motor learning theories Flashcards
reflex theory
assessment:
treatment:
movement is controlled by a response to a external stimulus
assessment:
- movement able to be interpreted by presence or absence of cotrolling reflexes (test for reflexes)
treatment:
- able to stimulate desired and inhbit undesired reflexes to improve function
- use sensory input to control motor output
rely heavily on feedback
hierarchical theory
assessment:
intervention:
- top down organization, brains higher levels control the middle and lower levels
- reflexes emergy only with cortical damage
assessment:
- allows for better understanding of clinical presentation with stroke and crebral palsy (when the brain has damamge we see hierarchical theory)
intervention:
- managment of reflexes present following cortical injury
- understanding of how the cortexcan exert influence over the primitive reflexes
Neuromaturational theory of development
key assumptions for recovery of function?
assessment
intervention
- normal motor development is attributed to corticalization
- recovery of function (take some one back to the very beginning/basics and relearn)
key assumptions:
- functional skills will automatically return once abnormal movement patterns are inhibited and normal movement patterns facilitated
assessment:
- identify presence or absence of normal and abnormal reflexes controlling movement
treatment:
- modify reflexes that control movement
- increaseing focus on explicitly training function
motor programming theories:
What is a CPG?
central generated motor patterns/programs (CPG):
more flexible than the concept of a reflex, as it can be aactivated either by sensory stimuli or by central processes
- movement is possible in the absence of reflexive action
- sensory input has an important function in modulating action
- reflexes do not drive action
motor programming: CPG
assessment
interventions
assessment:
- increased diagnostic ability, now including abnormalities in CPG’s or higher lvl programs
interventions:
- adds the importance of retraining patients using the correct “rules” for action (error managment)
- supports using specific functional task training vs. isolated muscle or joint training
- reduced focus on inhibiting reflexes and reducing spasticity (we are trying to work w/them)
- mental rehearsal of actions can be effective
systems theory
- looked at hte body as more than the nervous system, identify8ing the role that external and internal forces play in movement
- identified many degrees of freedom that need to be controlled
- still uses top–> down model
What is degrees of freedom problem?
- body has multiple muscle and joints
- control of these is imperative to lead to successful movement
- offers a multitude of options in how to complete a teask = multiple equivalent solutions
systems theory:
Hierarchical neural model
what is level 1? level 2? level 3? level 4?
- level of tonus
a. muscle language
b. resides in spinal cord
c. never leads, background level - levels of synergies
a. resides in the middle brain
b. constrains degrees of freedom of motor apparatus
muscles that work together = a syngergy
systems theory:
Hierarchical neural model
what is level 3? level 4?
- level of space
a. facilitates purposeful, goal-oriented and dextrous movements within environment
b. sensory input from previous experiences and external space - level of action
a. resides in the frontal cortex
b. contorls and organizes movement sewquences to attain actions goal
hierarchical neural model:
what is motor equivalence?
level of action finds several potential solutions for same problem
ecological theory
- the person, the task and the environment interact to influence motor behavior and learning
ecological theory
assessment:
interventions:
assessment:
- observe tasks being performed in various environments
- determine personal goals to increase motivation, learning
interventions
- help patient explore multiple ways in achieving functional task
dynamical systems theory
evolved from systems theory - adds i n the concept ofself-organization – motor patterns are not dictated by a central controller but rather from interactions of body systems and environmental constraints
- encourages variablity in practice, understanding that changes in constraints (fatigue, injury, surface, etc.) can lead to changes in movement patterns
dynamical systems theory
assessment
interventions
assessment:
- observe tasks being performed in various environments and at different times of day
interventiona:
- provide opportunity to explore different movement solutions
brunnstrom approach
developed for stroke rehabilitation
- follows the belief taht motor recovery follows a predictable sequence
- reflexive movements –> voluntary control
this approach is not widely used!! ( modern rehab favors functiona la nd task based training over reliance on syngergie)
neurodevelopmental treatment (NDT)
developed for individuals with cerebral palsy (CP) and stroke (CVA)
- origionally based on the idea that abnormal reflexes and movement patterns result from damage to higher CNS centers
modern update: NDT has evolved to incorporate motor learning and task oriented principles
rood approach
- emphasizes the use of sensory stimulit (icing, tapping, deep pressure) tofaciliate or inhibit muscle activity
- based on the idea that motor control develops in a predictable hierarchical sequence
- follows a developmenta ldequence (mobility -> stability -> controlled mobility -> skill)
proprioceptive neuromusuclar facilitation (PNF)
- attempts to promote the response of the neruve impulses to recruit muscle through stimulation of the proprioceptors in addition to other sensory stimuli in the beginning, decreasing with learning (muscle spindle and GTO)
- uses diagonal and psiral movement patterns that mimic natural functional motions (reaching, walking)
waht principles is PNF based on?
3 of them
irradiation (spreading of muscular activation)
reciprocal inhibition (activating one muscle group while relaxing another)
rhythmic initiation (gradual progression from passive to active movement)
What is PNF used?
- neuroloigcal rehab: used for patients with stroke, spinal cord injury and parkins to retrain movement and improve motor control
- orthopedic & sports: helps increase ROM, reduce muscle tightness and enhance functional strength
- flexibility & mobility: commonly used in stretching techniques like contract-relax, and hold-relax
task-oriented/systems model
multiple body systems overlap to activate synergies for the production of movements that are organzied around functional goals
What are the 3 key things for movement in the task-oriented/system model?
- nature of the task/activity
- characteristics of the environment
- resources of the individual
goal and task oriented behavior
systems underlying motor control:
sub-systems within the individual?
attrbutes of the task?
environmental constraints?
subsystems:
- posture
- cognition
- action
attributes:
- mobility
- stability
- manipulation
constraints:
- regulatory
- nonregulatory
task-oriented/systems model
assessment:
intervention:
assessment:
- observe performing specific task
- motivational interviewing
interventions:
- use of task specific training
- practice performed in a variety of conditions
- environmental contexts should be modified
task-oriented/systems model
environment:
what is regulatory vs nonregulatory?
regulatory: environamental aspects that shape the movmement
ex: type of flooring, weight and size of cup (they have to move differently)
nonregulatory: may affect performance but movement does not have to conform
ex: background nose, distractions, color of cup (can move differently but not necessary)
movement characteristic classifications:
- fine motor vs gross motor
- discrete vs. continuous vs serial
- stationary vs. mobile
- manipulation vs no manipulation
open and closed loop theory:
level 1 open loop control
executive motor –> movement
example: golf swing
has a clear beginning and clear end
open and closed loop theory:
level 2 closed loop control
executive motor –> movement –> feedback via muscles
ex: gymnastics
there is a start, an end and the muscles refining the movement
open and closed loop theory:
level 3 closed loop control
executive motor –> movement –> feedback via brain
ex: soccer
it is continuous and requires the brain to think about the next step
Walking barefoot on the beach is best categorized as waht type of task?
continuous
playing piano is best categorized as what type of task?
serial (discrete movements put together)
tapping on triceps muscle to elicit UE extension during a reaching task is an example of what theory?
reflex theory
using PNF D2 pattern to facilitate improved UE control is an example of what theory
hierachial theory
gait training in the parking lot on uneven surfaces is an example of what theory?
ecological theory
What are the 5 elements of the APTA model of practice?
examination
evaluation
diagnosis
prognosis
intervention
Evidence-based clinical practice (EBP)
philosophical approach to clincial practice that integrates best available research, clinician expertise and client characteristics
What is a task-oriented approach to clinical practice?
- a multi-faceted approach to clinical management of motor control challenges in patients with CNS apthology
- integrated within the ICF framework
What are the 4 points to task oreinted approach to examination?
- evaluate functional activities and participation
- describe the strategies used to accomplish functional skills
- quantify the underlying sensory, motor and cognitive impairments that constrain perforamnce of functional activities and restrict participation
- recognize the importance of contextual factors (evnironemtnal or personal) that affect how an individual functions in a social physical context
What is task specific analysis?
- provides a clearer picture of the patients functional skills related to a limited set of tasks the clinician will be directly involved in retraining
- basic functional movements (like sit to stand)
- balance and posture
- upper extremity skills
- locomotioin and mobility
What are the 6 core tasks developed by Quinn et al 2021 for movement analysis of tasks
- sitting
- sit to stand
- standing
- walking
- step up/down
- reach/grasp/manipulate
the postural systems look at what 6 components?
- msk
- cognitive resources
- coginitive strategies
- sensory organization
- sensory systems
- muscle synergies
What 6 things does the balance evaluation systems test (BESTest)?
- biomechanical constraints
- stability limits/verticality
- anticipatory postural adjustments
- postural responses
- sensory orientation
-stability in gait
What 6 things are components of motor control?
- agility
- balance
- speed
- power
- coordination
- reaction time
coordination is more qualitative than quantitative and includes?
- heel to shin
- finger to nose
-rapid alternating movements (RAM)
What is degrees of freedom problem (DoF or df)?
- number of independent components in a control system and the number of ways each component can vary
- control problem that occurs in the designing of a complex system that must produce a specific result
What uses angle/angle diagrams?
coordination as it improves quantitative nature
what are the 3 types of reaction time?
simple: 1 stimulus and 1 response
choice: more than 1 stimulus but each stimulus has adesignated response
discriminate: multiple stimuli but only 1 response
What can reaction time (RT) tell us?
- infer what a performer does to prepare an action
- identify the environmental context information a person uses to prepare an action
assess the capabilities ofa person to anticipate a required action and determine when to initiate it
How would you apply events and time intervals of reaction time and movement time in the clinic?
recovery vs compensation?
recovery: returning capability of the individual to perform a task using mechanisms used prior to injury (get function back/their normal)
compensatory strategies: Atypical appraches that take advantage of the patients resudual abilities (if working with stroke you probably are wokring towrad compensation. they don’t have a limb functioning like it used to –> eventually could switch to recovery)
- critiera can inlcue time ( acute vs chronic), nature of impairment (temporary vs permanent) etc.
*working with neuro you make be utilizgin compensatory strategies more than recovery
the CNS must consider attributes of environment when planning task-specific movments
regulatory:
nonregulatory:
regulatory: environmental aspects that shapes the movement (type of flooring, weight and size of cup)
nonregulatory: may affect perforamnce but movement does not have to conform (background noise, distractions, color of cup)
what is simple reaction time (SRT)
one stimulus, one reaction
(pavlov’s dog)
- recorded as minimal time needed to response
what is choice reaction time (CRT)
- multiple stimuli, each requiring a different response
- recorded as time that elapses between presentation of stimulus and the response
- requires increased time to process info
what is discriminate reaction time (DRT)
- used to measure cognitive processes such as attention, perception and decision making
- multiple stimuli presented, required to respond only to one specific target stimulus while ignoring other distractors
