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Motor Control Theories

definitionand benefits and downfalls

Definition

the ability to regulate or direct the mechanisms essential to movement.

Benefits and downfalls

-provides philosphy about how the brain controls movement

-frameworks for interpreting behavior

-guide for clinical rotation

-provides new ideas about movement

-keep in mind they are a working hypothesis.

Considering the Whole Patient

Using the ICF Model in Motor Control

Analyzing Movement

Theories

Task Oriented Approach to Intervention

  • Anticipate patient's movement disorder based on helath condition and body structure/function
  • identify barriers to independednt movement that are specific to patient (personal factors?)
  • identify and utilize patient's facilitory factors to promote movement
  • identify goals for the patient's plan of care.

1. Resolve, reduce or prevent impairments @ body structure/function level

2. effective and efficient task specific strategies

3. change task and environmental conditions to maximize participation and independence

International classification of functioning model

Task Oriented Approach

Health Conditions-Medical Diagnosis

  • Body Structure/Function=Impairment level
  • Activities Level- the ability to execute a task by an indificual
  • Participation Level=ability to participate in life roles
  • Environemental Factors-
  • physical or social factors that people have to face in the environment in which they function
  • Personal Factors
  • specific characteristics of the individual
  • Environmental and Personal factors can be facilitory or inhibitory.
  • integrates a systems theory aproach

with concepts from rehabilitation science

Assumptions

  • Movement is organized around behavioral, goal and environmental constrainsts
  • movement is the result of interaction of different systems
  • focus on functional task rather than movement patterns just for the sake of movement
  • patient should be involved in problem solving(that is like a mckenzie type idea, with self treatment)
  • adaptability is the key (that reminds me of the factors that affect movement, regulatind non-regulating factors of the environement

Task oriented aproach to evaluation

1. Reflex Theory- developed by charles sherrington in 1947

2. Hierarchial Theory-developed by Hughley Jackson

3. Motor Programming Theory- Berstein Keele and wilson

4.Systes Theories- nicolai berstein (dynamic systems theories-other peeps)

5. Ecological theraoy-James Gibson in the 1960's

the systems theories and the ecological theory are the two that are the most current expansions

Motor Control-Neuroanatomy

Review

preparation for a motor plan-somatosensory and visual system

aferent peripheral sensory fibers from sensory systems to spinal cord and brain stem

-all sensory tracts travel through thalamus except small which filters information to appropriate cerebral cortex

allows for feed forward control

customization of the motor plan- frontal lobe BG cerebellum which continuously communicates with the brain stem and the thalamus

Execution of Motor Plan- primary motor area of the precentral gyrus, pyramidal cells in corticopsinal and corticobulbar tracts, skeletal muscles.

Integrates the ICF model to give a rounded view of the patient

1. Evaluate functional activites (activity level- the ability of an individual to do a task) and participation restriction

2describe the strategies used to accomplish the tasks

3. quantify underlying impairments (body structure and function)

4. acknowledge contextual factors-environmental and personal factors (which can be facilitory or inhibiting)

The environment

Factors Affecting Movement

Regulatory Factors- aspects of the environment that shape the movement

  • physical aspects of the task
  • ex; people have to conform to the height of a chair

Non-Regulatory Factors-feautures that affect performance but the person does not have to conform to them in order to complete the task

noise- you don't change movement because of it

open environments- unpredictable distraction

closed environments- distraction is limited

Task

  • mobility
  • stability
  • manipulation

Individual

  • action
  • perception
  • cognition

Environment

  • Regulatory Factors
  • Non-Regulatory Factors

Taxonom of the task sit to stand

The individual

Closed Environment-

  • stability-gettup up from hospital room bed
  • quasimobile- hospital room bed new height
  • walking around room, standing up from the hospital bed on one foot

Open Environement

  • stability- outside on the park bench
  • quasimobile-different chairs
  • mobile-musical chairs, car transfers

Action

  • what is required of the systems to complete the action

Perception( the ecological theory focuses on the perception)

  • Includes sensory information and processing that info
  • Meaningful Interaction(saliency)

Cognition

  • Attention, planning, problem solving,
  • motivation, and emotional stability

Neuroplasticity

Integration of movement Analysis

Movement-The task

neuroplasticity

denervation super sensitvity- if you don't use certain areas of your brain then they will stop working

unmasking of silent synapses-sometimes there are synapses that aren't being used as much and you can find and utilized those when you are trying to rehab toward recovery

neuronal regneration-neurons grow back

collaterals sprouting- sprouting of dendrites to make more synapses

cortical reorganization- the brain can reorganized certain areas

what does this mean for physica l therapist? we can take advantage of this to help our patients make a more ful recovery

neuroplasticity

Discrete vs. Continuous Tasks

does it have a recognizable end

Stability vs mobility of a task

is the base of support moving?

stability BOS not moving

mobility-BOS moving

Manipulation Components-component of task that increases the demand of the stability task

closed or open movement tasks (movement variability)

is the task predictable with little variability

open=performer has to adapt behavior in changing environments

closed=movement realtively stereotyped and typically predictable

training induced neuroplasticity

not all training includeds cortical reorganization

-experience dependent

-10 principles to facilitate neuroplasticity

  • use it or lose it- brain commits less area to a skill if you don't use it
  • use it and improve it- which is related to use it or lose it- just means that you can improve a skill
  • specificity-retrainging by doing specific motion
  • repetition matters
  • intensity matter-hard to get appropriate intensity
  • tansferrence- the ability to do the same skill in different environments
  • interference- the ability to do a skill during interference
  • time from injury- the sooner the better
  • saliency matters- that patients find value in what they are doing
  • age matters- younger people have better neuroplastic changes

Analyze a movement to identify underlying impairments or strategies being utilized( almost sounds like the icf model a litle bit but you are anticipating their movement based on their health conditions)

stages of movement

initial conditions(present before movement)

  • posture
  • ability to interact with the environment
  • environmental context
  • Preparation (might be outcome changes because person has cognition perception changes)
  • stimulus identification
  • response selection
  • response programming

Initiation (describing how they do those)

-timing

-direction

-smoothness

Execution (describinng how)

-amplitude

-direction

-speed

-smoothness

Termination (describing how)

-timing

-stability

-accuracy

Outcome

The theories

systems theories

developed by nicolai Bernstein in the mid 1900's

Assumptions:

looked at the human body as mechanical system

2. degreee of freedom theory, movement of the body from a mechanical perspective

3.synergies (movements that go together)

Limitations

1.places less importance on nervous system output than other theories

2.due to emphasis on other factors.

Motor programming Theories

Developed by multiple scientists: Bernstien, Keele Wilson

Assumptions:

1.concept of central pattern generators (CPD)

2.Acknowledge movements in the absense of sensation

Limitations:

1.CPG cannot account for all movement patterns

2.does not acount for environemental or musculoskeletal affects on different outputs

Hierarchial theory

started by English physician Hughlings Jackson

Assumptions

1.movement is controlled in a top down manner(Brain on down)

2. maturation of nervous system is seen with appearance/disappearance of primitive reflexes (babinski)

3 contemporary theory acknowledges that each level of the hiearchy cann affect other levels (in higher or lower order)

Limitations

1. does not explain reflexes in healthy adults:flexor withdrawal reflex

2. does not account variability in outcomes.

dynamic systems theories

Reflex theory

expanded systems theory by a number of researches

Assumptions:

1. all the assumptions for systems theory

2. self organizing of systems

3. variability is not necessarily a negative thing

Limitations

1. same as systems theories.

developed by charles sherrington in 1947

Assumptions

1. all behaviors are explained by individual reflexes that are connected

2. interpret behavior and movement as a result of the presence or absence of stimuli

Limitations

1. does not account for voluntary movements

2. does not account for movement in absence of sensory input

3.does not account for fast movements that do not allow sensory feedback

4.does not acccount for how a single input can produce different output depending on the context of the situation

Ecological theory

developed in the 1960's by James Gibson

Assumptions:

1. Movement is a result of individual responding to and interacting with the environment

2. emphasis on perceptions

3. task oriented

Limitations

1. Decreased emphasis on the nervous system and the organization of the nervous system.

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