Motor Control, Coordination & Reach

Question 1

Motor Control?

Answer 1

The unconscious ability to make continuous postural adjustments & regulate or direct movement

Eg) if picking up a chair I’m not thinking about posture

Question 2

Selective Movement?

Answer 2

The ability to control movements at each individual joint

The final stage of Brunnstrom’s stages of motor recovery

Question 3

Coordination?

Answer 3

The interaction of multiple muscles in the limb that allows for the production of accurate controlled movement.

Question 4

The 3 components to movement?

Answer 4

Velocity (speed)
Direction
Force

Question 5

Pre-requisites for Coordination?

Answer 5

Voluntary control of muscles

Voluntary control of postural tone:
(Postural mechanisms)
- Protective extension
- Righting reactions
- Equilibrium reactions

Balanced interaction between muscle groups:
- while agonist contracts the antagonist relaxes and joint-stabilizers co-contracts

Intact sensory systems:

• Proprioception
• Body schema
• Spatial awareness

Question 6

Protective Extension?

Answer 6

Arms go out if falling

Question 7

Righting Reactions?

Answer 7

Body moves but head stays neutral

Question 8

Equilibrium Reactions?

Answer 8

Helps maintain us in alignment

Eg) if balance board goes up we bring our body back to maintain center of gravity

Question 9

Ataxia?

Answer 9

Gross lack of coordination of muscle movements:

• impaired gross coordination and gait
• errors in range, speed and force of movement
• Staggering gait,
• Wide BOS,
• No arm swing
• Lack of postural stability

Question 10

Adiadochokinesia?

Answer 10

Unable to do rapid alternating movements

Test = clapping hands then knees fast

Question 11

Dysmetria?

Answer 11

Unable to estimate the ROM needed to reach a target

Test = finger to nose

Question 12

Dystonia?

Answer 12

Faulty muscle tension or tone

Results in twisting and repetitive movements

Athetoid movements:
- a form of dystonia
(slow, large writhing worm-like movements)

Question 13

Dysarthria?

Answer 13

Faulty speech production

Slurred speech

Question 14

Ballism?

Answer 14

Continuous, gross, abrupt contractions

Question 15

Brunnstrom’s 6 Stages of Motor Recovery?

Answer 15

STAGE 1:

• Low tone
• no voluntary movement

STAGE 2:

• Emerging tone/not normal = between normal & high
• Emerging spasticity, hyper-reflexia
• Mass patterns of movement

STAGE 3:

• High tone (peaks)
• Strong spasticity
• Voluntary movements (synergies only)

STAGE 4:

• Slightly lower tone
• Emerging voluntary control in isolated joint movements

STAGE 5:

• Almost normal tone
• Increasing voluntary control (out of synergies)

STAGE 6:

• Normal
• Control and coordination near normal

Question 16

Components of Reach?

Answer 16

Scapula:

• Upward rotation
• Abduction/protraction

Shoulder:

• Elevation, flexion, depression
• Abduction , external rotation

Elbow:

• Extension
• Supination/pronation

Wrist:

• Extension
• Ulnar deviation

Question 17

Treatment Principles of Neuromuscular Control?

Answer 17

GOAL = improve muscle strength, precision control of single muscles

FOUNDATION SKILL
- precursor to coordinated movement

Requires conscious attention

Guided movement of individual muscles:

• Move through ROM, feel the motion
• Provide visual/tactile cueing & feedback
• Contract muscle and move through ROM
• Repetition required

Question 18

Treatment for Coordination?

Answer 18

GOAL = achieve multi-muscle motor patterns that are smooth, fast, precise, efficient, strong and automatic

Requires intact neuromuscular control

Conscious awareness (very tiring!!)

• Give short, frequent breaks
• Utilizes pre-programmed motor patterns

Part/Whole Training:

• Perfect components and build on sequence
• Start simple and slow
• Provide visual/tactile/prop feedback (attend to sensations)
• Repetition required
• Functional activities use existing motor plans

Grading:

• Precision (large vs small target)
• Number of components - building on learning (part of whole)
• Change in task demand - conscious effort (speed & force)
• Complexity (changes in direction)
• Amount of support provided

Increase challenge without compromising
quality of movement

Question 19

Proprioceptive Neuromuscular Facilitation (PNF)?

Answer 19

Treatment based on normal movement patterns

Diagonal (mass movement) patterns

Facilitation:

• Verbal and visual cues
• Manual contact, stretch, traction, approximation
• Repetition, rhythmic contraction, relaxation