Optimizing motor planning

Question 1

What is a newer 3rd category of UMN dysfunction

Answer 1

Adaptive features: can include synergies and maladaptive strategies

Question 2

How do adaptive features develop

Answer 2

in response to an individuals attempts to move w/in the constraints of their impairment

Question 3

What are the 2 kinds of primary impairments

Answer 3

Negative

positive

Question 4

What are negative impairments

Answer 4

hemiplegia/hemiparesis
sensory loss
fatigue
decreased mvmt and speed 
decreased motor praxis

Question 5

what are positive impairments

Answer 5

if you display these you have the disorder
spasticity
aaxia
intention tremor
resting tremor

Question 6

What are the 2 primary ways of motor learning

Answer 6

Implicit

Explicit

Question 7

What is explicit learning

Answer 7

conscious encoding of specific facts, tasks, rules, and events

Question 8

How to facilitate explicit motor learning

Answer 8

provide task-relevant feedback and cues that are more generalizable

Question 9

What is implicit motor learning

Answer 9

unconscious change in behavior resulting from repetition w/in a stable context

Question 10

How to facilitate implicit moor learning

Answer 10

structuring the environment to create consistent cues and frequent opportunities for practice

Question 11

What is the dynamical systems theory based in

Answer 11

mathematics

Question 12

what are basic concepts of the dynamical systems theory

Answer 12

they are self-organizing
systems exist to solve problems that are internal or external challenges
have the capacity to self-organize to meet the challenge
seek the most efficient solutions to self organize

Question 13

What are the most efficient solutions in dynamic systems

Answer 13

those w/ the least amount of degrees of freedom (# of components that are free to vary)

Question 14

What are OTs interested in in dynamical systems

Answer 14

the disequilibrium that occurs when a dynamic system is disrupted

Question 15

how is the dynamical systems organized

Answer 15

Heterarchical not hierarchical
not a specific order and spinal levels strucutres aren’t responsible for direct mvmt commands
not bottom up or top down

Question 16

What is the ecological systems theory

Answer 16

human dev. is influenced by different types of environmental systems

Question 17

What does the ecological systems theory help us understand

Answer 17

Why we behave differently when we compare our behavior in the presence of family and at wok/school.

Question 18

Why was the motor program theory developed

Answer 18

to limit the degrees of freedom during motor performance

Question 19

What are the 2 distinct concepts of the motor program theory

Answer 19

1. a motor program is a memory based schema that controls coordinated movt.
2. Attractor is a preferred pattern w/in a motor control system that leads to a consistent pattern of performance (practice makes perfect)

Question 20

What is the goal of the motor program theory

Answer 20

to create a stable yet flexible attractor state

Question 21

What are generalized motor programs

Answer 21

prestructured sets of central commands that govern a particular class of actions (muscle memory)

Question 22

What is EXCITE

Answer 22

extremity constraint induced therapy evaluation

largest systematic outcomes study in history of stroke rehab

Question 23

what was the goal in developing a modified cimt protocol

Answer 23

to decrease cost and increase accessibility while maintaining the outcomes of cimt

Question 24

How does CIMT work with the dynamic systems theory

Answer 24

ots can provide external challenge through structuring constraints during task related performance

Question 25

What is bilateral arm training

Answer 25

technique in which pts perform repetitive identical movts w/ both arms simultaneously

Question 26

What do the most relevant improvements in motor skills result from

Answer 26

implicit learning

Question 27

For improvements to occur pts must what

Answer 27

be actively engaged and attempting to move for a functional purpose

Question 28

What did robots in therapy indicate

Answer 28

support for motor learning

Question 29

What is more effective than exercise to individual muscles

Answer 29

Tx that continuously challenges and assists the pt. to perform task-driven movts

Question 30

Treatment approaches for stroke

Answer 30

CIMT mCIMT Bilateral arm training Robotics and virtual reality Mirror therapy

Question 31

What is mirror therapy used for

Answer 31

to improve motor function

Question 32

What are the 4 main factors of optimal motor performance

Answer 32

1. 5 mechanical requirements for movt execution 2. Kinesthetic understanding of foundational movt strategies 3. postural adjustments 4. task demands and capabilities

Question 33

What are the 5 mechanical requirements for movt execution

Answer 33

``` joint mobility dissociation optimal postural alignment freedom from other secondary impairments capacity to generate muscle contraction ```

Question 34

What is joint mobility

Answer 34

capacity of limbs to be moved passively around a joint

Question 35

What is jt mobility necessary for

Answer 35

active movt and functional performance

Question 36

What is dissociation

Answer 36

underlying potential for adjacent body segments to move independently from another

Question 37

what does optimal posture alignment do

Answer 37

allows a person to efficiently maintain balance against the force of gravity, to freely dissociate adjacent body segmnts and move arms and legs o a s table foundation at the body core

Question 38

What is the importance of the pelvis

Answer 38

serves as a corner stone to allingment of the trunk and limbs

Question 39

what does anterior tilt do

Answer 39

accentuate lordosis abdominal shortening of extensors weakness of abs

Question 40

What will posterior tilt do

Answer 40

decrease normal lordotic curve of lumbar spine resulting in kyphotic posture

Question 41

What do stroke pts exhibit in sitting

Answer 41

excessive posterior pelvic tilt | excessive lateral pelvic tilt

Question 42

What do strke pts exhibit in stading

Answer 42

greater weight bearing to unaffeted side

Question 43

What are the two categories of UMN dysfunctions

Answer 43

Primary: impairments related directly to the lesion Secondary: preventable deficits that develop over time in response to immobility, inactivity, or asymmetries in postural alignment (decreased JROM, pain, edema)

Question 44

What to do with freedom from other secondar impairments

Answer 44

address edema, pain, and complex pain syndromes

Question 45

What is viewed as the ultimate goal in neuro rehab

Answer 45

capacity to generate muscle contraction q

Question 46

What is the criteria for dev. stronger motor memories

Answer 46

learner has opportunity to practice practice occurs in a natural setting variable rather than repetitive and blocked practice learner develops an intrinsic feedback sstem

Question 47

Individuals with impairments in postural adjustments will have what

Answer 47

fear of falling when changing positions

Question 48

What are individuals with impairments in postural adjustments liekly to develop

Answer 48

adaptive strategies that become maladaptive long term

Question 49

What is the goal of task based interventions

Answer 49

generalization pt. will develop an underlying strategy for performing an infinite variety of tasks that require motor skills (take thigns they learned and use in a different setting)

Question 50

What should the therapist do as the coach

Answer 50

structure practice sessions provide instructions develop pts. ability to actively analyze performance focus attention

Question 51

What are 4 factors to consider prior to interventions

Answer 51

pelvic/trunk alignment/mobility spasticity scapular and glenohumeral alignment scapular mobility

Question 52

What are some interventions to promote movt in the arm and hand

Answer 52

``` FES Mental practice mirror therapy priming kinesotaping ```

Question 53

Muscles that are spastic are what

Answer 53

hyperresponsive to quick stretch (stretch fast, increases spasticity)

Question 54

How to have functional use of the arm and hand

Answer 54

prevent learned non-use (use my arm program, breakfast group) Dev. effective motor programs or reach and grasp match task demands to the persons capability