Test 2: Sensorimotor system Flashcards
4 processes of information flow to control movement, what are they?
motivation, ideation, programming, execution
• The shortcoming of traditional sensorimotor approaches
They do not include the volitional intent or motivation to perform a motor act
Motor relearning program should be ____ oriented & tied to an _____ or task when possible
cognitively
occupational goal
Interventions occur on a with the therapist providing ____ so that voluntary motor control is achieved.
continuum
less and less external sensory stimulation
Brunnstrom or movement therapy approach has a ___ background
- Designed approach for
- Original Approach: Facilitates recovery through the progression of reflexive to volitional movement
PT
Brunnstrom or movement therapy approach was originally designed for ____
CVA recovery
Original Brunnstrom Approach: Facilitates recovery through the progression of
reflexive to volitional movement
Brunnstrom’s approach is not typically used in practice today secondary to fear of
reinforcing abnormal movement patterns
Brunnstrom’s approach (original; not used in therapy today) Apply resistance on one side of the body to ______ Note: The current understanding is that reflexive movements are NOT precursors to active, functional motor performance
increase muscle tone on the opposite side thereby creating a reflexive movement response or associated movement •
Brunnstrom’s revised approach
• Instead of focus on reflexive movements, it emphasizes use of _____• Willed movement is utilized to gain control over synergistic movement patterns • Functional, repetitive use of movement from everyday activities is utilized to increase voluntary movement of the affected limb.
attention to movement
Margaret Rood promoted the use of _____ to promote changes in muscle tone
developmental postures
Shortcomings of Margaret Rood’s approach: •
Passive nature of sensory stimulation • Effects may be short-lasting and unpredictable
Deep pressure to tendon’s insertion can elicit an _____ effect on muscle tone
inhibitory (decreased
PNF is based on mass movement patterns that are ____ and ___
“spiral” and “diagonal”
The growth of motor behavior has ____ trends, as evidenced by shifts between flexor and extensor dominance •
cyclic
Normal motor development has an orderly sequence by lacks a _____ quality.
step-by step
PNF progression
start at Head/Neck => Upper trunk => UE’s => Lower Trunk => LE’s • Watch how patient moves with functional activities, place in positions and see if can maintain, compensatory movements?
• D1 Flexion
• Scapula Anterior Elevation, abduction and rotation • Shoulder flexion, adduction and external rotation • Elbow flexion/extension, forearm supination, wrist flexed and radially deviated • Fingers flexed and adducted, thumb adduction
• D1 Extension
• Scapula posterior depression, adduction and rotation • Shoulder extension, abduction and internal rotation • Elbow in flexion/extension, forearm pronation, wrist extended and ulnarly deviated • Fingers extended and abducted, thumb palmer abduction
• D2 Flexion
• Scapula posterior elevation, adduction and rotation • Shoulder flexion, abduction and external rotation • Elbow flexion/extension, forearm supination, wrist extension with radial deviation • Finger extension and abduction, thumb extension
• D2 Extension
• Scapula anterior depression, abduction, rotation • Shoulder extension, adduction and internal rotation • Elbow flexion/extension, forearm pronation, wrist flexion with ulnar deviation • Finger flexion and adduction, thumb opposition
• Rhythmic Initiation •
Used to initiate the movement • Voluntary relaxation during passive movement through the pattern followed by isotonic contraction into the direction of the pattern • “Relax let me move you” – passive movement • “Now you do it with me” - voluntary isotonic contraction- active movement
• Repeated Contractions
• Used to improve ROM, strength and endurance • At the point of weakness, perform an isometric contraction “hold”, followed by repeated stretches and isotonic contractions “pull or push” or verbal command for activity
• Slow Reversal
• Begin with isotonic contraction against resistance of the antagonist followed by isotonic contraction of agonist.
• Rhythmic Stabilization
• Alternating isometric contractions • Used to improve muscle balance, endurance and control of movement
• Contract-Relax
• Bring to end range, isotonic contraction of antagonist pattern against resistance followed by relaxation • Used to improve ROM
• Hold-Relax
• Bring to end range and perform an isometric contraction of the antagonist, followed by relaxation, and then movement into agonistic pattern
GOALS OF NDT
• Normalize muscle tone • Inhibition of primitive reflexes • Facilitation of normal postural reactions • Improve quality of movement • Remediation of normal movement patterns
NDT Approach
Introduced the concept that therapy could “prevent ” development of abnormal limb synergy patterns by removing mechanical obstacles to movement. • Employs kinesiological concepts for motor interventions.
TECHNIQUES USED IN NDT
• Therapeutic handling • Weight-bearing over an affected limb • Positioning to promote use of both sides of the body • Avoidance of sensory input that may adversely affect muscle tone
WOULD YOU CATEGORIZE THE NDT APPROACH AS REMEDIAL OR ADAPTIVE?
Remedial, NOT adaptive
