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Motor Learning > Neurologic Impairments > Flashcards

Neurologic Impairments Flashcards

1
Q

Signs

A

Objective findings determined by physical examination

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2
Q

Symptoms

A

Subjective reports associated with pathology perceived by patients

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3
Q

Positive Signs/Symptoms

A

Release of abnormal behavior (i.e. Hyperactive reflex)

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4
Q

Negative Signs/Symptoms

A

Loss of normal behavior (i.e. paresis)

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5
Q

Primary Effect of Lesion

A

Impairments causing problems in motor, sensory/perceptual and/or cognitive systems.

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6
Q

Secondary Effect of Lesion

A

Impairments NOT directly resulting from CNS lesion, developed as result of original problems

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7
Q

Lesion in descending motor

A

Primary: Paresis, Spasticity
Secondary: Structural & Functional changes in muscles

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8
Q

Motor Weakness (paresis)

A

Inability to generate sufficient tension in a muscle and a major impairment of motor function in UMN syndrome

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9
Q

Spasticity

A

Velocity-dependent increase in tonic stretch reflexes

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10
Q

Muscle tone

A

Muscle’s resistance to a passive stretch

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11
Q

Modified Ashworth

A 
0 = No increase in muscle tone; 
1 = slight increase in tone …;  
1+ = slight increase in tone;
4 = affected parts rigid in flexion/extension
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12
Q

Coordination Problems

A

Capacity to generate force does not predict the ability of that muscle to perform a specific task

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13
Q

Abnormal synergies

A

Loss of ability to recruit a limited number of muscles controlling movement and to control individual joints

Inappropriate muscle activation in sequence, causing unnecessary movements

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14
Q

Flexor Synergy

A

Scapular retraction/elevation
Shoulder abduction/ER
Elbow Flexion, forearm supination
Wrist/finger flexion

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15
Q

Impairments in Cerebellar Pathology

A

Hypotonia, Ataxia, Dysmetria, Action/Intention tremor

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16
Q

Impairments in BG

A

Hypokinetic and Hyperkinetic

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17
Q

Hypokinetic Disorders

A

PD

Bradykinesia, Rigidity, Resting tremor, Postural Instability

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18
Q

Hyperkinetic Disorders

A

Huntingtons: Excessive involuntary movement and low muscle tone
Chorea & Dystonia

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19
Q

Somatosensory cortex deficits

A 
Discriminative sensations
(Proprioception, 2-point Stereognosis, touch localization)
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20
Q

Visual Deficits based on location of lesion

A

optic nerve: loss of vision in ipsilateral eye
optic chiasm: loss of vision in temporal visual field from both eyes (bitemporal hemianopsia or tunnel vision)
optic tract (temporal & parietal lobes): loss of vision in contralateral visual fields in both eyes (homonymous hemianopsia)
optic radiation: contralateral homonymous hemianopsia

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21
Q

Assessment of Visual Deficits

A

Visual Acuity, Depth Perception, Visual Field Confrontation test, Oculomotor Control test

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22
Q

Vestibular Deficits

A

Gaze Stabilization problem
Impairments in balance and posture
Dizziness or vertigo (BBPV most common)

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23
Q

Motor Learning

A

Study of acquisition and modification of movement
Conventionally: Learn new skills
Recovery of function: Reacquire lost due to injury

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24
Q

Motor learning and control emerge from interaction between?

A

Individual, task, environment

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25
Q

Learning

Performance

A

Practice/experience leading to permanent changes

Temporary changes in motor behavior

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26
Q

Plasticity

A

Ability to show modification

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27
Q

Nondeclarative learning

A

Nonassociative, Associative, Procedural

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28
Q

Nonassociative

A

Habituation: Decreased responsiveness after repeated exposure
Sensitization: Increased responsiveness following threatening stimulus

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29
Q

Associative learning

A

Classical conditioning: Pair two stimuli

Operant conditioning: associate a response with a consequence

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30
Q

Procedural learning

A

Learning tasks that can be performed automatically without attention
Develops gradually through repetition of act over many trials

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31
Q

Declarative Learning

A

Results in knowledge of facts/events, such as awareness, attention, and reflection
*Practice can make transition from declarative to procedural knowledge

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32
Q

Closed versus open loop

A

Closed: Feedback from movement used for guidance
Open: Movements performed in absence of feedback

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33
Q

Schema Theory

A

Emphasize open loop

Generalized motor programs: Rules for creating spatial and temporal patterns of muscle activity needed for a task

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34
Q

Five Components to conceptual framework

A

A model of practice, A model of function and disability, Hypothesis-driven clinical practice, Principles of motor control and learning, Evidence-based practice

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35
Q

Nagi’s Model

A

Pathology, Impairment, Functional limitation, disability

36
Q

Impairment

A

Abnormalities, defects or losses in function of system

37
Q

Functional limitation

A

Impairment at level of organ

38
Q

Disability

A

Limitation of person in performing socially defined roles or tasks.

39
Q

Evidence-based practice

A

Integration of clinical expertise, the best available research evidence, and patient’s value

40
Q

Task-oriented approach

A

Integrates ICF model in EXAMINATION at a number of different levels

Framework for retraining posture, mobility, and manipulation

41
Q

Task-oriented Approach

What, how, why

A

What: Functional
How: Strategy
Why: Impairment

42
Q

Task-oriented Approach

What, how, why

A

Functional level
What can the patient do?
What does he/she have difficulty with?

Strategy level
What strategies are used to perform the task and what’s the ability to adapt strategy to changing task and environmental conditions?
How does he/she move?

Impairment level – What prevents him/her from doing what he/she wants to do? Limited ROM, weakness

43
Q

Three Stage Model

A

Reduce DoF to simple movement; More cocontraction; made at cost of efficiency and flexibility;
Advance
Expert: all DoF released; take advantage of passive force and movt expenditure to increase efficiency reduce fatigue

44
Q

Closed skills versus Open skills

A

Closed: Distinguish features of environment (Bowling, gymnastics)

Open: Adapt to ever changing environment and the demands
(Playing soccer, riding a bike)

45
Q

Blocked Practice

A

Same task, several repetitions

46
Q

Massed vs. distributed

A

Massed: more time in trial than rest

Distributed: time is equal or less than rest

47
Q

Part verse whole practice

A

part: Tasks naturally divided into units (single joint motion)
whole: Multi joint coordination

48
Q

guidance versus discovery

A

discovery is trial and error

49
Q

constant practice

A

same task, multiple times

50
Q

Factors affecting recovery of function

A

Age/gender, genetic make-up, lesion size/site, pre injury/experience, post injury factors

51
Q

Postural control - Purpose

A

The ability to control our body’s position in space is fundamental to everything we do.

52
Q

Alignment

A

relationship of body segments to one another, as well as to the position of the body with reference to gravity and the base of support.

53
Q

Posture

A

the biomechanical alignment of the body and the orientation of the body in the environment.

54
Q

Postural Control

A

control of the body’s position in space for orientation and stability

55
Q

Postural Tone

A

activity increases in antigravity muscle, which keeps the body from collapsing in response to the pull of gravity during quiet stance.

56
Q

Postural Orientation

A

ability to maintain an appropriate relationship between body segments, and between the body and the environment for a specific task

57
Q

Postural stability or balance

A

ability to control the center of mass in relationship to the base of support

58
Q

Center of Pressure

A

center of distribution of total force applied to supporting surface

59
Q

Center of Gravity

A

vertical projection of the center of mass

60
Q

Center of Mass

A

point at center of the total body mass

61
Q

Clinical Definition of falls

A

an event that results in a person coming to rest inadvertently on the ground (unplanned or unexpected contact with a supporting surface)

62
Q

Research Definition of falls

A

Research definition: movement of the CoM outside of the base of support (including stepping to recover stability)

63
Q

Movement strategy to maintain balance

A
  1. Control body sway
  2. Feedback control
  3. Feedforward control
  4. Anteriorposterior stability
  5. Lateral stability
  6. Multidirectional stability
64
Q

Anterioposterior stability

A

ankle strategy
hip strategy
stepping strategy

65
Q

Feedback Control

A

postural control that occurs in response to sensory feedback (somatosensory, visual or vestibular) from an unexpected perturbation

66
Q

Feedforward Control

A

postural responses that are made in anticipation of a voluntary movement potentially destabilizing in order to maintain stability during movement

67
Q

Ankle Strategy: Forward Sway

A

Use posterior muscles to restore CoM

68
Q

Ankle Strategy: Backward Sway

A

Use anterior muscles to restore CoM

69
Q

Ankle Strategy: Timing of activation

A

From distal to proximal muscles

70
Q

Hip Strategy: Forward Sway

A

Large anterior muscles used to prevent falls

71
Q

Hip Strategy: Backward Sway

A

Large posterior muscles used to prevent falls

72
Q

Hip Strategy: Timing

A

From proximal to distal muscles

73
Q

Stepping Strategy

A

When the ankle and hip strategies are not enough to maintain the balance, a step will restore the CoM.

74
Q

Sensory Inputs Contributing to Postural Control

A

Visual inputs - body/objects in environment
Somatosensory inputs - surface of support
Vestibular inputs - gravity

75
Q

Sensory Weighted Hypothesis

A

When one sensory system is less reliable, the input to the CNS from that system is weighted less heavily, and inputs from other systems will be weighted more heavily

76
Q

Major Factors Contributing to Aging

A

Primary or Genetic factors

contribute to the loss of neuronal function within a system over which we have LITTLE control

77
Q

Secondary or experimental factors contributing to aging

A

environment, nutrition, and lifestyle, affect our nervous system function over which we have MORE control.

78
Q

Physically Frail

A

JORDAN: Light house keeping, food preparation, can pass some IADL and all BADLs

79
Q

Muscles and aging

A

Number of motor units declines with aging

Some loss of Type II fibers or atrophy of type II fibers

80
Q

Age-Related change in somatosensory system

A

vibratory sensation threshold increases with age; tactile sensitivity decreases (or increased threshold to touch stimuli) with age;

81
Q

Age-Related change in vision

A

visual threshold increases with age, as well as decrease in visual acuity

82
Q

Age-Related change in vestibular system

A

aging causes a reduction in vestibular function, with a loss of 40% of vestibular hair by 70 years

83
Q

Geriatric Society Recommendations for Prevention of Falls

A

All older individuals should be asked whether there was a fall for the last 12 months.

An older person reporting a fall should be asked about the frequency and circumstance of the fall.

Older adults should be asked if they experience difficulties with walking or balance.

Older persons presenting with a single fall should be evaluated for gait and balance, and many more.

84
Q

As you age you vibration threshold will?

A

Increase

85
Q

Walking/Talking what area/strategy is used?

A

attentional strategy

86
Q

As you age visual threshold ____, and visual acuity ______.

A

Increases, decreases

87
Q

Majority of falls in neurological pathologies associated with?

A

Mobility (gait)
Transfers
Stair Climbing

Motor Learning (1 decks)

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