Motor Control Theory

Question 1

Upper motor neuron (UMN)

Answer 1

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.

Question 2

Lower motor neuron (LMN)

Answer 2

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

Question 3

Motor control

Answer 3

ability to regulate and direct the mechanisms essential to movement. Control of movement already acquired. The outcome of motor learning.

Question 4

Neurological systems collaborate to makes motor control possible

Answer 4

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.

Question 5

movement (three parts)

Answer 5

Task, Individual, and the environment

Question 6

what we look at in persons with CNS insult for evaluation

Answer 6

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

Question 7

Tone

Answer 7

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

Question 8

Normal tone

Answer 8

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

Question 9

muscle tone continuum

Answer 9

High tone-
Rigidity,
Spasticity,
Normal,
Hypotonia,
Flaccidity
Low tone-

Question 10

Flaccidity

Answer 10

Complete loss of muscle tone

Question 11

Hypotonia

Answer 11

Reduction in muscles stiffness,

Characterized by low tone, weak neck and trunk control, poor muscular co-contraction, limited stability

Question 12

Spasticity

Answer 12

Hypertonicity

Question 13

Rigidity

Answer 13

Hypertonicity with heightened resistance to passive movement

Question 14

Modified Ashworth Scale

Answer 14

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

Question 15

Clonus

Answer 15

Uncontrolled oscillations in spastic muscle groups.

Repetitive contractions in the antagonistic muscles in response to rapid stretch. Weight bearing activity can stop it.

Question 16

Cogwheel rigidity

Answer 16

Jerky resistance

Question 17

Clasp knife syndrome

Answer 17

Severe rigidity- sustained stretch will relax muscle group and give way.

Question 18

Tone following insult

Answer 18

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.

Question 19

Postural Control

Answer 19

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)

Question 20

Normal postural control and mechanisms

Answer 20

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.

Question 21

Balance

Answer 21

controlling the center of mass (COM) in relation to the base of support (BOS)
Static balance
Dynamic balance

Question 22

reflexes

Answer 22

righting reactions, equilibrium reactions, protective reactions, primitive reflexes (can be affected by head injury)

Question 23

Coordination

Answer 23

ability to produce accurate, controlled movement

Question 24

Synergy

Answer 24

Abnormal or disordered motor control

Question 25

Coactivation

Answer 25

agonist and antagonist muscles both fire, preventing functional movement

Question 26

features of coordinated movement

Answer 26

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

Question 27

Incoordination

Answer 27

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).

Question 28

Secondary effect factors that impair coordinated mvmts

Answer 28

Contractures, pain, edema, subluxation, decreased endurance- muscular and cardiovascular

Question 29

Motor learning

Answer 29

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.

Question 30

when does motor learning occur

Answer 30

during normal motor development as the NS matures, relearning motor skills post injury or disease, requires practice and feedback

Question 31

Training

Answer 31

temporary change that occurs when performer is provided with solution to problems. results in short term performance capabilities.

Question 32

Learning

Answer 32

relatively permanent change in capability for responding that occurs as a result of practice or experience

Question 33

Factors influencing motor learning

Answer 33

Stages of learning, type of task, feedback, practice,

Question 34

Stages of motor learning- Cognitive (verbal) stage

Answer 34

info gathered about task demands, movement slow with lots of errors, explanations and demonstrations valuable.

Question 35

Stages of motor learning- Associative

Answer 35

Distinguish between correct performance and error, | attention to finer details

Question 36

Stages of motor learning- Autonomous stage

Answer 36

Skill is automatic, does not require attention, | performance is stable

Question 37

Feedback

Answer 37

``` provides guidance, reference for correction, and motivation. Sensory feedback (sensory information) ```

Question 38

types of Feedback- Concurrent

Answer 38

offered during movement

Question 39

Feedback- terminal

Answer 39

offered at the end of movement

Question 40

Feedback- Intrinsic

Answer 40

feedback from individual's sensory systems as a result of movement.

Question 41

Feedback-Extrinsic

Answer 41

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.

Question 42

Practice

Answer 42

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

Question 43

Practice- massed

Answer 43

practice time is greater than amount of time between trails (fatigue)

Question 44

Practice- distributed

Answer 44

rest time between trials equals or is greater than time in trial.

Question 45

Practice- constant

Answer 45

Performance of task in same way (may improve performance but fatiguing, less effect)

Question 46

Practice- variable

Answer 46

Perform task in different way by varying characteristics of the task (improves ability to generalize to various situations)

Question 47

Practice- blocked

Answer 47

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.

Question 48

Practice- random practice

Answer 48

practicing a series of tasks in a random order, | random ordered series of tasks

Question 49

Practice- part practice

Answer 49

Practicing a subset of task component, | only action of brushing teeth, no set up

Question 50

Practice- whole practice

Answer 50

practicing the entire task, | set up and put away along with teeth brushing

Question 51

Skill acquisition

Answer 51

the initial learning of a new skill, feedback: frequent extrinsic, concurrent Practice: physical and mental, repetition, consistency Provide manual and verbal cueing.

Question 52

Retention and Transfer

Answer 52

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

Question 53

treatment assumptions

Answer 53

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.