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Neuro muscular > motor control and skill > Flashcards

motor control and skill Flashcards

1
Q

what is motor control?

A

-understanding of the neural, physical, and behavioral aspects of biological movement.

Stimulus, stimulus identification, response selection, response programming, movement output

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2
Q

what is motor skill

A

coordinated movement strategies with a goal or attaining and action.

Require voluntary control so reflexes are not motor skills

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3
Q

What are Categories of motor skills

A

-Mobility: requires the individual to move the body from one posture to another in a controlled manner. BOS and COG are moving

-stability: static postural control (maintain a posture with unchanging COM and BOS) and dynamic postural control (adjusted and maintained while UE/LE are moving)

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4
Q

gross motor skills are

A

Large muscle groups and body parts, acquired in early childhood

Rolling, crawling, standing

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5
Q

fine motor skills

A

Require control of small muscles, smaller movement with precision

ADLs, eating, buttoning, writing

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6
Q

what is discrete motor skills

A

Have a recognized beginning and end
Sit to stand, lying down, throwing a ball

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7
Q

Serial Motor skills

A

Series of discrete skills with specific order

Transfers bed to w/c

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8
Q

Continuous Motor skills

A

No recognizable beginning or end
Swimming, running

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9
Q

Closed Motor skills

A

Stable and predictable environment
Walking in quiet hall, brushing teeth

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10
Q

Open Motor skills

A

In a constantly changing and unpredictable environment

Shopping in grocery store or mall, crossing busy street

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11
Q

Simple Motor skills

A

Simple that produces an individual movement response
Kicking a ball while sitting

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12
Q

Complex Motor skills

A

Involve multiple actions and motor programs combined to create coordinated movement

Gymnastics, running and kicking a ball

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13
Q

Dual task skills

A

Motor skills that also involves a cognitive or physical task

Walking while talking, walking while holding objects

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14
Q

What are strategies for motor learning skill.

The Recall Stage of motor learning

A

-Cognitive stage: understanding of the task
-Associated stage: practice movements, refine motor programs

-Autonomous stage: practice movement and refine motor processes

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15
Q

Strategies for motor learning/skill

A

-Therapist should model the task exactly how it should be performed (smooth timing and ideal performance)

-Therapist can assist the patient through the movement (guided movements) which can have a positive effect on learning new skills
–It allows the patient to learn the sensation of the movement

-Verbal guidance can also help with improving and learning a task

-Limit verbal and guided movement to only the amount needed. Over guidance can result in over dependence on therapist

-Guidance is more effective in slower positional task and less effective in ballistic tasks

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16
Q

Strategies for motor learning/skill continue

A

Allow the patient to make errors and do not overload with feedback and cuing

As the patient progresses to associative and autonomous stages, the patient should now be focusing on more proprioceptive feedback rather than verbal or guided movements

Guided movements become counterproductive as they can limit active practice

Dual task can be initiated in the last 2 stages

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17
Q

Strategies for motor learning/skill
practice

A

-Has a major affect on motor learning

-Increased practice = increased motor learning
-Therapist should prepare the patient for practice with the desired movement and insure enough time.

-Avoid negative learning situations where the patient is learning improper habits and postures

-When choosing practice, the therapist must consider motivation, attention span, concentration, endurance, and type of task.

-Mass vs distributed practice

-Blocked vs random practice

-Blocked order vs random order vs serial order

-Mental practice

-Part-whole

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18
Q

what is intrinsic feedback

A

information given by the body

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19
Q

what is extrinsic feedback

A

external sources (timers, sensors, therapist)

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20
Q

Knowledge of results is

A

information about the movement outcome

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21
Q

Knowledge of performance

A

information about the nature or quality

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22
Q

Frequent extrinsic

A

feedback can slow retention and foster dependence on an external source

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23
Q

New learners need more immediate feedback but as the learner improves they need less frequent feedback

A
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24
Q

Flexibility (Interventions for motor control/skill)

A

Preventative: ROM and stretching exercises

Limits in range due to tone/contracture may require low load prolonged stretching through splinting or bracing

Include a warmup period to enhance stretching

Cold may help reduce spasms if they are limiting motion

FES, PNF, botox, baclofen can help reduce spasticity if it is present and limiting function

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25
Q

Strengthening/neuro re-ed with(Interventions for motor control/skill)

A

-Isometrics used for stability and maintaining postures and positions

-Concentric and eccentric help initiate movement

-Electromyographic feedback used with sever weakness and used to assist in recruitment of muscles and re-education

-May need to move to gravity eliminated positions

26
Q

what happens with Neuromuscular endurance and fatigue

A

Usually present after a neurological event (CVA) or with a neuromuscular disease (MS)

Patients may be able to generate muscle function but do not have the ability to sustain the contraction over time.

27
Q

Coordination
Interventions for motor control/skill

A

Ataxia: inability to coordinate muscles, joints, and limbs for smooth and accurate movement. Usually due to cerebellar lesion

Usually require hands on support or Ads

Proprioceptive loading, core stability, intense functional training

28
Q

Balance and postural control

A

-First attain postural alignment and static stability upright followed by center of mass control training

-Begin with weight shifting and exploring limits of stability

-Weight bearing on the MORE affected side is encouraged and activity/WB on the unaffected is discouraged

-Can change difficulty of the task: BOS, support surface, sensory inputs, UE support, UE movements, LE movements, trunk movements, functional activities, walking, dual task, modify environment

-Postural strategies training needs to be incorporated (ankle strategy, hip strategy, stepping)

29
Q

Task specific training consistent of

A

-Treatment for neurological patients need to be meaningful, effortful, and task specific

-Task specific based on motor learning principals along with exercise are the core for rehabilitation for patients with neurological deficits

-When choosing tasks, make sure you understand the task demands and consider the above impairments (strength, coordination, flexibility)

-Challenge the patient (not too easy, not to hard)

-Structure the environment, schedule practice, provide feedback, dose the intervention, progress, and encourage problem solving

30
Q

examples of Task specific, structuring the environment

A

-Stationary person in stationary environment (sitting on stable mat)

-Moving person in stationary environment (sitting on ball)

-Stationary person in moving environment (sitting in a wheelchair)

-Moving person in moving environment (moving in the wheelchair)

31
Q

what is dosage

A

-High intensity to achieve neuroplastic changes

-Use the FITT principle (frequency, intensity, time, type)

-Add difficulty by changing environment, moving from stability to mobility, and adding manipulation

32
Q

what is Proprioceptive Neuromuscular Facilitation (PNF)

A

-Intervention that uses the facilitation of total patterns of movement to promote motor learning

-Based on the idea that normal movements are spiral and diagonal

-Emphasis on recovery of function vs compensation

Hands on treatment to facilitate movement patterns

Evolved over the years to integrate principles of motor learning

33
Q

Elements of PNF

Resistance:

A

improves contraction, motor control, strength, and motor learning

34
Q

Irradiation and Reinforcement

A

response to stimulus spread to adjacent muscles

35
Q

Manual contacts

A

guides movement

36
Q

Body position

A

helps control of motion

37
Q

Timing:

A

facilitates normal timing and activation of muscles

38
Q

Verbal cues

A

gives direction for movement

39
Q

Vision

A

: guides movemen

40
Q

Approximation

A

: compression of force to joints that stimulates nerves and facilitates extensor muscles and stabilizing patterns

41
Q

Traction

A

distraction force applied to facilitate flexor muscles mobilizing patterns

42
Q

Patient position

A

-As close to neutral alignment as possible and providing support to body segments as needed

-Muscle position at optimal range allows for maximal contractile response
–Midrange = greatest tension
–Shortened range = weak contractile forces
–Lengthened = optimal stretch for spindle

-Changing the patient’s positon can emphasize certain segments of a pattern and alter demands

43
Q

Therapist position

A

Positioned directly in line with the desired motion to optimize resistance

44
Q

Manual contacts

A

-Hand placement overactive muscles to guide movement, facilitate strength and contraction, also can provide resistance

-Lumbrical grip is used to provide comfort

45
Q

Verbal cues

A

Clear and concise
Focused on preparation, action, and correction

46
Q

Patterns of movement

A

Normal functional synergistic patterns are facilitated

47
Q

Timing

A

Sequence of muscle activity for smooth and coordinated movement
Normal timing is distal to proximal

48
Q

Appropriate resistance

A

Resistance facilitates muscle contraction

Appropriate resistance allows for smooth and coordinated contraction

49
Q

Approximation

A

Joint compression used to facilitate muscle responses in extensor patterns during stabilization

Can be applied manually or positions

50
Q

Traction

A

Elongation of an extremity

Applied throughout the arc of motion and is used to facilitate muscles

51
Q

Visual Input

A

Patient uses vision as a source of feedback to guide movements

52
Q

Irradiation and reinforcement

A

Overflow of neuronal excitation from stronger motor units to motor units that may be weaker or inhibited

Spread of expansion of muscle response from stronger muscles to weaker muscles

53
Q

Stretch

A

Lengthened muscle and stretch reflex are used to initiate movements and to facilitate contractions

Verbal cues should be synchronized with the stretch to enhance movement

54
Q

Rhythmic Initiation

A

Used to promote learning of new movement, improve coordination, and promote relaxation and independent movement

4 phases of movement:
1. passive movement through range 2. active assisted movement
3. independent movement
4. resisted movement

55
Q

reversals of Antagonists

A

Dynamic reversals (isotonic reversals): use isotonic concentric contractions of agonists then antagonists performed against resistance

Stabilizing reversals: alternating contraction with minimal movement (slow reversals) progressing to smaller ranges and stabilizing holds of first agonists then antagonists

56
Q

Rhythmic stabilization

A

Uses isometric contractions of antagonist patterns with focus on contraction of muscles

Start on one body part in one direction and another body part in opposite direction

57
Q

Repeated stretch

A

Repeated contractions

Repeated isotonic contraction directed to the agonist muscles, initiated by quick stretch and using resistance

Can be used in lengthened range for weaker muscles of just in the range that is weaker

58
Q

Combination of Isotonics

A

Uses concentric, isometric, and eccentric contractions of agonists muscles without loss of tension.

Limb is resisted moving through the range followed by stabilizing contraction (holding) and then an eccentric lengthening contraction, moving slowly back to starting position.

No relaxation between contractions

59
Q

Timing for emphasis

A

Alters the normal timing of a pattern using resistance to enhance more localized contraction

Allow irradiation to occur

Used for weak or poor coordination

60
Q

contract-relax (CR)

A

Stretching facilitation that is used at a limited point of ROM

Therapist asks for a strong contraction in the range restricting (antagonists)

Contraction is held for 5-8 seconds enhancing relaxation

Voluntary relaxation and active movement then follows

Works through reciprocal inhibition

61
Q

Hold-relax (HR)

A

Stretching facilitation performed in a position of comfort and below level of pain

Patient actively moves the limb to the pain free end ROM

A strong isometric contraction of the antagonist is resisted followed by relaxation and passive movement into the new range

62
Q

Replication (Hold-relax-active movement)

A

Stretching technique that is performed with the patient in the shortened range

Isometric contraction is resisted followed by relaxation and passive movement to lengthened range then an isotonic contraction through the range into the end position again

Goal is increasing ROM

Neuro muscular (12 decks)

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