Neuro Interventions Flashcards
Define motor program
- A set of prestructured muscle commands that when initiated results in the production of a coordinated movement sequence (learned task)
Define motor plan
- An overall strategy for movement
- An action sequence requiring the coordination of a number of motor programs
Describe feedback versus feedforward
- Feedback: afferent (sensory) info sent by various sensory receptors to control centers; allows motor responses to be adapted to the demands of the environment
- Feedforward: readies the system in advance of movement; anticipatory responses that adjust the system for incoming sensory feedback for future movements
Define motor learning
- A change in the capability of a person to perform a skill; the result of practice or experience
Define generalizability
- The acquired capability to apply what has been learned to other similar tasks (transfer tests)
Define resistance to contextual change
- Acquired capability to apply what has been learned to other environmental contexts
Describe intrinsic versus augmented feedback
- Intrinsic: sensory info normally acquired during performance of a task
- Augmented: externally presented feedback that is added to that normally acquired during task performance
Describe knowledge of results versus knowledge of performance
- Results: augmented feedback about the outcome of a movement
- Performance: augmented feedback about the nature of the movement produced
Describe the different types of practice
- Blocked: practice of a single motor skill repeatedly
- Variable: practice of varied motor skills in which the performer is required to make rapid modifications of the skill in order to match the demands of the task
- Random: practice of a group of motor skills in random order
- Serial: practice of a group of motor skills in serial or predictable order
- Massed: relatively continuous practice in which the amount of rest time is small
- Distributed: practice time is less than rest time
- Mental: cognitive rehearsal of a motor skill w/o overt physical performance
Define transfer of a skill
- The effects of having previous practice of a skill or skills upon the learning of a new skill or upon performance in a new context
Describe part-whole versus bilateral transfer
- Part-whole: a learning technique in a which a complex motor task is broken down into its component parts for separate practice before practice of the integrated whole
- Bilateral: improvement in movement skill performance with one limb results from practice of similar movements with the opposite limb
When to provide feedback to improve performance versus learning/retention
- Performance: feedback after every trial
- Learning/retention: feedback should be variable
What type of feedback is good for early/cognitive phase of learning versus later/associative phase
- Cognitive: visual feedback
- Associative: proprioceptive feedback
What should be the focus of feedback in early versus later stages of learning
- Early: feedback on correct aspects of performance
- Later: feedback on errors as they become consistent
Strategies to vary locomotor task demands
- Walking forward/backward
- Side-stepping
- Cross-stepping (braiding)
- Stopping, starting, and turning on cue
- Head movements
- Step-ups, step-up and over, and stair climbing
- Obstacles
CPG for locomotor training for chronic (≥6 months) stroke, SCI, or brain injury
- Perform: mod-high intensity over ground ambulation and virtual reality TT
- Consider: strength training multiple sets at 70% 1RM, cycle training (high intensity), circuit training, and virtual reality standing balance exercise
- Do not perform: sitting/standing balance w/o visual feedback, robotic assistance walking training, or BWS TT w/PT assistance
Adherence-enhancing behavioral strategies for constraint induced movement therapy (CIMT)
- Daily administration of motor activity log
- Home diary
- Problem-solving to overcome barriers to use of the more affected UE
- Behavioral contract
- Caregiver contract
- Home skill assignment, home practice, & daily schedule
Training parameters for BWS TT (body weight support treadmill training)
- High frequency: 3-5 days/wk
- Moderate duration: 20-30 minutes
- Maximum tolerated intensity: speed and slope
Training parameters for constraint induced movement therapy (CIMT)
- High intensity: several hours/day
- High frequency: daily for a period of 2-3 consecutive weeks
Describe a short interval HIIT protocol
- Typically use repeated 30s burst of high intensity exercise at maximum but safe speeds, alternated with 30-60 secs of lower intensity or rest periods
Describe a long interval HIIT protocol
- Often targeted at repeated cycles of 3 minutes of high intensity activity followed by 4 minutes of lower activity or rest
What are the benefits of HIIT
- Improved peak VO2
- Improved balance (Berg Balance Scale)
- Increased gait speed
- Increased endurance (6-minute walk test)
- Improved domains of cognition (Trail Making test part B)
Contraindications to HIIT
- Unstable cardiac condition
- Significant arrhythmia or myocardial ischemia on treadmill ECG stress test
- Poorly controlled resting BP (>180/100)
- Subarachnoid hemorrhage
- Other conditions where VO2 peak is contraindicated
Describe UE D1 flexion and extension movements/diagonals
- Flexion: flexion, adduction, and ER of shoulder
- Extension: extension, abduction, and IR of shoulder
Describe UE D2 flexion and extension movements/diagonals
- Disco movement/pulling out a sword
- Flexion: flexion, abduction, and ER of shoulder
- Extension: extension, adduction, and IR of shoulder
Describe LE D1 flexion and extension movements/diagonals
- Flexion: flexion, adduction, and ER of hip
- Extension: extension, abduction, and IR of hip
Describe LE D2 flexion and extension movements/diagonals
- Flexion: flexion, abduction, and IR of hip
- Extension: extension, adduction, and ER of hip
Describe a chop and lift movement/diagonal
- Chop: upper trunk flexion with rotation to R/L, lead arm moves in D1E, assist arm holds on top of wrist
- Lift: upper trunk extension with rotation to R/L, lead arm moves in D2F, assist arm holds beneath the wrist
Describe spatial versus temporal summation
- Spatial: multiple techniques
- Temporal: repeated application of the same technique
