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the ability to regulate or direct the mechanisms essential to movement.
-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
Task Oriented Approach to Intervention
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
with concepts from rehabilitation science
Assumptions
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
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
Individual
Environment
Taxonom of the task sit to stand
The individual
Closed Environment-
Open Environement
Action
Perception( the ecological theory focuses on the perception)
Cognition
Integration of movement Analysis
Movement-The task
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
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
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)
Initiation (describing how they do those)
-timing
-direction
-smoothness
Execution (describinng how)
-amplitude
-direction
-speed
-smoothness
Termination (describing how)
-timing
-stability
-accuracy
Outcome
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.
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
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
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.