Motor Control, Coordination & Reach Flashcards
Motor Control?
The unconscious ability to make continuous postural adjustments & regulate or direct movement
Eg) if picking up a chair I’m not thinking about posture
Selective Movement?
The ability to control movements at each individual joint
The final stage of Brunnstrom’s stages of motor recovery
Coordination?
The interaction of multiple muscles in the limb that allows for the production of accurate controlled movement.
The 3 components to movement?
Velocity (speed)
Direction
Force
Pre-requisites for Coordination?
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
Protective Extension?
Arms go out if falling
Righting Reactions?
Body moves but head stays neutral
Equilibrium Reactions?
Helps maintain us in alignment
Eg) if balance board goes up we bring our body back to maintain center of gravity
Ataxia?
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
Adiadochokinesia?
Unable to do rapid alternating movements
Test = clapping hands then knees fast
Dysmetria?
Unable to estimate the ROM needed to reach a target
Test = finger to nose
Dystonia?
Faulty muscle tension or tone
Results in twisting and repetitive movements
Athetoid movements:
- a form of dystonia
(slow, large writhing worm-like movements)
Dysarthria?
Faulty speech production
Slurred speech
Ballism?
Continuous, gross, abrupt contractions
Brunnstrom’s 6 Stages of Motor Recovery?
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
Components of Reach?
Scapula:
- Upward rotation
- Abduction/protraction
Shoulder:
- Elevation, flexion, depression
- Abduction , external rotation
Elbow:
- Extension
- Supination/pronation
Wrist:
- Extension
- Ulnar deviation
Treatment Principles of Neuromuscular Control?
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
Treatment for Coordination?
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
Proprioceptive Neuromuscular Facilitation (PNF)?
Treatment based on normal movement patterns
Diagonal (mass movement) patterns
Facilitation:
- Verbal and visual cues
- Manual contact, stretch, traction, approximation
- Repetition, rhythmic contraction, relaxation
