Neurological Rehabilitation Flashcards
Define Motor Control.
The study of the nature of movement; or the ability to regulate or direct essential movement
Historically though to arise from reflex or hierarchical models where the cortex was perceived as the highest functioning component of the system and spinal level reflexes were the lowest functioning components
Name a few of the motor control theories.
- Reflex theory
- Hierarchical theory
- Motor programming theory
- Task-oriented theory
- Ecological theory
Define Motor Learning.
Study of the acquisition or modification of movement.
What does Motor Learning differentiate?
Differentiates learning vs performance, provides guidelines for appropriate use of feedback, prioritizes the impact of practice as it relates to skill and movement, and also focuses on the transfer of learning across tasks and environments of practice.
What are the two initial theories of motor learning?
- Adam’s closed loop theory
2. Schmidt’s schema theory
What is Adam’s closed loop theory?
- First attempt at the creation of a comprehensive motor learning theory with the precise of sensory feedback as an ongoing processes for the nervous system to compare current movements w/stored information on memory of past movement
- high emphasis on the concept of practice
What is Schmidt’s schema theory?
- response to the limitations of the closed loop theory
- Main construct relies on open loop control processes and a motor program concept
- promotes clinical value of FB and importance of variation with practice
What are the 3 stages in the 3 stage model of motor learning?
- Cognitive stage
- Associative stage
- Autonomous Stage
Describe the cognitive stage.
-initial stage of learning where there is a high concentration of conscious processing of information
What will a person acquire during the cognitive stage?
Acquire information regarding the goal
What is the ideal environment for a person in the cognitive stage of learning?
controlled environment
What are the characteristics of the cognitive stage?
- large amount of errors
- inconsistent attempts
- repetition of effort allows for improvement in strategies
- inconsistent performance
- high degree of cognitive work; listening, observing and processing FB
Describe the associative stage of learning.
-intermediate stage of learning where a person is able to more independently distinguish correct vs incorrect performance
What is the person doing during the associative stage?
The person is linking the FB that has been received with the movement that has been performed and the ultimate goal
What environment should the person be in during the associative learning phase?
-A controlled environment is helpful but at this stage the person can progress to a less structured or more open environment
What should be avoided during the associative stage of learning?
Avoid excessive external FB as the person should have improved internal or proprioceptive FB for the task at hand
What are the characteristics of the Associative stage of learning?
- decreased errors with new skill performance
- decreased need for concentration and cognition regarding the activity
- skill refinement
- increased coordination of movement
- large amount of practice yields refinement of the motor program surrounding the activity
Describe the autonomous stage of learning
-the final stage of learning or skilled learning where a person improves the efficiency of the activity without a great need for cognitive control
What environment is a person in the autonomous stage of learning able to perform in?
Person in this stage of learning is able to perform the task with interference from a variable environment
What is the autonomous stage characterized by?
- automatic response
- mainly error-free regardless of the environment
- patterns of movement are non-cognitive and automatic
- distraction does not impact the activity
- the person can simultaneously perform more than one task If needed
- extrinsic Feedback should be very limited or should not be provided
- internal feedback or self-assessment should be dominant
Why is feedback important?
- It is imperative for the progression of motor learning.
- Allows for correction and adaptation within the environment
- Pts will rely on both intrinsic and extrinsic feedback
What does current research support in regards to extrinsic feedback ?
Research supports reducing the extrinsic feedback (fading of feedback) in order to ultimately enhance learning
List the types of feedback
- Intrinsic (inherent) FB
- Extrinsic (augmented) FB
- Knowledge of results (KR)
- Knowledge of performance (KP)
Describe Intrinsic (inherent) FB.
- represents all FB that comes to the person through sensory systems as a result of the movement.
- Includes: visual, vestibular, proprioceptive, and somatosensory inputs
Describe extrinsic (augmented) FB.
- represents the information that can be provided while a task or movement is in progress or subsequent to the movement
- typically in the form of verbal FB or manual contacts
Describe KR.
- important form of extrinsic FB
- includes: terminal FB regarding the outcome of a movement that has been performed in relation to the movement’s goals
Describe KP
Extrinsic FB that relates to the actual movement pattern that someone used to achieve their goal of movement
In NeuroRehab what does practice refer to?
Repeated performance of an activity in order to learn or perfect a skill
What does practice allow?
Allows for direct physical experience and kinesthetic stimulation to assist with acquisition of the skill
What is mental practice?
Cognitive rehearsal of a task or experience without any physical movement
List the types of practice in NeuroRehab.
- Massed Practice
- Distributed Practice
- Constant Practice
- Variable Practice
- Random Practice
- Blocked Practice
- Whole Training
- Part Training
Massed Practice
The practice time in a trial > the amount of rest b/t trials
Distributed practice
The amount of rest time b/t trials is =/> the amount of practice time for each trial
Constant practice
Practice of a given task under a UNIFORM condition
Variable practice
Practice of a given task under differing conditions
Random practice
Varying practice amongst different tasks
Blocked Practice
Consistent practice of a single task
Whole training
Practice of an entire task
Part training
Practice of an individual component or selected components of a task
Closed System model
- characterized by transfers of information that incorporates multiple FB loops and larger distribution of control
- the NS is seen as an active “participant” with the ability to enable the initiation of the movement as opposed to solely “reacting” to stimuli
Compensation
Ability to utilize alternate motor and sensory strategies due to an impairment tha limits the normal completion of a task
Habituation
Decrease in response that will occur as a result of consistent exposure to non-painful stimuli
Learning
The process of acquiring knowledge about the world that leads to relatively permanent change in a person’s capability to perform a skilled action
Types of learning
- Non-associative
2 associative - Procedural
- Declarative
Non-associative Learning
A single repeated stimulus (habituation, sensitization)
Associative Learning
Gaining understanding of the relationship b/t two stimuli, causal relationships or stimulus and consequence (classical conditions, operant conditioning)
Procedural Learning
- Learning tasks that can be performed without attention or concentration to the task
- A task is learned by forming movement habits (developing a habit through repetitive practice)
Declarative Learning
Requires attention, awareness, and reflection in order to attain knowledge that can be consciously recalled (mental practice)
Motor learning
- ability to perform a movement as a result of internal processes that interact with the environment and provide a consistent strategy to generate the correct movement.
- acquisition of, or modification of movement
Motor program
- concept of a central motor pattern that can be activated by sensory stimuli or central processes.
- motor programs are seen as contains the rules for creating spatial and temporal patterns of motor activity needed to carry out a given motor task
Open system model
- characterized by a single transfer of information w/o any FB loop (reflexive hierarchical theory)
- in theory, the NS is seen as awaiting stimuli in order to react
Performance
- temporary change in motor behavior seen during a particular session of practice that is a result of many variables, however, only one variable is focusing on the act of learning.
- Performance is not an absolute measure of learning since there are multiple variables that potentially affect performance
Plasticity
-ability to modify or change at the synapse level either temporarily or permanently in order to perform a particular function
Plasticity
-ability of the motor and sensory systems to stabilize position and control movment
Recovery
-ability to utilize pervious strategies to return to the same level of functioning
Sensitization
The increase in response that will occur as a result of a noxious stimuli
Strategy
A plan used to produce a specific result or outcome that will influence the structure or system
