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NM PCM > Strategies to Improve Motor Function > Flashcards

Strategies to Improve Motor Function Flashcards

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1
Q

Motor control

A

Area of study dealing with the understanding of the neural, physical, and behavioral aspects of movement

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2
Q

Motor control sequence

A

stimulus –> stim identification –> response selection –> response programming –> movement output

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3
Q

Who’s associated with Reflex theory?

A

Sherrington.

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4
Q

What is reflex theory?

A

stimulus –> response sequence of events

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5
Q

Limitations of reflex theory

A

Voluntary movements can be activated without sensory input

Speed of movements; some so fast that no feedback

Variety of motor responses to same stimulus

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6
Q

Who is associated with Hierarchical theory?

A

Hughlings Jackson

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7
Q

What is Hierarchical theory?

A

CNS organized into 3 levels: high, middle, and low centers. Control proceeds in a descending direction from higher to lower centers, “top-down”

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8
Q

Modern model of Hierarchical theory highest level

A

association cortex; elaborating perceptions, and planning strategies

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9
Q

Modern model of Hierarchical theory middle level

A

sensorimotor cortex along with basal ganglia, brainstem, cerebellum

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10
Q

Modern model of Hierarchical theory lowest level

A

spinal cord, resulting in execution of movement

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11
Q

Who is associated with Systems Theory?

A

Bernstein

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12
Q

What is systems theory?

A

Cooperative actions of many systems; internal and external factors; shifting locus of control: distributed model of control
Coordinative structures simplify control with coordinated patterns or synergies
(Central patterns generators (locomotion) &
Postural synergies - normal)

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13
Q

Who is associated with Systems Model?

A

Vereijken

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14
Q

What is systems model?

A

3 levels:
Novice: learner simplifies the movement to reduce the degrees of freedom
Advanced: learner begins to release additional degrees of freedom; muscle synergies used to produce coordinated movement
Expert: learner has released all degrees of freedom, optimizes efficiency of movement

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15
Q

Open loop control system

A

absence of peripheral feedback and error detection

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16
Q

Closed loop control system

A

Feedback, reference for correct movement, can initiate corrections

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17
Q

Motor learning

A

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

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18
Q

Aspects of motor learning

A

performance, retention, generalizability/adaptability, resistance to contextual change

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19
Q

Basic learning principles

A
  • need to be able to problem solve & practice solutions for independent ADL
  • must be possibility of success
  • revert to safer/familiar patterns to solve the problem if task is difficult or unfamiliar.
  • learning occurs in multiple parts of CNS
  • motivation to experience the unknown is necessary
  • success in learning is essential to retain motivation
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20
Q

Who is associated with Closed loop theory?

A

Adams

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21
Q

What is closed loop theory?

A

Sensory feedback compared with perceptual trace (stored memory of intended movement)

Provides reference of correctness and error detection
Practice enhances perceptual trace

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22
Q

Who is associated with Schema Theory?

A

Schmidt

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23
Q

What is Schema theory?

A

Slow movements: feedback-based
Fast movements: program-based
Schema: rule, concept, or relationship formed on the basis of experience
Initial conditions
Relationships between movement parameters
Environmental outcomes
Sensory consequences

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24
Q

Recall schema

A

used to select, define initial movement conditions

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25
Recognition schema
used to evaluate movement responses based on expected sensory consequences/outcomes
26
Who is associated with the 3 stages of motor learning?
Fitts and Posner
27
What are the three stages?
Cognitive Associative Autonomous
28
Cognitive stage
finding appropriate strategy, overall understanding of skill, cognitive map, What to do
29
Associative Stage
refining a movement pattern, use of proprioceptive rather than visual cues; How to do
30
Autonomous Stage
skilled at movement, automatic, less attention needed for task, motor program runs itself, highly coordinated, focus on success, can perform equally well in closed skill or open skill; How to succeed
31
Who is associated with the Two-stage theory of motor acquisition?
Gentile
32
What is the Two-stage theory of motor acquisition?
1) getting the idea of the movement | 2) fixation/diversification
33
What does "getting the idea of the movement" consist of?
Understanding goal of task Develop appropriate movement strategies Understanding the environmental features critical to the organization of movement learn to distinguish constraining (regulatory) features of the environment from non-regulatory
34
What does "fixation/diversification" consist of?
refining movement patterns developing the capability of adapting the movement to changing task and environmental demand performing task efficiently, consistently from trial to trial.
35
Strategy development
Help learner develop an internal cognitive map or reference of correctness DEMONSTRATION Clear, concise instructions Allow for trial and error learning Guidance Active decision making Strategy refinement Motor plans specific to activity Context in which the pt practices Sequence of activities has an outcome measurement perspective Drawing cognitive attention off the task and to perform the activity as a “procedure”
36
Intrinsic feedback
comes from proprioception and kinesthetic senses
37
Extrinsic feeback
Augmented sensory cues
38
Concurrent feedback
Given during the performance of task
39
Terminal feedback
Given at end of performance of task
40
Knowledge of performance
(KP) feedback about the quality of the movement pattern
41
Knowledge of results
(KR) feedback about the end result or outcome
42
Clinical decisions around feedback
What type (mode), how much (intensity), when (timing/scheduling)
43
Modes of feedbacl
Visual, auditory, tactile
44
What intensity feedback is better for improved retention?
Varied feedback. But slows initial acquisition.
45
What intensity feedback helps correct early performance but slows retention?
Frequent/constant
46
Types of scheduling of feedback
summed, faded, bandwidth, delayed
47
Summed scheduling
Given after set number of trials
48
Faded scheduling
Given after every trial initially, then progressively less frequently
49
Bandwidth scheduling
Given only when performance outside given error range
50
Delayed scheduling
Given after brief delay (allows for self-reflection)
51
Closed practice environment
Stable, predictable
52
Open practice environment
changing, variable
53
Which practice distribution has less rest time than practice time?
Massed practice.
54
What person is massed practice good for?
high motivation, good concentration, and good endurance/energy level
55
What is a distributed practice distribution?
rest time equal to or longer than practice time. MOST LEARNING PER TRAINING TIME.
56
What is a blocked practice order?
Repeated practice in a predictable order (111222333)
57
What is blocked practice good for?
Early acquisition of skills
58
What is practice in a predictable but non-repeating order called?
Serial. (123123123)
59
What practice orders are good for retention and generalizability
Serial and Random.
60
What is a non-repeating and unpredictable practice order?
Random. (123321231)
61
Does mental practice facilitate motor skill acquisition?
Yes. & it activates similar areas of brain as actual task, very good when combined with physical practice (increase accuracy and efficiency of task faster)
62
Transfer of learning
the gain (or loss) of task performance as a result of practice or experience on some other task.
63
Parts-to whole transfer
Practicing component parts of a motor activity in order to learn the whole activity
64
Bilateral transfer
the patient practices movement on unaffected side first, then progresses to practice with the affected side
65
Speed-accuracy tradeoff
the accuracy of a movement is decreased as its speed is increased
66
Regenerative synaptogenesis
sprouting of injured axons to innervate previously innervated synapses
67
Reactive synapytogenesis
[collateral sprouting] reclaiming of synaptic sites of injured axon by dendritic fibers from neighboring axons
68
Synaptic plasticity
Improvement in neurotransmitter release and receptor sensitivity
69
What is function induced recover also known as?
Use-dependent cortical reorganization - Vicariance - Substitution
70
Who is associated with NDT
(neurodevelopmental treatment) | Karl and Berta Bobath
71
What is NDT?
Postural control is foundation for all skill learning. Control movement through the use of developmental sequence promoting “normal” selective movements. Facilitate through the use of handling and key points of control to improve postural alignment and control/stability
72
How does NDT work?
Excessive tone inhibited through dynamic reflex inhibiting patterns Sensory stimulation used to facilitate normal movement experiences Activities are varied in terms of difficulty and environmental context Compensatory strategies are avoided
73
What are Carr and Shepard associated with?
Motor relearning programme for stroke
74
What is motor relearning programme for stroke
Task performance analyzed and activities selected for practice. Environment modified to create appropriate setting to promote learning and goal-directed behaviors. Complex movements are broken down into discrete parts and then practiced as a whole. Motor learning training strategies are used, visual guidance of movement and verbal feedback (corrections) are stressed. Manual guidance of movements limited to essential assistance to movement.
75
What is Signe Brunnstrom associated with?
Recovery Stages in Patients with Stroke & abnormal synergistic control in patients with stroke
76
What are the Recovery Stages in Patients with Stroke ?
Stages 1 - 6
77
Brunnstrom stages 1-2
1) presence of flaccidity | 2) emergence of basic limb strategies
78
Brunnstrom stages 3-4
3) voluntary performance of all or part of basic limb synergies 4) beginning of controlled movement outside of synergistic pattern
79
Brunnstrom stages 5-6
5) Relative independence of basic limb synergies | 6) Isolated, coordinated joint movement
80
What are Kabat, Knott and Voss known for?
PNF!
81
What is PNF?
Functional patterns that are spiral and diagonal, based on normal movements Developmental emphasis was added later to include practice in the various different patterns of the developmental sequence. Motor learning strategies: practice, repetition, visual guidance of movement
82
What is Margaret Rood associated with?
Neuromuscular/Sensory stimulation techniques.
83
What are neuromuscular/sensory stimulation techniques
Phasic stimuli [quick ice, quick stretch] Tonic stimuli [approximation, steady resistance] Facilitatory or inhibitory stimuli used to achieve desired outcome
84
Reciprocal innervation
reflex activation for movement patterns in developmental sequence
85
Coinnervation
cocontraction of agonist and antagonist to stabilize body from head to feet
86
Heavy work
movement superimposed on cocontraction
87
Skill
Skilled work, with emphasis on distal portions of body segment

NM PCM (6 decks)

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