Types Of Motor Learning Approaches Flashcards
Carr and Shepard motor relearning approach targets what?
Targets normal movement and how it is relearned after neurological insult
Carr and Shepard believed what?
That factors that are involved with learning are also involved with releasing and should include:
- identification of a goal
- inhibition of any unnecessary activity that does not relate to normal movement
- the ability to adjust during activity to the effects of gravity and balance
- proper body alignment
- proper motivation
- incorporate internal or mental practice as well as external or physical practice
- feedback
- KR
Describe Carr and Shephard’s approach in a clinical setting.
- PT observation of the pt during examination in order to identify the variations in normal movement
- through critical assessment the PT identifies components of movement that are missing or abnormal and the corresponding interventions
Closed motor skill
Skill that is performed under a stable and unchanging environment
KR in Carr and Shepard
- Providing the pt with external FB regarding a pt’s performance of a task
- include observations as well as objective data and can be positive or negative in nature with the goal of influencing the learner
Open motor skill
Skill that is permed under a consistently changing environment
Transfer of learning
An action cannot be separated from the environment that it is performed in.
Patient must be able to transfer the skill or motor task into different environments
Who developed the neuromuscular developmental treatment (NDT) concept
Bobaths’
What is the NDT concept ?
- Pt should learn to control movement through activities that promote normal movement patterns that integrate function
- based on a hierarchical model of neurophysiological function
- recognizes the interference of normal function within the brain caused by CNS dysfunction leads to a slowing down or cessation of motor development and inhibition of righting reactions, equilibrium reactions and automatic movements.
What new assumptions have been incorporated into NDT?
- Postural control can be learned and modified through experience
- Postural control uses both FB and feed-forward mechanisms for execution of tasks
- Postural control is initiated from a pt’s BOS
- Postural control is required for skill development
- Postural control develops by assuming progressive positions in which there is an increase in the distance b/t the COG and BOS; BOS should decrease
Facilitation
A technique utilized to elicit I voluntary muscular contraction
Inhibition
A technique utilized to decrease excessive tone or movment
Key points of control
Specific handling of designated areas of the body (shoulder, pelvis, hand and foot) will influence and facilitate posture, alignment and control
Placing
The act of moving an extremity into a position that the pt must hold against gravity
Reflex inhibiting posture
Designated static positions that bob that found to inhibit abnormal tonal influences and reflexes
Describe the Brunnstrom Concept of therapy in hemiplegia
- was believed to immediately practice synergy patterns and subsequently develop combinations of movement patterns outside of the Synergy
- Research has indicated that reinforced synergy patterns are very difficult to change (so this is rarely utilized today)
Brunnstorm’s 7 Stages of Recovery
Stage 1: no volitional movement initiated (Flaccidity)
Stage 2: the appearance of basic limb synergies. Spasticity begins
Stage 3: Synergies are performed voluntarily; Spasticity increases
Stage 4: Spasticity begins to decrease. Movement patterns are not dictated solely by limb synergies
Stage 5: Further decrease in spasticity is noted w/independence from Limb synergy patterns
Stage 6: Isolated joint movements are performed with coordination
Stage 7: normal motor function is restored
Associated reaction
Involuntary and automatic movment of a body part as ra euslt of an intestinal active or resistive movment in another body part
Homolateral synkinessis
A flexion pattern of the involved upper extremity facilitates flexion of the involved lower extremity
Limb synergies
A group of muscles that produce a predictable pattern of movement in flexion or extension
Raimiste’s phenomenon
Involved LE will abduct or adduct with applied resistance to the uninvolved LE in the same direction
Souques’ phenomenon
Raising the involved UE above 100 degrees with elbow extension will produce Extension and abduction of the fingers
Stages of recovery
Brunnstorm separates neurological recovery into seven separate stages based on progression through abnormal tone and spasticity. These 7 stages of recovery describe tone, reflex activity, and volitional movement
Who developed proprioceptive neuromuscular facilitation (PNF)?
- original goal of Tx was to establish gross motor patterns within the CNS
- based on the premise that stronger parts of the body are utilized to simulate and strengthen the weaker parts
- places great emphasis on manual constant and correct handling
- movement patterns follow Diagnosis or spirals that each posses a flexion, Extension and Rotator component and are directed toward or away from midline
Chopping
Combination of bilateral UE asymmetrical patterns performed as a closed-chain activity
Developmental sequence
- Progression of motor skill acquisition
- stages of motor control include: mobility, stability, controlled mobility and skill
Mass movement patterns
The hip, knee, and ankle move into flexion or extension simultaneously
Overflow
Muscle activation fo an involved extremity due to intense action of an uninvolved muscle or group of muscles
D1 UE flexion pattern
Scapula: Elevation, Abduction, Upward Rotation Shoulder: Flexion, Adduction, ER Elbow: flexion or extension Radioulnar: Supination Wrist: Flexion, Radial Deviation Thumb: Adduction
D1 UE Extension Pattern
Scapula: Depression, adduction, Downward Rotation Shoulder: Extension, abduction, IR Elbow: flexion or extension Radioulnar: Pronation Wrist: Extension, Ulnar deviation Thumb: Abduction
D2 UE Flexion pattern
Scapula: Elevation, Adduction, Upward Rotation Shoulder: Flexion, Abduction, Er Elbow: Flexion or extension Radioulnar: Supination Wrist: Extension, radial deviation Thumb: Extension
D2 UE Extension Pattern
Scapula: Depression, Abduction, Downward rotation Shoulder: Extension, Adduction, IR Elbow: Flexion or extension Radioulnar: Pronation Wrist: Flexion, ulnar deviation Thumb: Opposition
D1 LE Flexion Pattern
Pelvis: Protraction
Hip: flexion, adduction, ER
Knee: Flexion and extension
Ankle and toes: Dorsiflexion, inversion
D1 LE Extension Pattern
Pelvis: Retraction
Hip: Extension, Abduction, IR
Knee: flexion or extension
Ankle and toes: Plantar Flexion and eversion
D2 LE Extensor Synergy
Pelvis: Elevation
Hip: Flexion, Abduction, IR
Knee: Flexion or extension
Ankle and Toes: Dorsiflexion and Eversion
D2 LE Extensors Synergy
Pelvis: depression
Hip: Extension, adduction, ER
Knee: Flexion or extension
Ankle and Toes: Plantar flexion and inversion
Mobility
Ability to initiate movment though a functional range of motion
Stability
Ability to maintain a position or posture through cocontraction and tonic holding around a joint
Example: Unsupported siting with midline control
Controlled Moblitiy
ability to move within a WB position or rotate around a long axis.
Example: Activities in prone on elbows or WS in quadruped
Skill
- Ability to consistently perform functional tasks and manipulate the environment with normal Postural reflex mechanism and balance reactions
- Skill activities included ADLS and community locomotion
What is the Rood theory?
- Based of Sherrington and the reflex stimulus model
- all motor output was the result of both parts and present sensory input
- Tx based on sensorimotor learning
What is the goal of the Rood approach?
-obtain homeostasis in motor output and auto activate muscles to perform a task independently of a stimulus
What are facilitation sensory stimulation techniques?
- Approximation
- Joint compression
- Icing
- Light touch
- Quick stretch
- Resistance
- Tapping
- Traction
What are inhibition sensory stimulation techniques (rood)?
- deep pressure
- prolonged stretch
- warmth
- prolonged cold
Heavy work
A method used to develop stability by performing an activity (work) against gravity or resistance
Heavy work focuses on the strengthening of Postural muscles
Light work
- method used to develop controlled movement and skilled function b performing an activity (work) without resistance
- light work focuses on extremities
Key patterns
A developmental sequence designed by Rood that directs patient’s mobility recovery form synergy patterns through controlled motion
