question

Charles Sherrington (1906) - Reflex Model

answer

- Peripherally based - Sensory system must be intact for movement to occur - A chain of response occurs in response to sensory stimuli which produces movement Purely focuses on reflexes - does not speak to higher cortical control - only involves peripheral receptors, SC and brain stem

question

What is an example of using the reflex system?

answer

tapping

question

Hughlings Jackson - Hierarchical Model

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- everything happens in a predictable, developmental sequence - top down approach - CNS has higher, middle, and lower levels of control - developmental sequence of the CNS - almost a theory of maturation - cannot function at a higher level of control before lower level

question

The hierarchical model does not take into account stereotypical patterns aka...

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central program generators

question

Nicolai Bernstein (1932) - Systems Model

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- looks at relationship of environment and your ability to respond to it Forces needed to create movement may differ depending on two factors: 1. environments in which the action occurs 2. internal forces generated to accomplish the action "A major assumption of the systems model is that the nervous system is organized to control the endpoints of motor behavior: the accomplishment of tasks goals.. normal movements are coordinated... because strategies of motion emerge from the interaction of systems." - There is an INTERPLAY of systems - Looks at CNS, MSK - Focuses on a "task-oriented" approach

question

What component do critics say the systems model leaves out?

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environment

question

Kamm, Kugler, and Turvey - Dynamic Action Theory

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- Broad study of dynamics or synergetics within the physical world - Principle of "self organization" with the environment - Tries to find mathematical descriptions for the self organizing systems - Degree to which an individual can alter their preferred patterns shows a higher level of function for self-organization (variability becomes a predictor of overall function) Attractor states - preferred patterns of movements used to accomplish common activities - ability to change your attractor states speaks to your recovery ability

question

According to the dynamic action theory, the more you can change your movement patterns or ________, the better prognosis you will have

answer

variability

question

James Gibson (1960s) - Ecological Theory

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- Research focused on how we detect information in the environment that is relevant to our actions and how we use that information to control our movements rather than the sensorimotor portions - Looks at cognitive and perceptual contributions to movement - Actions require perceptual information that is specific to the task and the environment in which the task is being performed - Broadened our understanding of the nervous system response - We need the ability to explore our interaction with the environment in order to aid recovery

question

Which two theories de-emphasize the neuro system?

answer

dynamic action theory ecological theory

question

How can a physical therapist utilize the ecological theory?

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- Allows us to focus on the task at hand in response to their environment - Focus on the pt accomplishing the task in their own way, as opposed to us telling them how to do it

question

Rood Rehab Model

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1. Motor development or designs of movement - Mobility, Stability, Controlled Mobility, Skill 2. Sensory stimulation techniques - facilitation or inhibition - Phasic: so it pertained to a particular phase of movement ex: quick stretch, jt compression - Tonic: a sustained contraction

question

Bobath NDT Rehab Model

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- Observed that abnormal tone and coordination problems were due to the release of abnormal postural reflexes - inhibit that which is abnormal and facilitate that which is normal and encourage anything that is in its ideal functional state - WOULD NEVER use spasticity functionally

question

NDT is based on which model?

answer

hierarchical model

question

Goal of NDT

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"achieve a balance between muscle groups and to decreased the effects of abnormal tonal influence on automatic responses and movement patterns"

question

Emphasis of NDT

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- Normalizing muscle tone - Inhibit primitive reflexes - preparing the pt from a tone perspective associated with ATR, then position them to elicit the ATNR while you help to eliminate/ integrate it - Facilitation normal postural reactions through the developmental sequence

question

Treatment Principles for NDT

answer

- Change abnormal patterns of movement with dynamic reflex inhibiting patterns - NDT therapists will usually facilitate proximally (at the hip) - Use key points of control - Use of proximal control rather than distal control - Replace abnormal tone or patterns of movement immediately with normal movement patterns

question

Other Components of NDT

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- Variation to the degree the patient can handle - Varying the context in which the activity occurs - Recognizing the role of the environment and bringing other theories into their rx - Adhering to the developmental sequence but not necessarily in sequence - NDT training is good to develop handling skills

question

Signe Brunnstrom

answer

- Worked on pts with stroke to develop her rx - Her descriptions are accurate, but originally it was founded on hierarchical model - Philosophically does not have a problem with using functional movement patterns - Believed that movement synergies occurred at a spinal cord level as a result of hierarchical organization of the CNS

question

Brunnstrom 7 Stages of Recovery: Stage 1

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acute, flaccidity of the involved limbs is present, and no movement (reflexive or voluntary) is present

question

Brunnstrom 7 Stages of Recovery: Stage 2

answer

basic limb synergies may appear as associated reactions, or minimal voluntary responses, spasticity in the muscle groups that dominate the synergistic pattern (elbow flexors, knee extensors)

question

Brunnstrom 7 Stages of Recovery: Stage 3

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- voluntary control of the movement synergies, although the full range of all synergy components does not necessarily develop - spasticity reaches its PEAK - poor quality of movement

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Brunnstrom 7 Stages of Recovery: Stage 4

answer

- some movement patterns that do not follow the paths of basic limb synergies are mastered, initially difficult - spasticity begins to decline - Synergistic movement pattern: go to flex shoulder and their elbow will automatically flex and then their wrist will flex - LE synergistic movement is more variable: can be extensor and flexor synergistic patterns

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Brunnstrom 7 Stages of Recovery: Stage 5

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- more difficult movement patterns are mastered - basic limb synergies lose their dominance over motor acts - spasticity continues to decline

question

Brunnstrom 7 Stages of Recovery: Stage 6

answer

- individual joint movements become possible - coordination approached normalcy - spasticity disappears the patient becomes capable of a full range of movements

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Brunnstrom 7 Stages of Recovery: Stage 7

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- normal motor function is restored **Not everyone goes through all 7 stages; not all pts normalize their spasticity**

question

Kabat, Knott, and Voss - PNF

answer

Goal - to strengthen the muscles in the movement patterns in which they were designed to function - Functional in diagonals, even at the pelvis and the shoulder girdle

question

Characteristics of PNF

answer

- Patterns of motion are mass movement patterns - Patterns are spiral and diagonal - Diagonal patterns were developed to address specific problems such as weakness through partial ranges, lack of stability, and weakness in eccentric contractions - 2 diagonals of motion for each major part of the body - Each diagonal is made up of two patterns that are antagonistic to each other to address muscle imbalances - Each pattern has a major component of flexion or extension - Each movement involves movement toward and across the midline or across and away from the midline - Each diagonal includes rotation with the flexion or extension pattern

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Carr and Shepherd - Contemporary Task-Oriented Model

answer

- Practice sessions may include breaking the task down into discrete components followed by practice of the whole task - Emphasizes using the patient's own internal biofeedback systems Motor Relearning Program: Step 1 - Analysis of the task Step 2 - Practice of missing components Step 3 - Practice the task Step 4 - Transference of training - Used to generalize the task to apply to other tasks

question

Gordon Task-Oriented Model

answer

- Focused on understanding the problems faced by the CNS in controlling movement is a key assumption of the task oriented model - Problems may include changes within the MSK system, previously learned movement strategies stored in the brain, and the challenges of the environment - Motor learning requires multiple repetitions in varying environments

question

Horak Task-Oriented Model

answer

"From the systems model of motor control, the task oriented model assumes that control of movement is organized around goal directed, functional behaviors rather than on muscles or movement patterns" - Emphasizes that different people can perform the same task differently - Stresses the need to teach patients multiple ways to achieve a task

question

Adam's Closed-Loop (1971) Theory of Motor Learning

answer

- Sensory feedback is needed to provide the closed loop movement - Hypothesize that in motor learning, sensory feedback from the ongoing movement was compared within the nervous systems with the stored memory of the intended movement Memory trace - used in the selection and initiation of movement Perceptual trace - built up over a period of practice and becomes an internal reference of corrections - Gets stronger with practice, increases with knowledge of results - Once the movement was initiated by memory trace, the perceptual trace takes over for the completion of the movement - Through knowledge of feedback and performance you shape a task to become more and more desired, so that the function and skill improves over time

question

Schmidt's Schema (1970s) Theory of Motor Learning

answer

- Emphasized an open-loop control processes - Proposed that motor programs do not contain specific movements but instead contain generalized rules for a specific class of movements - There are not specific perceptual traces, instead generalized traces - Generalized set of rules that can be applied to various conditions "Schema" - an abstract representation stored in memory following multiple presentations of a class of objects

question

Schmidt's Schema addresses two limitations of Adam's Closed Loop:

answer

ability to have variability and produce novel movements

question

Newell's Ecological (1990s) Theory of Motor Learning

answer

- Systems and ecological theories - Motor learning is a process that increases the coordination between perception and action in a way that is consistent with the task and environmental constraints - He proposed that during practice there is a search for optimal strategies to solve the task given the task constraints - Both perception and action systems are incorporated into an optimal task solution - Perceptual cues that are critical to the way in which a task is executed are also called "regulatory cues"

question

Fitts and Posner Three Stage Model

answer

3 main phases in motor learning: Cognitive - Pt experiences variety of strategies, abandons the ones that don't work, keeps the ones that do Associative - Person has selected the best strategy for the task and is refining the skill - Less variability in performance, improvement is more slowly, can last days to weeks to months Autonomous - Automatic quality to the skill, low degree of attention required, can devote more time to other aspects of the skill (Like scanning the environment)

question

Systems Three Stage Model

answer

Emphasis is on controlling the stages of movement with degrees of freedom 3 stages: Novice - learning simplifies the movement in order to reduce degrees of freedom Advanced - performer will begin to release degrees of freedom by allowing more movements to occur during a given task - greater ability to adapt at this point Expert - released all degrees of freedom in the most efficient and coordinated way - learned to take advantage of mechanics and optimize the environment

question

Gentile's 2 Stage Model

answer

1. Understanding the task dynamics, develop strategies, understand the environmental features 2. Fixation/diversification stage: refinement of movement - Ability perform open and closed skills Closed skills - single movement patterns Open skills - diverse movement patterns

question

Cajal

answer

- silver staining of the nervous system - peripheral axons can regenerate

question

Hebb

answer

"neurons that wire together, fire together" - activity-dependent neural stimulation

question

Sperry

answer

- biochemical factors necessary for development - function localized between hemispheres (cut corpus callosum)

question

Levi-Montalcini

answer

- NGF - reactive synaptogenesis in the PNS in response to polio

question

Hubel and Wiesel

answer

- visual pathways from the retina to cortex

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Aguayo

answer

CNS axonal regeneration

question

Smith

answer

regeneration dependent on Schwann cells

question

Kromer

answer

cholinergic neuron survival enhanced by NGF

question

Smith and Kromer

answer

fetal tissue could produce trophic factors and act as substrate for regenerating axons to original target

question

Bjorklund

answer

embryonic dopamine axon cells into the striatum

question

Taub

answer

- constraint-induced therapy by cutting sensory pathways in monkey - "learned non-use"

question

Nudo

answer

motor mapping and constraint-induced therapy and neuroplasticity in monkeys

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