Motor & Postural Control Flashcards
What are the different motor control theories?
- Reflex Theory
- Hierarchical Theory
- Motor Programming Theories
- Systems Theories
- Dynamical Action Theory
- Ecological Theory
Describe the systems model of motor control.
- The ability to regulate & direct mechanisms of movement
- What characteristics of task, individual + environment will influence movement?
- Requires good underlying postural control
- Lateral descending tracts (corticospinal + rubrospinal + lateral reticulospinal)
- Many systems, subsystems + multiple connections within the nervous system working in parallel + hierarchy to produce movement
- Focus therefore clinically on functional tasks rather than trying to ‘fix’ the damaged pathway or circuit
What are some features of postural control?
- Posture
- Balance
- Recovery from instability
- Ability to anticipate + correct for potential instability
- A combination of postural orientation (maintaining alignment) & postural stability (balance – maintaining CoG with in BoS)
- Requires some motor control
- Related to medial descending systems (vestibulospinal, medial reticulospinal + tectospinal)
What does normal movement require?
Integration and co-ordination of both postural & motor control (as well as ascending sensory information)
What is motor learning?
How we learn new movement patterns in healthy people
What is habituation?
Learned suppression of a non-noxious response
- Decrease in synaptic activity
(E.g. some vestibular exercises, wearing a new watch)
What is sensitisation?
Increased response to one stimulus that is consistently preceded by a noxious stimulus
- Increase in synaptic activity
(E.g. respond more to gentle rub on the arm if you have just caught your arm on a door handle)
What stages can motor learning be broken down into?
Fitts and Posner (1967):
- Cognitive phase
- Associative phase
- Autonomous phase
Gentile (1972):
- Acquire a movement pattern (regulatory and non-regulatory conditions) (explicit)
- Adaptation, consistency and economy (implicit)
What are methods of associative learning?
- Classical conditioning
- Operant conditioning
- Procedural learning
- Declarative learning
Describe classical conditioning.
- Predicting relationship between two stimuli
- An extension of sensitisation
(E.g. Pavlov’s Dogs)
Describe operant conditioning.
- Relationship of behaviour to a consequence (positive or negative)
- Similar neural mechanism to classical conditioning
(E.g. being rewarded for good behaviour)
Describe procedural learning.
- Implicit knowledge
- Cerebellar circuitry
Describe declarative learning.
- Explicit knowledge
- Temporal circuitry
- Long term potentiation
What do you need to be able to do in order to learn a motor skill?
- Acquire it
- Retain it
- Transfer it
Describe motor learning in relation to physiotherapy.
Use dependent learning
- Repeated task specific practice
- Needs cognition & some motor output
Instructive motor learning
- Knowledge of performance
- Change achieved through intentional movement strategies
- Change in response to explicit feedback
- Needs cognition
Reinforcement motor learning
- Knowledge of results
- Driven by binary outcome-based feedback
- Feedback from success or failure
Sensori-motor adaptation-based motor learning
- Change driven by sensory prediction errors
- Not reliant on cognition
- Cerebellum!
Need to select the most appropriate (or mix of appropriate) strategies to manage the patient in front of you.
What enhances motor learning?
Practice
- More is better
- Massed v distributed practice
- Constant v variable
- Random v block
Specificity
- Be task specific
Transferability
- Whole v part training
- Any impairment focussed work must be transferred to function
Feedback
- External focus but move from external to internal feedback
- Knowledge of results rather than knowledge of performance
Mental Practice
Modelling
Allow choice
