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NMR II > Motor Relearning Program > Flashcards

Motor Relearning Program Flashcards

1
Q

What is MRP?

A

Motor Relearning Program

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2
Q

What is dynamic system theory?

A
  • Movement produced from interactions of multiple sub-systems within person, task, environment
  • Sub system self organize
  • Non linear process with steady changes occurring
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3
Q

What is plasticity? how is it different in intact and lesions brains?

A
  • Ability of CNS to adapt & reorganize
  • In intact brain it is the process of learning
  • In lesioned brain recovery of function is spontaneous, requires reorganization
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4
Q

What is the task oriented approach?

A
  • Approach to patient management emerging from dynamic systems and motor learning theories
  • Use of functional task to which target neuromuscular & musculoskeletal system to treat motor behavior
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5
Q

Describe MRP

A
  • Task oriented approach to examination & intervention
  • Relearning will occur with opportunities for extensive, meaningful, task oriented training in a stimulating environment
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6
Q

What are some general principles of MRP

A
  • Early imitation of rehab
  • Rehab environment should be mentally stimulating and use functional equipment
  • Motivation
  • Education & consistency
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7
Q

What is the general structure of MRP intervention?

A
  • Training motor control via task oriented exercise
  • Restoration of Optimal Functional performance
  • Opportunities for practice
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8
Q

What are the 4 critical actions established by MRP?

A
  • Standing up & sitting down
  • Walking
  • Reaching & manipulation
  • Balance
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9
Q

T/F: MRP uses functional training within the 4 critical actions of everyday life to analyze each task, determine what is missing, train patient in missing aspects, and put missing pieces together to train the entire daily activity.

A

True

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10
Q

What are the 4 steps for implementing MRP approach?

A
  • Step 1: Observation/ Analysis of Task
  • Step 2: Practice of Missing Components
  • Step 3: Practice of task
  • Step 4: Transference of training
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11
Q

What is the breakdown of step 1 of MRP approach?

A
  • Observation
  • Comparison
  • Analysis (identification of impairments)
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12
Q

What is done in step 2 of the MRP approach?

A
  • Explantation - Identification of the areas to address in context of task (focus on most critical to that task)
  • Instruction
  • Practice + verbal & visual feedback + manual guidance
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13
Q

What is done in step 3 of the MRP approach?

A
  • Explanation & identification of goal
  • Instruction
  • Practice (verbal/ visual feedback, manual guidance & similar conditions)
  • Re evaluation
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14
Q

What is done in step 4 of the MRP approach?

A
  • Opportunity to practice in & out of context
  • Consistency of practice
  • Organization of self-monitored practice
  • Structured learning environment
  • Involvement of family & staff
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15
Q

How does MRP describe strength impairments?

A
  • Decrease contractility (force)
  • Slowness of movement & prolonged rise to peak force
  • Timing of muscle forces
  • Intersegmental control
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16
Q

How does MRP describe coordination impairments?

A

Speed/force of movement, amplitude of displacement, directional accuracy

17
Q

What does MRP refer to spasticity as?

A

Intrinsic stiffness & adaptive shortening

18
Q

What are the impairments MRP recognizes?

A
  • Strength
  • Coordination
  • Somatosensory (tactile)
  • Proprioception (position & passive movement sense)
  • Perceptual - Cognitive
  • Soft tissue flexibility (adaptive shortening)
  • Intrinsic stiffness & adaptive shortening
19
Q

What are the muscle strengthening principles?

A
  • Task oriented (concentric & eccentric)
  • Intensive to mild fatigue
  • Resistance & repetition to patient ability & focus area
  • Increase load to improve strength
  • Increase rep to improve endurance
  • Increase speed to improve power
20
Q

Which is more effective passive or active stretching?

A

Active

21
Q

How is somatosensory training performed?

A
  • Direct selective attention to the sensory aspects of functional tasks
  • Manipulate task in a functional way that provides different sensory experiences
22
Q

How is perceptual cognitive training performed?

A
  • Focusing attention on appropriate cues
  • Scanning environment
  • Integrate moving objects into treatment when able
23
Q

What are the critical factors for learning?

A
  • Motivation
  • Attention
  • Instructions & demonstration
  • Feedback
  • Practice & intensity
24
Q

How can attention be improved?

A
  • External focus of attention
  • Concrete goal
  • Ask patient to reflect on performance
25
Q

How should instructions & demonstrations be given early on?

A
  • Frequent but brief
  • Cue most critical missing aspect (detail) in context of goal
  • Use demo/videos, mirrors
26
Q

How should instructions & demonstration be given later on?

A
  • Cue goal
  • Decrease instructions & demos
27
Q

How should be feedback be given?

A
  • Visual, auditory, tactile
  • Focused, deliberate & decreased over time
  • Specific to patients needs
28
Q

What should the approach for the action of standing up & sitting down look like?

A
  • Repetitive practice of LE flexion/extension
  • Carryover to stance phase of gait, stair negotiation, squat & recover
  • Vary task & contextual factors while avoiding compensations
29
Q

What is the emphasis on when training walking?

A

Support & push off, balance of COM over changing BOS, & control of ankle/knee during swing

30
Q

What should training focus on when training for walking?

A
  • Functional strength training to load limbs equally
  • Treadmill training
  • Over ground walking
  • Environmental modifications
31
Q

What should the treatment approach look like when the goal is to improve reaching & manipulation?

A
  • UE movement driven by functional target
  • Simple repetitive exercises
  • Functional strength training
  • Training of bimanual activities
32
Q

What is the emphasis on when improving balance?

A

Strength, power/ endurance, coordination, sensory & perceptual processes & cognition

33
Q

Name some way to integrate MRP into practice

A
  • Have patient attempt functional task prior to initiation of treatment
  • Ask them to reflect on performance, then provide them with focused & deliberate feedback most critical to task
  • Use mental practice
  • Treat those critical aspects using task oriented exercise, then practice the whole task using functional objects
  • Fade feedback & input
  • Increase challenge of task as treatment progresses

NMR II (14 decks)

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