Motor Control Theory Flashcards
Upper motor neuron (UMN)
carries motor messages from the primary motor cortex to the CN nuclei (the brainstem) or to the interneurons in the ventral horn. part of the CNS. (the brain and the spinal cord) typically spasticity will show up. carries messages to the brain and spinal cord.
Lower motor neuron (LMN)
carries motor messages from motor cell bodies in ventral horn to skeletal muscles in periphery. part of the PNS. Includes cranial nerves, conus medullaris, causa equina, and ventral horn. carries messages from ventral horn to skeletal muscles in periphery. presents itself as flaccid
Motor control
ability to regulate and direct the mechanisms essential to movement. Control of movement already acquired. The outcome of motor learning.
Neurological systems collaborate to makes motor control possible
Cerebral cortex- motor, visual, auditory, cognition, intellect.
Basal Ganglia- Coordination, tone, equilibrium.
Cerebellum- coordinated movements.
Brain stem- righting reactions.
This is what you look at if someone is having issues with movement.
movement (three parts)
Task, Individual, and the environment
what we look at in persons with CNS insult for evaluation
Selectie movements- what are we trying to get them to do, Tone, Postural control and mechanism -balance -reflexes (primitive, equilibrium, righting reactions), Coordination -types -involuntary movements
Tone
resistance of a muscle to passive elongation or stretching. resistance of a muscle to passive elongation or stretching. involuntary resistance in your muscle to the movement
Normal tone
effective co-activation of axial and proximal joints,
Can maintain position of limb passively places and released,
balances agonist and antagonist muscle tone,
ease of shifting from stability to mobility and vice versa,
ability to use muscles in groups or separately,
slight resistance in response to passive movement
muscle tone continuum
High tone- Rigidity, Spasticity, Normal, Hypotonia, Flaccidity Low tone-
Flaccidity
Complete loss of muscle tone
Hypotonia
Reduction in muscles stiffness,
Characterized by low tone, weak neck and trunk control, poor muscular co-contraction, limited stability
Spasticity
Hypertonicity
Rigidity
Hypertonicity with heightened resistance to passive movement
Modified Ashworth Scale
0- No increase in muscle tone,
1- slight increase in muscle tone, manifested by a catch or by minimal resistance at the end of the ROM when the affected part is moved in flexion or extension,
1+- Slight increase in muscle tone, manifested by a catch, followed by minimal resistance throughout the remainder (less than half) of the ROM,
2- More marked increase in muscle tone through most of the ROM, but affected part easily moved,
3- Considerable increase in muscle tone, passive movement difficult,
4- Affected part rigid in flexion or extension,
9- Unable to test
Clonus
Uncontrolled oscillations in spastic muscle groups.
Repetitive contractions in the antagonistic muscles in response to rapid stretch. Weight bearing activity can stop it.
Cogwheel rigidity
Jerky resistance
Clasp knife syndrome
Severe rigidity- sustained stretch will relax muscle group and give way.
Tone following insult
Typically flaccid first 48 hours,
Followed by increasing resistance to PROM,
Spasticity pronounced in UE flexor muscles and LE extensors,
Treatment: encourage voluntary movement, ROM, meds, splinting,
Goal is to normalize tone.
Postural Control
ability to maintain a steady position in weight bearing, antigravity posture.
Influenced by: neuromuscular mechanisms (postural alignment, muscle tone, and postural tone), Musculoskeletal mechanisms (ROM and strength), Sensory mechanisms (vision, vestibular, somatosensory), Perceptual mechanisms (body image, laterality), Cognitive mechanism (attention and judgement)
Normal postural control and mechanisms
automatic movements: provide an appropriate level of stability and mobility,
Automatic reactions develop early in life and allow for: trunk control and mobility, head control, midline orientation, weight bearing and weight shifting in all directions, dynamic balance, controlled voluntary limb movements.
Balance
controlling the center of mass (COM) in relation to the base of support (BOS)
Static balance
Dynamic balance
reflexes
righting reactions, equilibrium reactions, protective reactions, primitive reflexes (can be affected by head injury)
Coordination
ability to produce accurate, controlled movement
Synergy
Abnormal or disordered motor control
Coactivation
agonist and antagonist muscles both fire, preventing functional movement
features of coordinated movement
Precision, Smoothness (quality of movement), appropriate force and muscle tension Rhythm (how you transition from one mvmt to another), speed (how quickly you perform mvmt), Minimum # of muscle groups used- efficiency
Incoordination
extraneous, uneven, or inaccurate movements. Caused by: trauma to muscle or peripheral nerve disease, CNS dysfunction (cerebellar, posterior column disfunction, basal ganglia dysfunction, frontal or postcentral cortex).
Secondary effect factors that impair coordinated mvmts
Contractures, pain, edema, subluxation, decreased endurance- muscular and cardiovascular
Motor learning
the study of the acquisition and modification of movement
a set of processes associated with practice and experience that leads to permanent change in behavior or capacity to respond.
when does motor learning occur
during normal motor development as the NS matures, relearning motor skills post injury or disease, requires practice and feedback
Training
temporary change that occurs when performer is provided with solution to problems. results in short term performance capabilities.
Learning
relatively permanent change in capability for responding that occurs as a result of practice or experience
Factors influencing motor learning
Stages of learning,
type of task,
feedback,
practice,
Stages of motor learning- Cognitive (verbal) stage
info gathered about task demands,
movement slow with lots of errors,
explanations and demonstrations valuable.
Stages of motor learning- Associative
Distinguish between correct performance and error,
attention to finer details
Stages of motor learning- Autonomous stage
Skill is automatic, does not require attention,
performance is stable
Feedback
provides guidance, reference for correction, and motivation. Sensory feedback (sensory information)
types of Feedback- Concurrent
offered during movement
Feedback- terminal
offered at the end of movement
Feedback- Intrinsic
feedback from individual’s sensory systems as a result of movement.
Feedback-Extrinsic
feedback from the environment (therapist or a device)
KR/knowledge or results: knowledge of what the movement produces (outcome) in terms of achieving goal or result. correcting errors.
KP/Knowledge of performance: knowledge about the movement pattern or process used during task performance (biofeedback, verbal comments, mirror) what they see and what they are feeling.
Practice
Effort to become proficient.
Physical practice,
Mental practice
Should be active and accurate- correct them if they are wrong
Motor skill increases directly in relation to amount of practice.
Effect varies depending on age, dx, amount and type of practice and task specifiticty
Practice- massed
practice time is greater than amount of time between trails (fatigue)
Practice- distributed
rest time between trials equals or is greater than time in trial.
Practice- constant
Performance of task in same way (may improve performance but fatiguing, less effect)
Practice- variable
Perform task in different way by varying characteristics of the task (improves ability to generalize to various situations)
Practice- blocked
practicing each task in a block before progressing to a new task (better for cognitive impairment),
specific order and you do it in that exact same way every time.
Practice- random practice
practicing a series of tasks in a random order,
random ordered series of tasks
Practice- part practice
Practicing a subset of task component,
only action of brushing teeth, no set up
Practice- whole practice
practicing the entire task,
set up and put away along with teeth brushing
Skill acquisition
the initial learning of a new skill,
feedback: frequent extrinsic, concurrent
Practice: physical and mental, repetition, consistency
Provide manual and verbal cueing.
Retention and Transfer
Long term learning of skill and ability to generalize skill to new contexts.
Feedback: less frequent, terminal
Practice: promote entire pattern, encourage problem solving, variable
Allow for error and refinement, don’t over cue
treatment assumptions
Mobility is established 1st, then proximal stability, then controlled mobility, and finally distal skilled movement.
Gross to fine
midrange before end range
movement should be relearned in purposeful patterns rather than specific actions
repetition is key for gaining motor control.
