Motor Learning Theories Flashcards
Karl & Berta Bobath
Primary Principles
- based on heirarchal model of neurophysiologic function
- interference of normal function of CNS leads to slowing down or cessation of motor development and inhibition of righting/equillibrium reactions and automatic movements
- Key terms:
- facilitation
- inhibition
- key points of control
- placing
- reflex inhibiting posture
Neuromuscular Developmental Treatment (NDT)
(Bobath)
Inhibition of abnormal patterns of movement with simultaneous facilitation of normal patterns.
Avoid utilization of abnormal reflexes or associated reactions during treatment
utilize manual contact and handling through key points of control for fascil and inhib
emphasize the use of rotation during treatment activities
provide orientation to midline control by moving in and out of midline with dynamic activity
Brunnstrom
Primary Principles
Movement therapy in hemiplegia, based on the heirarchal model by Hughlings Jackson.
This approach created and defined the term “synergy” and initially encouraged the use of synergy patterns during rehabilitation
Brunnstrom Key Terminology:
- associated reactions
- homolateral synkinesis
- limb synergies
- raimeste’s phenomenon
- souque’s phenomenon
- stages of recovery
- assoc rxn: involuntary/automatic mvmnt of body part as result of an intentional mvmnt in another
- homo synk: a flexion pattern of involved UE facilitates flexion of involved LE
- limb synergies: group of muscles that produce a predictable pattern of movement in flex or ext
- raimiste: involved LE will ABD/ADD w/ applied resistance to uninvolved in same direction
- souque’s: raising involved UE above 100 w/ elbow ext will produce ext/abd of fingers
- recovery: 7 stages of neurological recovery based on progression through abnormal tone/spasticity (tone, reflex, volitional movement)
Movement Therapy in Hemiplegia Intervention Constructs
(Brunnstrom)
- evaluation of strength focuses on patterns of mvmnt rather than straight plane motion
- initially limb synergies are encouraged and necessary
- encourage overflow to recruit active movement of the weak side
- pt will follow the stages of recovery, but may experience a plataeu at any point (full recovery not acheived)
- Treatment should incorporate only tasks the the patient can master or almost master
Rood
Primary Principles
theory is based on Sherrington and the Reflex stimulis model. Rood believed that all motor output was the result of both past and present sensory input .
Treatment is based on sensorimotor learning.
A goal of this approach is to obtain homeostasis in motor output and to activate muscles and perform a task independently of a stimulis
Sensory Stimulation Techniques
(Rood)
Facilitation:
- approximation
- joint compression
- icing
- light touch
- quick stretch
- resistance
- tapping
- traction
Inhibition:
- deep pressure
- prolonged stretch
- warmth
- prolonged cold
Rood Key Terminology
- heavy work
- light work
- key patterns
- heavy work: develop stability by performing activity against gravity or resistance – focuses on strengthening postural muscles
- Light work: used to develop controlled movement and skilled fucntion by performing an activity without resistance –focus on extremities
- Key: developmental sequence designed by rood that directs patients’ mobility recovery from syndergy patterns through controlled motion
Rood Sensory Intervention Constructs
- utilization of sensory stimulation to achieve motor output during treatment
- homeostasis of all systems is essential
- techniques such as neutral warmth, maintained pressure and slow rhythmical stroking can be used to calm a patient
- tactile stimulation is used to facilitate normal movement
- exercise must provide proper sensory feedback in order to be therapeutic
Motor Control
Definition
the study of the nature of movement, or the ability to regulate or direct essential movement.
Historically, control was thought to arise from reflex or hierarchal models where the cortex was percieved as the highest functioning components and reflexes were the lowest.
new theories believe that there is a greater distribution
Motor Learning
Definition
the study of the aquisition or modification of movement. motor learning differentiates learning vs. perofrmance, provides guidelines for appropriate use of feedback, prioritizes the impact of practice in skill/movemnt, and also focuses on the transfer of learning across tasks and environment.
Stages of Learning
Cognitive: high concentration of conscious processing information, problem solving, controlled environment
- large amounts of error
- repetiion of effort allows for improvement
- ^ cog work: listen, observe, process feedback
Associative: distinguish b/t in/correct, linking feedback, avoid excessive external feedback
- decreased errors with new skill performance
- decreased need for concentration/cognition
- large # practice yeilds refinement motor program
Autonomous Stage: final stage, improved efficiency without cognitive need, perform task w. interference from variable environment
- automatic response; distraction - no impact
- mainly error-free regardless of environment
- internal feedback or self assessment should be dominant
Feedback Terminology Motor Control
Intrinsic
Extrinsic
Knowledge of Results
Knowledge of Performance
- Intrinsic: all sensory feedback
- Extrinsic: information provided while the task is in progress, usually verbal or manual contact
- KOR: (extrinsic) terminal feedback regarding the outcome of movement that has been performed in relation to movement’s goals
- KOP: (extrinsic) relates to actual movemnt patter that someone used to achieve their goal mvmnt
Types of Practice: Motor Control
Massed
Distributed
Constant
Variable
Random
Blocked
- Massed: practice/trial time is greater than rest
- Distributed: practice/trial time is = to rest
- Constant: practice task under uniform condition
- Variable: practice task under differing condition
- Random: varying practice amongst different tasks
- Blocked: consistent practice of single task
