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Neuromuscular > Neuroplasticity & Motor Control/Learning > Flashcards

Neuroplasticity & Motor Control/Learning Flashcards

1
Q

Motor Learning

A

-learning new strategies from moving
-permanent changes in behavior
-increases activity of thalamocortical pathways
-parallel pathways aid in efficiency and redundancy

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2
Q

Performance

A

-temporary change in motor behavior

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3
Q

Classical Conditioning

A

-1 stimulus to conditioned response
-weak stumulus and response paired with stronger stimulus
-pavlov

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4
Q

Operant Conditioning

A

-behavior to consequences
-trial and error: behavior shaped by internal throughts and motivation
-consequences: reinforcement to strengthen behavior and punishment to weaken

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5
Q

Implicit Procedural Learning

A

-skills and habits performed without attention
-must be performed by learner
-basal ganglia loops
-riding a bike

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6
Q

Explicit Learning

A

-conscious processes with end product of acquiring knowledge
-prefrontal cortex, limbic
-learning to code

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7
Q

Early Cognitive Phase

A

-high attention
-activation inc then dec in dorsolateral PFC, sensorimotor corticies, parietal and cerebellum
-sesnory feedback
-performance with rapid improvement
-lots of error

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8
Q

Associative Phase

A

-motor/sensory pathways active but less
-inc in cerebellar activity and basal ganglia
-executive function needed
-new skills, compare results
-refine skill
-slower improvements

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9
Q

Autonomous Stage

A

-primary cortex remains active but decreased
-more automatic basal ganglia
-increased accuracy, less attention
-stable performance

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10
Q

Degrees of Freedom

A

-coordination of movement
-start with a little and increase overtime as mmt becomes habitual

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11
Q

Movement Schema

A
  1. Initial Movement Conditions: where
  2. Parameters in Motor Program (KOP): how to
  3. Knowledge of Results: How did i do
  4. Sensory Consequences
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12
Q

Instability

A

-lots of instability following brain injuries
-need instability to form new patterns of stability

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13
Q

Gordon’s Investment Principle: Task-Oriented Theory

A

-plateau using old strategy
-new strategy will increase performance

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14
Q

Newell’s Theory of Learning

A

-during practice optimal strategies to solve the task
-Perception as prescriptive: understanding of goal and movements
-Perception as feedback: knowledge of performance and knowledge of results

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15
Q

Knowledge of Results

A

-extrinsic feedback about outcome
-given after pt has thought about their performance

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16
Q

Knowledge of Performance

A

-during task, analyzing performance
-movement parameters

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17
Q

Massed vs Distributed

A

Masses: same time
Distributed: spaced out (better for learning)

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18
Q

Constant vs variable

A

Constant: same circumstances
Variable: different (better for learning)

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19
Q

Contextual Interference

A

-doing something different in between breaks

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20
Q

Learned Non-use

A

-pt can use arm, they just havent learned not to use it
-from overuse of other limbs or learning compensations

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21
Q

Prior to Practice Considerations

A

Consider:
-stage of learning
-goal
-environment
-instructions

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22
Q

During Practice Considerations

A

Consider:
-task specific activity
-time allowances
-mental practice
-trial and error

23
Q

Levels of Movement Analysis

A

Action Level: behavioral outcome; could it be done

Movement Level: movement strategy to accomplish outcome; how was it done

Neuromotor Level: underlying process contributing to movement; why was it done

24
Q

Organization of Movement: Individual

A

-cognition
-perception
-action

25
Q

Organization of Movement: Task

A

-mobility
-stability
-manipulation

26
Q

Organization of Movement: Environment

A

-regulatory
-nonregulatory

27
Q

Gentile’s Taxonomy

A

-system to classify tasks to understand demands on person
-environment
-function

28
Q

Gentile’s Taxonomy: Environmental Context

A

-mmt matches environ features

Stationary: timing not specified

Motion:
-occurs independently of person
-must match movements of environment
-compensatte for delays
-predictions

29
Q

Intertrial Variability

A

-changes in conditions between tasks

As movement variability decreases
-less attention paid
-pattern, schema, less late practice
-closed skill
ex: turning on the same light everyday

As movement variability increases
-more attentiveness
-new movement pattern generated
-open skill
-requires continued late practice
ex: working with a different patient each day

30
Q

Gentile’s Taxonomy: Task Categories

A

Closed Task: stationary objects
-don’t change each trial
-least interaction with environment
Ex: pick up a phone off a desk

Variable Motionless Tasks: stationary objects
-task may vary from one attempt to next
Ex: pick up a differing cup off of a desk

Consistent Motion Tasks: motion of object remains constant
-most interactiton with environment
Ex: getting on an escalator

Open Tasks: most interaction
-most complex
Ex: running in an obstacle course

31
Q

Gentile’s Taxonomy: Function of Action

A

Body Orientation:
-stabilizing or transporting tasks

Manipulation: usually with hands
-w/o manipulation, arms are part of postural system

32
Q

Principles of Neuroplasticity

A

Use it or lose it
Use it and improve it
Specificity
Repetition
Intention
Salience
Time Since Onset
Age
Transference
Interference

33
Q

Grading Functional Tasks: LE

A

-speed
-loading
-assistance
-Intensity
-error
-AD
-Cardiovascular factors
-Accuracy

34
Q

Grading Functional Tasks: UE

A

-position of patient (describe)
-objects being manipulated (position, weight, size)
-AD
-Time
-Unilateral vs Bilateral
-Accuracy

35
Q

Factors that Influence Neuroplasticity

A

Sleep: storage of earlier learning
-plasticity cotinues in sleep

Mood:
-Depression: reduces hippocampus, neuronal loss, decreased conentration/memory
-Stress: mild=enhances learning and memory; chronic can cause neuronal loss

Cardiorespiratory Funtion:
-decrease of dementia
-improves….everything

36
Q

Predictors of Walking Recovery Post Stroke

A

80% walk post stroke
98% walked at 6m IF:
-(I) sitting balance in first 3 days
-LE strength of 1/5 in first 3 days

27% walked if criteria was unmet in 3 days
10% if unmet in 9 days

-Berg balance <20/56 % FIM 1 or 2= 20x more likely for only home ambulation

37
Q

Predictors of UE Funcgtional Recovery Post Stroke

A

AROM of shoulder and middle finger predictted function at 3m
-if not at 3 months, likely wont have functional use

38
Q

AVERT Study

A

Control= standard of care
Experimental=
-1st mobilization within 24hrs
-upright 2x/d
-BID
-14 days total

Significant Differences:
-time in PT
-time to first mobilization
-cost of care
-function

39
Q

Standing Balance and Gait Study

A

-standing feedback traininer
-no significant differences
-ie, dont train gait using body weight supports

40
Q

Gait Speed

A

-6th vital sign

Unlimited Household Ambulation: 0.27m/s

Limited Community Ambulation: 0.58m/s

Unlimited Community Ambulattion: 0.8m/s

Cross Commercial Street: 2 m/s

Non-stroke Community Ambulation: 1.2m/s

41
Q

Neurology of Walking: Essential Neuroanatomy

A

-muscles and peripheral nerves
-spinal cord pattern generators
-Anteriolateral/medial SC pathways
-Medullary Reticular Formation
-Mesencephalic Locomotor Region
-Subthalamic Locomotor Regions

42
Q

Neurology of Walking: Important Neuroanatomy

A

-sensation
-Posteriolateral SC pathways
-Pontomedullary Locomotor Strip
-Cerebellum (vermis)
-Red nucleus
-Lateral Vestibular Nuclei
-Basal Ganglia
-Limbic Cortex (hippocampus)

Function:
-timing of swing vs stance phase
-coordination
-motivation (hippocampus)

43
Q

Neurology of Walking: Accessory Regions

A

-Motor cerebral cortex
-Pyramidal Tract

Functions:
-influence initiation, timing, transition of gait, positioning of the foot

44
Q

Spinal Cord Central Patern Generators

A

-intrinsic circuits located in grey matter that produces and repeas a functional behavior
-switches between flexors and extensors
-can react to sensory input
-can recover and learn

45
Q

Medial Medullary Reticular Formation

A

-final inttegrattive center for locomotion before spinal cord
-driving center for locomotion
-descends in anterolateral cord to provide drive to CPG
-treadmil training can create new CPG when forcing symmetrical mmts

46
Q

Mesencephalic Locomotor Region

A

-region of midbrain
-when stimulated, lococmotion is initiated with speed of movement consistent
-modulates speed of walking
-involved in exploratory walking

47
Q

Subthalamic Locomotor Region

A

-responsible for spontaneuous goal-directed locomotion

48
Q

3 Key Sensory Inputs for CPG

A

Sretch of hip flexors:
-resets CPG
-hip ext during mid stance triggers swing from muscle spindles
-stopping extension stops walking

Unweighting of triceps surae: -initiates step

Weight Bearing to facilitate extensor tone

49
Q

Lokomat

A

-Pt in suit that thelps them move
-max speed of 2mph

50
Q

Contraint Induced Movement Therapy (CIMT)

A

-learned non-use
-cortical reorganization can happen with aggressive treatment

Principals:
-increased arm use
-Massed practice
-High motivational drive

  1. Learned non-use
  2. increased motivation
  3. Use
  4. Reinforcement
  5. More Practice
  6. Cortical reorg
  7. Reversal of Learned non-use
51
Q

Candidates for CIMT

A

-raise arm 45deg
-extend elbow 30deg with shoulder flxed 90
-extend wrist 10-20deg , slightly extend at least 2 fingers and extend thumb 10deg**
-Stand for 2 min
-B/B continence
-understand and follow directions**
-Medically stable and highly Motivated

52
Q

CIMT Protocol

A

Repetitive, Task-oriented training:
-shaping
-task practice

Adherence-enhancing behaviors:
-behvaior contract
-diary
-log

Constraining use of less affected:
-Mitt restraint of less involved UE
-remind Pt to use involved limb

53
Q

EXCITE Trial

A

-stroke survivors recieving CIMT
-significant inprovements
-unmasked an ability already present

Neuromuscular (21 decks)

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