neuro motor control, learning, neuroplasticity

Question 1

3 necessary elements:

for motor control

Answer 1

1. A neural circuit
   Cortex, brainstem, cerebellum and spinal cord
2. A motor plan (program)
3. The environment

Question 2

Open loop

Answer 2

motor program don’t need sensory feedback

motor programs are run off virtually with out influence of peripheral FB or error detection processes

Question 3

Closed loop

Answer 3

constant sensory input, deciding how to move

Employs feedback and a reference for correctness to compute error and initiate subsequent corrections

Question 4

Reflex: Sherrington

Answer 4

Stimulus → response

Movement is a series of stimulus response events.

Question 5

Hierarchical: Hughlings Jackson

Answer 5

CNS development

CNS organized into high, middle, and lower centers: as we grow and develop, higher centers take over.

Question 6

Dynamic Systems: Bernstein

Answer 6

Contemporary view
Motor control as the result of cooperative actions of many interacting systems, working to accommodate the demands of a specific task.

Question 7

contemporary theory: systems

Answer 7

Motor Control requires the interaction of multiple body systems.

Musculoskeletal
Cardiovascular
Pulmonary
Neurological 
Cognitive

Question 8

Recovery of function

Answer 8

Mechanism:
Neural Plasticity-the ability of the brain to change and repair itself

Factors:
Age
Length of time since onset
Enriched environment
Active Participation

Question 9

Remediation/ Facilitation

NDT
PNF
Brunnstrom
Rood

Answer 9

NDT: normal posture, normal movement

PNF: sensory input, diagonal patterns

Brunnstrom: use synergies to gain movement, then work to modify to normal movement

Rood: sensory stim, stage of motor control

Question 10

Functional Task Oriented Training

Answer 10

Built on the need for patient to practice skill in order to regain function

Task analysis
=Parts to whole transfer

Question 11

The brain’s ability to adapt, & use cellular changes to learn/ relearn lost function is:

Answer 11

Neuroplasticity

Question 12

What is the most contemporary theory of motor control?

Answer 12

Systems

Question 13

The stage of motor control that allows a patient to maintain a position against resistance:

Answer 13

Static Stability

Question 14

What type of exercise is easiest for a patient with neurological disorder?

Answer 14

Isometric

Question 15

Motor learning

Answer 15

A set of internal processes associated with practice or experience leading to relatively permanent changes in the capability for skilled behavior

Question 16

Measures of learning

Answer 16

Retention
Generalizability: using new skill like sit<>stand from mat, at toilet
Resistance to contextual change: walking with same skill on grass and gravel

Question 17

Performance

Answer 17

temporary changes in motor behavior seen in practice, like an ice cube that you let sit, it melts

Question 18

Learning

Answer 18

relatively permanent change, like hard boiled eggs.

Question 19

Stages of motor learning

Answer 19

cognitive, associative, autonomous

Question 20

Cognitive

Answer 20

Deciding what to do,

Major task is to develop understanding of skill

stable environment

Question 21

Associative

Answer 21

Deciding how to do it,

Movement develops coordination
Fewer errors & extraneous mvmts

Developing an internal reference of correctness.

Question 22

Autonomous

Answer 22

How to succeed most effectively and efficiently, and how to dual task.

Movement becomes largely automatic without cognitive input

Simultaneous tasks
Competitive level
Unpredictable environments

Question 23

Early cognitive development

Answer 23

demo task exactly as it should be done, help establish internal reference, point out similarities of other learned tasks, visual feedback

natural environments, goal is to get info from ST to LT memory

Question 24

Later cognitive development

Answer 24

Ask the pt to assess their own performance

ask leading questions to have pt accurately assess self

carefully choose facilitation techniques

goal=to establish an internal reference of correctness.

Question 25

Strategy Development: Associative

Answer 25

Focus = refinement of skills, movement consistency in a variety of contexts Select appropriate feedback, Knowledge of performance=yes you did it Knowledge of results= now try to bring yourself to midline (quality) Assist learner to improve with self evaluation and decision making skills Wean off of facilitation and guided movement. Structure environment Goal = accurate self assessment.

Question 26

Strategy Development: Autonomous

Answer 26

Provide only occasional feedback Organize practice Use distractions, and more complex environments, dual tasking Simulate problems patient may encounter and ask patient to problem solve pt who can problem solve will be at a higher level of function in the community

Question 27

Key to motor learning/feedback

Answer 27

source of feedback, timing, focus

Question 28

concurrent feedback

Answer 28

during task

Question 29

terminal feedback

Answer 29

after completion

Question 30

varied schedule feedback

Answer 30

summed: first time faded: after every trial and then decrease Bandwidth: only given when outside error zone/risk of safety

Question 31

Elderly Learners

Answer 31

Allow for increased time Concentrate on one task at a time Overview entire session before starting Mental practice is highly effective– and conserves energy!

Question 32

Cognitive impairment learners

Answer 32

``` Simple cues, ↓distraction Be sure that goal is understood Repeat directions/ demos as needed Relate new to previous info Realize that progress may be slower. ```

Question 33

Brain Injury: learning

Answer 33

If cognitive demands are too great, will lead to frustration Demands should be at or just beyond the patient’s capability to stimulate & facilitate neural changes Learning potential influenced by multiple factors including severity of injury.

Question 34

CVA Learning

Answer 34

Active participation Contextual interference to promote retention and transfer Block and random practice Mental practice Be sure that patient understands relationship to function

Question 35

Parkinsonism: learning

Answer 35

``` Primary problem often akinesis Can try: Imitation Verbal and tactile cues Use of rhythm Visualization or imagination ```

Question 36

Which motor learning stage involves: fewer errors & extraneous movements, more proprioceptive feedback and a developing internal reference of correctness.

Answer 36

Associative

Question 37

Extrinsic feedback is most needed in which stage?

Answer 37

Cognitive

Question 38

The ability to demonstrate the skill over time and after a period of no practice is called?

Answer 38

Retention

Question 39

Which schedule of feedback leads to better learning?

Answer 39

Variable

Question 40

Which type of practice schedule leads to better retention & generalizability?

Answer 40

Variable and random