensory systems, perception (closed loop)
  • Intrinsic feedback may be distorted in patients with neurological lesions

Question 38

Extrinsic feedback

Answer 38

• Extrinsic feedback
  
  • Is augmented information provided from an external source
  • Purpose is to provide person with Knowledge of Results (outcome of movement) or Knowledge of Performance (how they did with each stage of movement)

Question 39

Plasticity occurs under 3 conditions

Answer 39

1. Normal brain development when immature brain begins to process sensory information through adulthood
2. Learning events
3. Brain injury-to compensate for lost functions or to maximize remaining functions

***Intensive rehabilitation if we did not develop normally and/or injury/disease process caused LOF