Motor Relearning Programme

motor learning

the acquisition of new skills with practice

basic principles of motor relearning programme

• Restoring motor ability involves learning, & all individuals, regardless of disabilities respond to the same learning principles

• Motor control is executed in both anticipatory and ongoing modes, postural adjustments and limb movements are interrelated.

• Execution of a specific motor task is best relearned by practice of that specific motor task, in various environmental contexts

• Sensory input related to motor tasks modulates motor execution – these may be position or negative

motor relearning programme

• Specific training of muscle activity and functional movement via:

  • Assessment of motor performance during tasks

  • Analysis of this performance to determine limiting factors

  • Prevention/reduction of these limiting factors

  • Design of activities to use as treatment to stimulate development of effective movement

• Main outcome → learning motor behaviors exemplary of typical movement patterns

motor relearning programme is based upon…

1. elimination of unnecessary muscle activity

2. motivation

3. feedback

4. practice

5. relationship between postural adjustment and movement

motor relearning programme assessment

Focus on…

• Mobility assessment at joints

• Direction and speed

• Missing or limited movement

• Impairments in timing of movement patterns

• Compensatory motor behaviors

• Position of body segments

• Possible use of the Motor Assessment Scale (MAS)

motor relearning program intervention

Step 1 Analysis of task (evaluation)

• Observation

• Comparison

• Analysis

Step 2 Practice of missing components

• Explanation (identification of goal)

• Instruction

• Practice and visual/verbal feedback and manual guidance

discourage compensatory movement

Step 3 Practice Task

• Explanation – identification of goal

• Instruction

• Practice with visual/verbal feedback and manual guidance

• Re-evaluation

• Encourage flexibility

Step 4 Transference of skills

• Opportunity to practice in context

• Consistent of practice

• Organization of self-monitored practice

• Structured learning environment

• Education/training of caregivers

motor relearning programme intervention techniques

• Explanation

• Instruction

• Demonstration

• Manual guidance

• Passive movement

• Spatial/temporal constraint

• Feedback

• Practice

role of OT in motor relearning programme

problem solving during treatment

5 stages:

1. recognition

2. analysis

3. decision-making

4. action-taking

5. re-evaluation

motor relearning and balance

• Balance is best challenged and re-learned in the context of self-initiated movements

• Postural adjustments are learned only in the context of task performance

• Balance training in one position or during 1 task does not generalize well to improved postural control

• position the person

• position the object

• change the object

• increase task demands

motor relearning program limitations

• Spasticity is not considered a significant residual problem of stroke.

No management is recommended to reduce abnormal muscle tone.

• Focus on active learning indicates limited applicability in patients

with severe cognitive deficits.