Motor Control Frame of Reference – Flashcards
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what is the definition of motor control
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The ability to use one's body effectively while performing an occupation
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The ability to use one's body effectively while performing an occupation - what does this involve (2)
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Generating & coordinating movement patterns of the head, neck, limbs and trunk. Maintaining balance during task performance.
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this theory uses knowledge from what five fields
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Neurophysiology Neuropsychology Human development Psychology Human movement science
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what are the four traditional theories of motor control
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Rood Approach Bobath's neurodevelopment treatment (NDT) Brunnstrom's movement theory Proprioceptive neuromotor facilitation
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the four traditional theories are used with what population
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people who have suffered damage to the CNS
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have these traditional theories been rejected - why or why not?
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These traditional theories have not been rejected, but have been modified and incorporated into newer theories.
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what are the four traditional theories collectively called and why
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"neurodevelopmental techniques" because they are based on a view of the nervous system that emphasizes it's developmental nature.
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the four traditional theories - what are two things they have in common
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- the goal of improving motor control - The use of neuroplasticity (the CNS' ability to organize and reorganize as a result of experience).
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how do the four traditional theories differ from the contemporary approach (2 things)
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Traditional -CNS is organized in a hierarchical manner. -Movement results from sensory input from the higher centers to the lower centers -Learning & development result from CNS changes -The environment does not directly influence motor control Contemporary -CNS is organized in a heterarchical manner -Higher and lower systems work together -Motor control is learned when the patient seeks optimal solutions for accomplishing a task
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what is the difference between hierarchical and heterarchical
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Hierarchy means movement is controlled from the top down (the higher centers control the lower centers) wheras heterarchical means that movement is the result of several factors working together.
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heterarchical means that movement is the result of several factors working together. what are these three factors
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-Personal factors-including the CNS and the musculoskeletal systems -Nature of the task being done -Environmental conditions
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what was the Rood approach originally developed for
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individuals with cerebral palsy
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according to Rood, where does motor control emerge from
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reflex patterns present at birth
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what two categories does Rood divide muscles into
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"light work muscles" and "heavy work muscles"
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what is central to Rood's theory
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the focus on reflex patterns
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light work muscles - what is their main function and how are they controlled
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-movement -Voluntarily controlled
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heavy work muscles - what is their main function and how are they controlled
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-stabilization -Reflexively controlled
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how does Rood view CNS damage (2)
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-the normal sequence of reflex development and voluntary motor don't occur -Abnormal muscle tone is present
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what is the gist of Rood's intervention strategy
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appropriate sensory stimulation elicits specific motor response
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What are Rood's 4 intervention strategies
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1. Normalize muscle tone using sensory stimuli to get a muscle response 2. Begin with patient's current developmental level and progress through a normal motor develop sequence 3. Focus on goal or purpose of an activity 4. Use repetition to reinforce learning
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describe sensory stimuli that is used to facilitate muscles
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-This includes the application of ice, brushing, stroking the area over the muscles: used to facilitate muscles -Proprioceptive stimuli: manual joint compression, tapping, quick stretch
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describe sensory stimuli that is used to inhibit muscles (3)
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-Slow, rhythmic movement -Maintained stretch -Neutral warmth
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what is the goal of Rood's intervention
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Person achieves satisfactory and voluntary control of the movement
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what are the steps of Rood's intervention (3)
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1) Identify the highest level of motor pattern that a person can manage with ease. 2) Begin treatment at the next level; the person struggles 3) Use sensory stimuli and manual assistance to help the person perform the movement
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who are the Bobaths
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Karel, a neurologist and Berta, a physiotherapist
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NDT was orginally developed for which two types of clients
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clients with stroke and cerebral palsy
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Bobaths' NDT is frequently used with which population
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adults with hemiplegia
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what is the central tenant of the Bobaths' NDT
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treatment emphasizes the correct "handling" to inhibit abnormal movement and facilitate normal movement
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according to the Bobaths, motor problems following brain damage result in . . . (2) and why?
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-abnormal muscle tone -abnormal posture patterns that affect functional activity -b/c with abnormal movement, the person's sensation results in abnormal sensory feedback providing incorrect information to the CNS
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name three highlights of the Bobaths' intervention
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-Abnormal patterns are inhibited -Normal movement patterns are elicited by providing appropriate sensory stimuli -The patient learns how appropriate movement feels
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what are two ways the Bobaths use sensory stimuli
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-Handling techniques -Physically tapping muscles: elicits a response
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name two results of the Bobaths' handling techniques
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-inhibits abnormal movement -facilitates normal movement
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what is the goal of Bobath sensory stimulation
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Once a person is able to control a particular movement pattern, they can begin to integrate it into skilled activities.
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who was Brunnstrom's Movement Therapy originally designed for
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stoke patients with hemiplegia
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what is one belief that is pivotal to Brunnstrom's movement therapy
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that there is a progression of reflex development
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what term is central to Brunnstrom's movement therapy
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limb synergy
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define limb synergy
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These are a group of muscles that produce a predictable pattern of movement in flexion and extension.
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will you see more flexion or extension during recovery
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more flexion
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this predictable pattern of movement in flexion and extension - what does it mean according to Brunnstrom
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the damaged CNS has reverted to an earlier developmental stage
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describe three steps of Brunnstrom's intervention
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1. Elicit reflex synergies 2. Use those synergies as a basis for progressively learning more mature voluntary movement (similar to normal development) 3. Use available movement patterns in order to progress through the recovery stage
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describe Brunnstrom's evaluation (5)
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1) Assess strength: Focus on patterns of movement rather than straight plane motion at the joint. 2) Determine the patient's sensory status (their ability to sense and recognize movement patterns important to treatment). Limb synergy patterns are initially encouraged. 3) Determine which reflexes are present 4) Use task repetition and positive reinforcement 5) Determine the current level of recovery
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what is the goal of Brunnstrom's movement therapy
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using controlled movements in purposeful activity
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describe the seven Brunnstrom hemiplegia recovery levels
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1. Flaccidity: no volitional movement 2. Appearance of basic limb synergies; spasticity begins to appear 3. Synergies are performed voluntarily; spasticity increases 4. Spasticity begins to decrease. Movement patterns are not dictated by synergies 5. Further decrease in spasticity is noted with independence from limb synergy patterns 6. Isolated joint movements are performed with coordination 7. Normal function is restored
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what does PNF stand for
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Proprioceptive Neuromuscular Facilitation
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who developed PNF
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Kabat
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what is the definition of PNF
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stimulation of proprioception to promote or hasten neuromuscular response
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according to Kabat, how does normal motor development occur
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cephalocaudally (from the head downward) and proximodistally (from the center outwards).
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Kabat believes that motor behavior is cyclic. what does this mean
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alternates between flexion & extension phases
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according to Kabat, how is normal movement behavior made up of
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reversing movements (ex. flexing, then extending)
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Kabat believes there is a balance btwn . . .
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antagonistic muscles
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what is central to PNF theory
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the use of diagonal patterns for recovery of motor function
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why are diagonal patterns important
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Diagonal patterns are important because they involve natural movements, are part of normal development and require integration of both sides of the body.
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describe PNF intervention
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Multisensory: includes physical contact by the therapist, verbal commands and visual cues.
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describe a PNF evaluation
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determine patient's strengths and weaknesses re: their capacity for movement
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according to Kabat, what is the most effective treatment
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goal directed movements combined with facilitation techniques.
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when was the contemporary model of motor control created
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1990s
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name three premises of the contemporary model
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-The nervous system is only one system that influences motor behavior. -The CNS is organized heterarchically. -The CNS interacts with multiple personal and environmental systems as a person attempts to achieve a goal....therefore, motor development is due to changes in multiple systems, not just maturation of the CNS.
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according to the contemporary model, motor development is due to changes in multiple systems. What about according to the traditional models, what causes motor development
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Changes in motor development are due to maturation of the nervous system
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name 6 aspects of the contemporary approach
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-Does not emphasize a fixed developmental or motor learning sequence. -Learning or motor change depends on the person's characteristics and environmental variations -Movement does not rely solely on the CNS -Emphasizes the role of the occupation being performed and the occupational context in which it is performed. -Motor control is a behavior that self-organizes (neural plasticity) specifically in the context of performing a given task. - "functional tasks help organize behavior".
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how does the contemporary approach view motor problems
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-After CNS damage, motor behavior problems compensate for the damage while performing a specific occupational form in a given context. -Movement patterns are the consequence of the dynamics between that patient, their abilities & limitations, the task itself and the environmental conditions.
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explain the evaluation of the traditional approaches
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-primary focus on sensorimotor and cognitive components of muscle tone, reflexes, abnormal movement patterns, postural control, sensation, perception, memory and judgement. -Occupational performance areas would be evaluated secondarily.
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explain the intervention of the traditional approaches
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-Treatment focuses on remediation of impaired components. -Treatment follows the normal developmental sequence.
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describe the evaluation of the contemporary approach (4)
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-Focus: occupational and role performance. Identify tasks that are difficult to perform -Note the preferred movement patterns for these tasks in the environmental context -Determine personal and environmental things that will improve or impair progress -Note the degree of stability/instability of motor behaviors across the occupational and environmental conditions.
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why does the contemporary approach emphasize doing the WHOLE task
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Learning the entire task, not just the discrete parts because feedback on completing the whole task is more beneficial than feedback on just a part of the task.
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describe the intervention of the contemporary approach
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-Allows patients to find their own optimal solutions to motor problems; allows patients to problem-solve and experiment in the context of occupational performance. -OT's may recommend more efficient and/or safer methods for patients to try.
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describe the essence of the contemporary approach
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-Is client-centered -Uses natural environments -more holistic approach than the traditional approach -this approach stresses a collaborative and client-centered approach that considers a client's roles and motives.
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what is the research available for the traditional approaches
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only limited research
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what is the research for the contemporary approach
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preliminary studies provide support for this approach
