Motor Control Exam 1

What Does Movement Emerge From

Task, Individual, Environment

Discrete Movement

Kicking a ball or moving from sit to stand. Has a recognizable beginning and end

Continuous Movement

Walking or running. The end point is decided by the performer

Open Movements

Playing soccer or tennis. Requires performer to adapt to constantly changing and unpredictable environment

Closed Movement

Tasks performed in fixed or predictable environments

Stability Tasks

Sitting or standing. Performed with non-moving BOS

Mobility Tasks

Walking and running. Requires moving BOS

Reflex Theory

Actions and behaviors are explained through a chain of reflexes.

Reflexes have a receptor, conductor, and effector

Doesn’t explain how 1 stimulus can produce different responses, the production of novel movements, and movements without sensory info

Hierarchical Theory

Control is top down (we know this isn’t true now)

Currently: Each level of nervous system acts on other levels, and things also happen in parallel

Central Motor Pattern and CPGs

Rules for how you move, retraining movements must be done functionally

CPGs

Hardwired support

Principle of Abundance

Muscles not used to eliminate redundant degrees of freedom are used to ensure flexible and stable performance of tasks

Ensures covariation

Covariation

Variability allows adaptation

High vs low chair, soft vs hard surface

System Theory: 1st Level

Tonus

Resides in spinal cord, prepares motor functions to respond appropriately

System Theory: 2nd Level

Synergies

In brain stem, responsible for subconscious and restricts degrees of freedom

System Theory: 3rd Level

Space

Large sensory inflow processes the environment to help dictate how you move

System Theory: 4th Level

Action

In the Frontal Cortex, flexibility to find several potential motor solutions for the same movement program

Leading Level

Controls goal directed movement

Background Level

Provides support so movement can be executed

Dynamic Systems Theory

When individual parts come together, its elements behave in an ordered way

Nonlinear System

Output not proportional to input

Control Parameter

Variable that regulates change in behavior of entire system

Neurofacilitation

Retraining motor control by facilitating or inhibiting different movement patterns

Limiting Factor on Emergence of Behavior

Immature systems

Birth-3 months

ATNR & STNR

Optical Righting

Labyrinthine Righting

Body on Head Righting

4 months

Prone balance

5-6 months

Neck on body righting

Body on neck righting

6-7 months

Forward catch (parachuting)

7-8 months

Sitting balance

8-9 months

Sideways catch

9-10 months

Backwards catch

10-12 months

Stance balance

Independent Sitting: Stage 1

No control

4 months

Independent Sitting: Stage 2

Attempts to initiate upright sitting

5 months

Independent Sitting: Stage 3

Partial control, large body sway

6 months

Independent Sitting: Stage 4

Functional control, minimal sway

8 months

Motor development/Designs of movement

Sensory stimulation techniques (sensitization and desensitization)

Rood

Weight Bearing and Stabilization Tasks

Heavy Work/Tonic Muscles

Muscles work in the background, normalise tone

Mobility Tasks

Light Work/Phasic Muscles

Acomplished in non-weight bearing

Rood’s Motor Development Level 1

Mobility

Free, flexible motion

Rood’s Motor Development Level 2

Stability

Co-contraction of agonists and antagonists to allow for weight bearing and later dynamic holding

Rood’s Motor Development Level 3

Controlled Mobility

Closed chain movement

Rood’s Motor Development Level 4

Skill

Open chain, coordinated movement

Light Touch

Facilitates contraction of underlying muscles

Tapping

Facilitates phasic contraction of the muscles

Quick Stretch

Facilitates contraction, muscle spindles

Quick Ice

Facilitates contraction of underlying muscles

Traction

Causes muscle relaxation and promotes movement

Approximation

Promotes stability

Resistance

Muscle activation, but requires patient to be strong

Prolonged Stretch

Inhibits muscle contraction

Deep Pressure

Relaxation of muscle

Pacinian Corpuscles

Neutral Warmth

General Relaxation

Slow Stroking

Calms Patient

Prolonged Cold

Relaxation and reduction of pain

Fugl-Meyer Assessment

Signe Brunnstrom

Gold standard for stroke patients, used in researh because of long admin time

Associated Reactions

Synergistic patterns move involuntarily when another part of body is performing strong or forceful movement

Flexor Synergy: Scapula

Retraction and Elevation

Flexor Synergy: Shoulder

Abduction and External Rotation

Flexor Synergy: Elbow

Flexion

Flexor Synergy: Forearm

Supination

Flexor Synergy: Wrist

Flexion

Flexor Synergy: Fingers/Thumb

Flexion/Adduction

Flexor Synergy: Pelvis

Elevation and Retraction

Flexor Synergy: Hip

Flexion, Abduction, External Rotation

Flexor Synergy: Knee

Flexion

Flexor Synergy: Ankle

Dorsiflexion and Inversion

Flexor Synergy: Toes

Dorsiflexion

Extensor Synergy: Scapula

Protraction and Depression

Extensor Synergy: Shoulder

Adduction, Internal Rotation

Extensor Synergy: Elbow

Extension

Extensor Synergy: Forearm

Pronation

Extensor Synergy: Wrist

Flexion or Extension

Extensor Synergy: Fingers/Thumb

Flexion and Adduction

Extensor Synergy: Hip

Extension, Adduction, Internal Rotation

Extensor Synergy: Knee

Extension

Extensor Synergy: Ankle

Plantarflexion and inversion

Extensor Synergy: Toes

Plantarflexion

Motor Recovery Stage 1

Extremities are flaccid. Typically occurs immediately after the lesion and persists for a few hours to a few days

Motor Recovery Stage 2

Minimal volitional motions are possible and associated reactions are in synergistic patterns. Spasticity begins to develop

Motor Recovery Stage 3

Voluntary control of the synergies is possible through partial range. Spasticity peaks

Motor Recovery Stage 4

Limited motions combining synergistic movements are possible. Spasticity begins to decline

Motor Recovery Stage 5

More advanced movement combinations are possible as spasticity continues to diminish

Motor Recovery Stage 6

Isolated movements are possible with near normal coordination. Spasticity has declined and may only be evident with increased speed of movement

Rhythmic Initiation

Initiate movement

Hold Relax

For full ROM and if they are stronger than you

Contract relax

For full ROM

Agonist Reversal

Eccentric Strength

Repeated Contractions

Concentric movements

Repeated Quick Stretch

Concentric movements

Sister Kenny

Developed muscle re-ed for children with polio

Kabel, Knott, and Voss

Developed PNF

Stepping Pattern 1

High Guard

Stepping Pattern 2

High step frequency (lots of little steps)

Stepping Pattern 3

Absence of reciprocal swinging movements between bilateral UE and LE

Stepping Pattern 4

Stance phase: increased knee flexion

Stepping Pattern 5

Swing phase: increased hip flexion, pelvic tilt, and hip abduction, decreased ankle flexion

Stepping Pattern 6

Heel Strike: ankle plantarflexion/foot flat

Side-lying to Supine

1-2 months

Supine to Side-lying

4-5 months