Movement Science (Exam 1) Flashcards
In the ICF model, what goes in the Health Condition portion?
-Acute or chronic disorders, injuries or circumstances that have an impact on the individuals level of function
-Medical Diagnosis
In the ICF model, what goes in the Body Function and Structure portion?
Impairment of Body structures:
ex. joints swelling, muscle spasms, scarring, wounds, and amputations
Impairment of Body functions:
ex. Pain, reduced sensation, decreased ROM, decreased Strength/Power/Endurance, impaired balance/coordination, poor posture, decreased aerobic ability
In the ICF model, what goes in the Activity portion?
Activity limitations
(Examples)
-Reach, throw, catch, grasp
-Lifting, lowering, carrying
-pushing or pulling
-Bending, stooping
-turing, twisting
-Rolling
-Sitting, standing
-Transfers
-Squatting, kneeling
-walking, crawling, running
-Ascend/descend stairs
In the ICF model, what goes in the Participation portion?
Participation Restrictions
(Examples)
-Self-care
-Mobility in the community
-Occupational tasks
-school related tasks
-Home management (in/outdoor)
-Caring for dependents
-Recreational and leisure activities
-Socializing with friends and family
-Community responsibilities and services
What is the difference between Activity and participation?
Activity: Execution of a task or action by the individual
Participation: Involvement in a life situation
In the ICF model, what goes in the Environmental factors portion?
-Associated with physical, social, attitudinal environment in which people conduct their lives
-Architectural characteristics
-Legal and social structures
-Climate, terrain, etc.
In the ICF model, what goes in the Personal factors portion?
-Race
-Gender
-Family background
-Coping skills
-Education
-Profession
-Past and current experience
-Fitness
Psychological assets
What goes in the Examination portion in the patient/client model?
History
System Review
Test and Measures
What goes in the Evaluation portion in the patient/client model?
-Patient response to test and measures
-Integrated data with data collected in history
-Determine diagnosis
-Determine prognosis
-Develop POC
What goes in the Diagnosis portion in the patient/client model?
Diagnostic process
-Collection of data
-Analysis and interpretation leading to working hypothesis
-Organization of data and classifications into categories
Diagnostic category
-Identify and describe patterns of findings
-Purpose of POC, intervention and prognosis
-impact of health condition of the human movement
What goes in the Prognosis portion in the patient/client model?
-Prediction of a patients optimal level of function expected as a result of PT
-Determine an accurate prognosis is challenging
What goes in the Intervention portion in the patient/client model?
-PT selects, prescribes and implements interventions based on examination data, evaluation, diagnosis, prognosis and goals
-Effective intervention results in the reduction/elimination of body function
What goes in the Outcome portion in the patine/client model?
-Results of implementing POC
-Functional outcomes
-Measuring outcomes
What is Hypothesis Oriented Practice?
-Hypothesis cause(s) of abnormal movement problems
-Determine appropriate test and measures (Rule in / Rule out)
What is Hypothesis-Oriented Algorithm for Clinicians II (HOAC II)?
-The algorithm for planning and evaluating, this facilitates use of science in practice
-Describes a series of steps involved in making informed clinical decisions
-Hypothesis oriented approach of creating problem lists and hypotheses as to WHY the problems exist
-Monitors intervention effects and altering the POC
(Incorporates elements of the APTA’s guide to PT practice)
What is the Integrated Framework for Decision making?
-This unifies models for Clinical Reasoning
-Each step pose a hypothesis and collect data to support or refute
-Big emphasis on Interview
-Uses motor learning theory to inform clinical reasoning
What is Clinical Prediction Rules?
-Contains predictive factors
-Identifies subgroups of patients who are likely to benefit from a particular approach
-Caveat- Limited Evidence
What are the 18 steps of extremity Examination?
(Hypothesis Generation)
S1- Pain Assessment
S2- Initial Observation
S3- History
(Hypothesis Testing)
S4-15- Objective test and measures
(Hypothesis Confirmation or Rejection)
S16- Evaluation
(Diagnosis and Prognosis)
S17
(Intervention)
S18
What is Evidence-Based Practice?
-Conscientious, explicit and judicious use of current best decisions about the patient care
-Combine knowledge of literature with clinical experience
What are the 8 Guiding Principles to achieve vision?
-Identity
-Quality
-Collaboration
-Value
-Innovation
-Consumer-Centricity
-Access and Equity
-Advocacy
What is the Identity Principle?
-Defines and promotes the movement system as the foundation for optimizing movement to improve health of society
-PT will evaluate and mange an individuals movement system across that life spine
-Movement system is core of PT practice, education, and research
What is the Movement System?
Integration of body systems that generate and maintain movement at all levels of bodily function
What is Quality Principle?
-Establish and adopt best practice standards in: Examination, Diagnosis, Intervention, and Outcome Measures
-Highest standards of teaching and learning
-Research collaborate with practitioners to expand evidence
What is the Collaboration Principle?
-Demonstrates value in collaboration: Health care providers, consumers, community organizations, & other disciplines
-Interprofessional education
-Interprofessional research
What is the Value Principle?
-“The health outcomes achieved per dollar spent”
-Service with best value will be: safe, effective, timely, patient-centered, equitable
-Meaningful and cost-effective PT outcomes
What is innovation Principle?
-Creative and proactive solutions to enhance delivery of services:
Delivery models, Practice patterns, Education, Research, Patient-centered procedures, and technology
What is Consumer-Centricity Prinicple?
Patient/client values and goals are central to all efforts
What is Access and Equity Principle?
Recognize and work to ameliorate health inequities and disparities
What is Advocacy Prinicple?
Advocacy for patient/clients as individuals and population
What is motor control?
The ability to regulate or direct mechanisms essential to movement
(Teacher Definition)
-Necessary INPUT, sufficiently processed, with an acceptable OUTPUT
What are the three Nature of Movements?
-Individual
-Task
-Environment
What are the individual systems underlying motor control? (3)
-Motor/Action systems
-Sensory/Perceptive systems
-Cognitive system
What is part of the Motor/Action systems?
-Neuromuscular
-Biomechanical
What is part of the Sensory/Perceptive systems?
-Peripheral sensory and higher-level processing
-Information regarding state of body and environment
What is part of the Cognitive systems?
-Attention
-Planning
-Problem-solving
-Motivation
-Emotional aspect of motor control
What is the difference between Discrete and Continuous, in terms of task constraints on movement control?
Discrete: Recognizable beginning and end
Continuous: Performer decides end
What is the difference between Closed and Open, in terms of task constraints on movement control?
Closed: Fixed or predictable environment (Little variation of movement)
Open: Unpredictable; must adopt movement strategy (Constant changing of positions)
What is the difference between Stability and Mobility, in terms of task constraints on movement control?
Stability: Nonmoving BOS
Mobility: Moving BOS
What is the difference between Manipulation and Non-Manipulation?
Manipulation: Use of your hands to accomplish a goal
Non-Manipulation: No use of hands
What are Regulatory Features, in terms of Environmental constraints on movement control?
Shapes movement, can affect motor performance (Weight, shape, size, surface, etc)
What are the Non-Regulatory Features, in terms of Environmental constraints on movement control?
May affect but does not shape movement (Background noise, wallcolor, etc.)
Referring to the 3 Natures of Movement (Task, individual, and Environment), what can be added in each category that affects movement?
Task-Mobility, Postural Control, UE function
Individual- Cognition, Motor/Action system, Sensory/Perceptual system
Environment- Regulatory features, Non-Regulatory features
What is the Theory of Motor Control?
-Ideas about the control of movement
-Provide a framework for interpreting behavior
-Guide for clinical action
-Dynamic and evolving
-Working hypothesis
What is Reflex Theory?
Sensation impairment in regulating movement. Reflexes were building blocks of behavior. Complex behavior resulted in reflex changing
What are the clinical Implications for Reflex Theory?
-Reflex testing should predict function
-Movement described/interpreted based on reflexes
-Motor retraining would focus on enhancing/reducing reflexes
What are some limitations for Reflex Theory?
-Does not explain spontaneous and voluntary movement
-Does not predict movement that occurs in absence of stimulus
-Does not explain fast movements
-Does not explain varies of movement responses
What is Hierarchical Theory?
Organizational control is Top-down. Brain controls all movement. Each successively higher level experts control over level below
Never Bottom-Up control
What are limitations of Hierarchical Theory?
Does not explain normal reflexive behavior
What are clinical implications of Hierarchical Theory?
-May explain presence of abnormal reflexive activity after cortical damage
-Facilitation of normal movement with proprioceptive input
What is Motor Programming Theory?
Central motor pattern or motor program activated by sensory stimulus or central processes
-Stereotyped, hardwired response
What are the limitations with Motor Programming Theory?
Central motor program cannot be the only determinant of action. Two identical commands can produce motor inputs
What are clinical implications for Motor Programming Theory?
-Abnormal movements results from abnormalities in CPG or higher motor outputs
-Interventions should focus on retraining movements important to task
What is System Theory?
Various brain and spinal centers work cooperatively to accommodate demands of intended movement
What are clinical implications for Systems Theory?
-Focus on individual systems and interaction of multiple systems
-Movement is emergent
-Normal movement has variability encourage flexible movement patterns
What are the assumptions for Task Oriented Approach to Patient Care?
-Normal movement emerges as interaction of many systems
-Movement is organized around a behavioral goal and is constrained by the environment
What are the clinical implications for Task Oriented Approach to Patient Care?
-Essential to work on functional tasks when retraining movement
-Learn through active problem solving
-Adaptation to changes in environment is critical
What is Task Analysis?
-Detailed observational analysis of whole body movement
–Determine if movement is typical
–Where performance problems occur
-Guides clinician to identify the nature of the movement pattern
-Shape the POC
What is the Temporal Sequence of Movement?
Initial Condition
Preparation
Initiation
Execution
Termination
Outcome
What is included in the Initial condition in the Temporal Sequence of Movement?
-State of the individual and environment
-Posture
-Ability to interact with environment
-Environment context
What is included in the Preparation in the Temporal Sequence of Movement?
Period of time when the movement is being organized within the CNS
-Stimulus identification
-Response selection
-Response programming
What is included in the Initiation portion in the Temporal Sequence of Movement?
Initiation of movement is the instance when the displacement begins
-5 body segments: Head/Neck, Upper truck, Lower trunk, UE, LE
-Important parameters:
Timing, Direction, and Smoothness
What is included in the Execution portion in the Temporal Sequence of Movement?
Period of actual segment movement
-Important parameters:
Amplitude, Direction, Speed, Smoothness
What is included in the Termination portion in the Temporal Sequence of Movement?
Refers to the instant when movement stops
Important parameters:
Timing, Stability, Accuracy
What is included in the Outcome portion in the Temporal Sequence of Movement?
Refers to whether the movement was reached successfully
What is Postural Control?
Postural stability?
Postural orientation?
Controlling the body’s position in space for the purpose of stability and orientation
Postural stability: Control COM within BOS
Postural orientation: Alignment and orientation
What are the three Movement Control Principles?
-Steady State Balance
-Reactive Balance (relies on feedback control)
-Anticipatory Balance (relies on Feedforward control)
What are the essential characteristics in Sit tTo Stand?
-Sufficient joint torque
-Stability
-Ability to modify
What are the phases of Sit To Stand?
Weight shift (Flexion moment)
Lift off
Extension
Stabilization
Why is Rolling important?
Important part of bed mobility.
-Movement strategies are highly variable.
Rolling typically requires a rotary component of the trunk combined with movements of the UE and/or LE
What is involved with locating a target or object?
Coordination of eye-head movements
-Involves feedforward and feedback control
What is the difference between Reach and Grasp?
Reach: Transportation of the arm and hand
Grasp: Grip formation, grasp and release of object
(Control of movement is dependent)
What is required for a successful grasp?
-Hand must be adaptive to the shape, size, and the use of the object
-Finger movement must be times appropriately
Power Grip vs. Precision Grip.
Power Grip: Finger and thumb pads are directly toward the palm to transmit a force to an object
Precision Grip: Forces are directed between the thumb and fingers
-Allows movement of object relative to hand and within the hand
What are the four phases of Grasp and Lift Tasks?
-Lift starts with contact between fingers and object
-Grip force and the load force increasing
-Load force overcomes the weight of object and it starts to move
-End of task when there is a decrease in the grip and load force
What is Fitt’s Law?
Whenever arm movement precision is increased or movement distance is increased, movement time becomes longer
What is Neuroplasticity?
The human nervous system that has the capability to grow, develop, and adapt to change over time
What is Positive and Negative Neuroplasticity? What the factors against the success of neuroplasticity?
As neuroplasticity occurs, it can be very effective and lead to great outcomes; however can be less effective and have negative or poorer outcomes.
Factors against:
-Nature/cause of disease or injury
-Environmental factors
-Quality of rehab
How does Neuroplasticity happen?
Neurogenesis
-Occurs in the development brain but also occurs in the adult brain in the hippocampus
Primary function of the hippocampus is for learning and memory
What happens if Cortical Recognition is damaged?
If damaged is sever and nerve cells die, the brain can re-organize itself so other areas of the brain take over the activity of the injured area.
-Areas adjust their function, location, and activity
–The brain will reorganize accordance to experience and stimulation (or lack of it)
What are the 10 Principles of Experience-dependent Plasticity?
-Use it or lose it: Failure to drive specific brain function can lead to degeneration
-Use it and improve it: Training that drives a specific brain function can enhance function
-Specificity: The nature of the training experience dictates the nature of plasticity
-Repetition Matters: Induction of plasticity requires repetition
-Intensity Matters: Induction of plasticity requires sufficient training intensity
-Time Matters: Different forms of plasticity occur at different times during training
-Salience Matters: Training experience must sufficiently salient to induce plasticity
-Age Matters: Training-induced plasticity more induced in younger brains
-Transference: Plasticity in response to one training experience can enhance the acquisition of similar behaviors
-Interference: Plasticity in response to ones experience can interfere with the acquisition of other behaviors
How can we promote neuroplasticity?
-Use the 10 principles of experience-dependent plasticity
-Exercise
-Healthy diet and nutrition
-Good sleep patterns
Motor Learning vs. Motor Performance.
Motor Learning: Relatively permanent change, happens over time
Motor Performance: Temporary change in motor behavior observed during practice, early in the learning process
What is the Cognitive Stage of Learning?
“What to do”
-Learners needs to understand what the task is and what is required to complete it
-Requires a lot of trial and error
-Provide learners with visual, auditory and physical instruction
-Have patient explain task verbally and provide feedback as needed
What is the Associative Stage of Learning?
“How to do it”
-Learner is now refining and perfecting the task
-Less errors are seen and more independent performance on task
-Less reliance on visual input as proprioception improves
-More consistent performance seen in task
What is the Autonomous Stage of Learning?
“How to Succeed”
-More independent practice
-Mostly error-free
-Movement becomes automatic
-Learner self-evaluates
-Able to dual task
What is intrinsic Feedback?
Individuals own sensory information from tactile, proprioception, visual, vestibular and/or auditory receptors
What is Extrinsic Feedback?
External feedback given by therapist such as tactile, visual, verbal
In Extrinsic Feedback Progression, what is Concurrent Feedback to Terminal Feedback?
Concurrent Feedback: Given during the task performance
TO
Terminal Feedback: Given at end of task performance
In Extrinsic Feedback Progression, what is Knowledge of Performance (KP) and Knowledge of Results (KR)?
Knowledge of Performance (KP): Feedback related to the movement pattern used to achieve the movement outcome
AND
Knowledge of Results (KR): Terminal feedback about movement outcome
In Extrinsic Feedback Progression, What is Immediate Feedback TO Delayed Feedback TO Summary Feedback TO Faded Feedback TO Bandwidth Feedback?
- Immediate Feedback: Given immediately after movement
TO - Delayed Feedback: Brief time delay allowed before given feedback
TO - Summary Feedback: Feedback after a set number of trials
TO - Faded Feedback: Feedback given less frequent with ongoing practice
TO - Bandwidth Feedback: Feedback given only if performance falls outside a predetermined error range
In Practice Progression, What is Massed vs. Distributed progression?
Masses: has more practice time vs rest time
Distributed: has more rest time vs practice time
*This depends on the patient, either can be chosen, however usually progressed TO massed in the autonomous stage**
In Practice Progression, What is Constant TO Variable?
Constant: Task is practiced in the same way with no variety
TO
Variable: Task is practiced in variable conditions and parameters
In Practice Progression, What is Blocked TO Random?
Blocked: Same task repeated throughout whole practice time
TO
Random: A variety of task are practiced during practice time
In Practice Progression, What is Part to Whole?
Part: Learning individual components of the task progressing
TO
Whole:complete the whole task at once
What are the three models of the Human Movement system?
- Kinesiologic Model
- Pathokinesiologic Model
- Kinesiopathologic Model
What is the key principle of the Kinesiologic Model?
Optimal functioning and interaction of body systems is needed to maintain good musculoskeletal health
In the Kinesiologic Model, what three elements determine optimal functioning?
-Variety in joint movements and postures
-Precise movement (Optimal kinesiological standard for movement)
-Good Musculoskeletal health
What is the Pathokinesiologic Model?
The study of abnormal movement that IS CAUSED BY an underlying pathologic condition
-How pathology affects movement
-Move beyond consideration of just pathoanatomical or pathophysiological conditions
What four element in the Pathokinesiologic model determine that abnormal movement is caused by an underlying condition ?
-Disease, injury, Abnormality
-Impairments in component elements
-Movement impairment
-Disability
What is the Kinesiopathologic Model?
The idea that imprecise, abnormal or excessive movement CAN CAUSE specific anatomical or physiological conditions
-Idea that movement can create pathology
-Empirical bases: Repetitive movements and sustained postures can positively or negatively influence bodily tissue
What five elements in the Kinesiopathologic Model determine that abnormal or excessive movement can cause specific anatomical or physiologic conditions?
-Increased, abnormal or excessive repetitive movements and sustained postures
-Impairments in component elements
-Movement impairments
-Disease, injury, abnormality
-Functional limitations and disability
What are the four elements of the Movement system?
-Base Element: Muscular and Skeletal system
-Modular System: Nervous system
-Support Elements: Cardiac, Pulmonary, Endocrine/Metabolic, Integumentary
-Biomechanics: Static and Dynamics
In the Muscular and Skeletal System, what are the 3 components?
1)Muscle Strength/Performance
2) Muscle Length
3) Joint mobility / Boney structural Variations
In the Muscular and Skeletal System, Muscle Strength/Performance portion, What are potential impairments?
-Muscle atrophy
-Muscle strain
-Neuromodulation
These three can cause Decreased force production, Muscle endurance and power
In the Muscular and Skeletal System, Muscle Length, What are potential impairments?
-Lengthened muscles
–Can cause weakness
-Short and/or Stiff Muscles
–Decreased Mobility
In the Muscular and Skeletal System, Joint integrity or mobility/Boney Structural variations portion, What are potential impairments?
-Joint surface or capsule impairments
–Can cause Joint Hyper/Hypomobility
In the Nervous System, what are the three components?
-Recruitment, Timing, order, magnitude of motor unit activation
-Sensation and Perception
-Cognition
In the Nervous System, Recruitment, Timing, order, magnitude of motor unit portion, what are potential impairments?
Altered motor unit activity. Coordination, timing, symmetry impairments
In the Nervous System, Sensation and perception portion, what are potential impairments?
Impairments in proprioception, kinesthesia, peripheral and higher-level processing
In the Nervous System, Cognition portion, what are potential impairments?
Impairments in attention, planning, problem solving, motivation, emotion, etc
In the Nervous System, Neural Mobility/Neurodynamics portion, what are potential impairments?
Adverse neurodynamics, decreased mobility, adhesions, hypersensitivity, pain, muscle atrophy, sensory loss, etc
In the movement system (In the support element portion which includes: Cardiac, Pulmonary, Endocrine/Metabolic, Integumentary), what are potential impairments of the Cardiovascular System?
Impaired oxygen consumption, distribution and/or utilization needed for movement
In the movement system (In the support element portion which includes: Cardiac, Pulmonary, Endocrine/Metabolic, Integumentary), what are potential impairments of the Pulmonary system?
Insufficient oxygen delivery/supply needed for movement
In the movement system (In the support element portion which includes: Cardiac, Pulmonary, Endocrine/Metabolic, Integumentary), what are potential impairments of the Endocrine/Metabolic system?
Altered homeostasis and production of necessary hormones. Impaired energy consumption and replenishment
In the movement system (In the support element portion which includes: Cardiac, Pulmonary, Endocrine/Metabolic, Integumentary), what are potential impairments of the Integumentary?
Decreased mobility secondary to poor skin integrity, wounds, restrictions, and adhesions.
In the movement system, in the Statics and Dynamics portion, what are potential Static impairments?
Alterations/impairments in alignment, muscle activation, joint/soft tissue stress, bone remodeling
In the movement system, in the Statics and Dynamics portion, what are potential Dynamic impairments?
Faulty arthrokinematics and/or Osteokinematic motion(s)
