MOTOR CONTROL LECTURE 16: TASK/MOVEMENT ANALYSIS (EXAM III)

Movement analysis:

- does the patient have adequate _____ capacity? (Enough mobility in their joints, soft tissue, muscles)

Mechanical

Movement analysis:

- does the patient have appropriate _____ control? (Ability to initiate a contraction & demonstrate adequate strength & endurance)

Neuromuscular

Movement analysis:

- does the patient have effective ____ control? (Using proper movement strategies, able to assume and maintain balance posture while engaged in a functional activity & adapt to the changing task demands)

Motor

Movement system diagnoses categorize patients/clients by impairments and activity limitations related to their ____ ____

Movement abilities

____ ____ is a key component of the evaluation process and development of diagnoses

Movement analysis

_____ skills have been central to PT since the beginning

Observation

Analysis of movement during _____ of tasks is a key tenet of PT practice

Performance

____ ____ of motor control emphasize that movement emerges from a complex interaction between the task, the performer, and their environment

Contemporary theories

Individuals choose optimal ____ ____ that meet the demands of the task given their current limitations & abilities

Movement strategies

Systematic ____ ___ ____ allows for theorization of underlying reasons for particular movement patterns and can drive decisions about further testing and intervention strategies

Observation of movement

Emphasize movement analysis in ____ ____

Everyday practice

Movement analysis begins with evaluation of the ____ _____ which includes evaluation of the environment and observing starting posture (what type of BOS is the patient using, what surface are they standing on)

Initial conditions

____ is generally not observed (does the patient understand the instruction)

Preparation

_____ is the instant when the displacement of the segments begins

Initiation

____ is the period of actual segment movement

Execution

_____ is the instant when motion stops

Termination

_____ is whether the goal of the movement was reached successfully

Outcome

If the outcome was reached successfully:

- do it again and make it more ____

Difficult

If the outcome was not reached successfully:

- do it again and make it ____

Easier

____ ____ is difficult because it is a whole body activity

Bed mobility

____ ____:

- bed mobility

- sit to stand

- transfers

Task analysis

Rolling:

- ____ lifts and reaches above shoulder level

Arm

Rolling:

- ____/_____: shoulder girdle leads

Head/trunk

Rolling:

- _____: unilateral lift

Leg

_____/_____ is necessary for:

- comfortable positioning

- pressure relief

- in bed self care activities

- prepares patient to come to sitting

- contributes to other functional activities

Scooting/rolling

_____ in bed:

- lateral

- towards head of the bed

- towards the foot of the bed

Scooting

You have more leverage and deal with less friction in a ____ position

Hooklying

Ideal position for scooting:

- hip at ____ degrees

- knees at _____ degrees

45; 90

_____:

- performed in a hooklying position

- lower trunk & hip muscles provide stability

- lower back and hip extensors lift the pelvis from the mat

- hamstrings enable the person to maintain knee flexion and foot position on the surface

Bridging

_____ scooting:

- bridge

- place pelvis to the right

- move feet to the right

- lift upper trunk & head and move to the right

Lateral

Scooting ____ in the bed:

- hooklying position

- lift head/forearm prop

- push through elbows/feet to lift hips

- knee/hip extension propel body towards head of the bed

Up

Scooting ____ in bed:

- hooklying with less knee flexion

- use of arms to assist legs in pulling patient down toward head of bed

- important to lift head to decrease friction and allow patient to see what they are doing

Down

____:

- segmental upper body initiated

- segmental lower body initiated

- non segmental log

Rolling

In ____ rolling, after the upper or lower body initiates the movement —> trunk rotation and dissociation

Segmental

Segmental ____ body initiated:

1. Cervical flexion & left rotation

2. Right scapular protraction with right shoulder flexion & ADD

3. Weight shift to left upper trunk with left rotation of upper trunk on lower trunk

4. Weight shift to left pelvis when right pelvis lifts & rotates left

5. Right hip and knee flexion with hip ADD to cross midline

Upper

Segmental _____ body initiated:

1. Right hip & knee flexion

2. Right LE flexion and ADD across midline or positioned to push off surface

3. Lower trunk rotation to left on upper trunk

4. Weight shift to left as right scapula lifts off surface

5. Cervical flexion & left rotation

Lower

___ ____ ____:

- can be initiated by the trunk or extremities

- no dissociation of the trunk

Non segmental rolling

___ ___ ____ is a necessary skill for:

- achieving upright positioning

- begin other transitional movements

Supine to sit

Supine to partial sit is the most common method for ____ adults

Young

Supine to ___ ____ requires moving the LE off the support surface

Partial sit

Supine to partial sit is most ____

Efficient

Supine to sidelying is most common method for _____ adults

Older

Supine to _____ requires sidelying to sitting with the use of UE to push off

Sidelying

Supine to sidelying is most ____

Stable

____ ___ ____ common characteristics:

- generate momentum to move the body to vertical

- stability requirements for controlling the COM

- ability to adapt how one moves to characteristics of environment

Supine to sit

___ ___ ____ essential components:

1. Cervical flexion

2. Trunk & LE flexion

3. Bilateral shoulders and elbows extend for partial sitting position

4. LE moved from the surface to the floor

5. UE extend the assist in aligning upper and lower trunk

6. Aligned sitting position achieved

Supine to sit

____ ____ ____:

1. Cervical left lateral flexion

2. Trunk flexion, right trunk rotation and left lateral flexion

3. Right shoulder ABD to push off

4. Left shoulder ADD to push off

5. Bilateral elbow extension

6. Trunk left lateral flexion to neural as weight shifts from L to R hip

7. Upper trunk aligns over lower trunk

8. Aligned sitting position achieved

Sidelying to sitting

___ ____ ____ phases:

1. Flexion momentum

2. Momentum transfer

3. Extension

4. Stabilization

Sit to stand

___ ___ ___:

- generating joint torque to rise (progression)

- stability by moving COM from one base of support (chair) to base of support defined solely by the feet

- ability to modify movement strategies to achieve goals depending on environmental constraints

Sit to stand

Sit to stand ____ ____:

- flexion of trunk

- COM within base of support of chair and feet

- erector spinae control forward motion of the trunk

Flexion momentum

Sit to stand ____:

- extension of the hips & knees as the body straightens and elongates vertically

- COM is between 2 feet

Extension

Sit to stand ____:

- after completion of the rise to standing and the body achieving stability in vertical

Stabilization

Sit to stand ____ ____:

- critical transition phase

- horizontal and vertical motion

- COM transfers from a larger to a smaller BOS

- begins as the buttocks lift off the support surface with continued momentum to assist the lift through forward tibial movement with maximal ankle DF

- see coactivation of the knee & hip extensors in this phase

Momentum transfer

____ ____ ____:

- body is lowered through controlled flexion of LE

- hip and knees flex

- COM shifts backward and must be counterbalances by the forward lean of the trunk t the hips to maintain stability

Stand to sit

____ ____ transfer (bed to wheelchair):

- sit to stand

- stand to sit

- pivot

- weight shifting in standing

Stand pivot

modified ____/____ ____ transfer (bed to wheelchair):

- partial stand

- partial stand to sit

- pivot

- weight shifting

Stand/squat pivot

We start by evaluating the patients ____ ____ and then improve their impairments by focusing on ____ ____ & _____

Activity level; body functions & structures

Interventions to improve ____ ____:

- supine to sidelying to sit

- supine to partial sit ti moving LE off surface to sitting

- partial sit up

- partial sit up diagonal

- supine hip ABD

- unilateral SLR

- roll to sidelying

- sidelying to sit

- bridging

- weight on hip & hold

Bed mobility

Interventions to improve ____ ___ ____:

- scooting forward

- seated trunk flexion

- partial stands

- hip & knee bends

Sit to stand

Interventions to improve ___ ___ ____:

- reduce friction

- help them get into hooklying

- have them work on bridging

- work on neck flexion

- get UE in correct position to push up

Scooting in bed