NMS 1 quiz/skills check 1

integrated systems theory of motor control

evidence based theory that combines all other models and states that motor control emerges from interaction between the individual, task, and environment

what are the 4 stages of motor control

mobility, stability, controlled mobility, and skill

what is stage 1 of motor control

mobility stage where initiation of non specific movement occurs

what is stage 2 of motor control

stability stage where they have the ability to have static postural control

what is stage 3 of motor control

controlled mobility where mobility is superimposed on stability

what is stage 4 of motor control

skill where controlled mobility is manipulated and incorporated into environment

righting reactions for postural control

orientation of the head in space and maintaining with head tilt or rotation

protective reactions for postural control

extremity movements in response to a rapid horizontal or diagonal displacement of the body

equilibrium reactions for postural control

whole body adapts to changes to keep COM within BOS

nasher's model for balance strategy

postural control in standing occurs via ankle, hip, stepping, and suspensatory strategies

fitts and posner model for motor learning

cognitive stage, associative stage, and autonomous stage are the three stages in which motor learning occurs

cognitive stage of fitts and posner model

gathering info and performance is inconsistent

associative stage of the fitts and posner model

putting actions together so performance is disjointed but pt making conscious effort

autonomous stage of fitts and posner model

performance is smooth, automatic, and occurs without conscious thought

novice stage of neo bernsteinian model of motor learning

number of degrees of freedom involved is low

advanced stage of neo bernsteinian model of motor learning

releasing some degrees of freedom

expert stage of neo bernsteinian model of motor learning

all degrees of freedom used

brunnstorm stages of recovery

process that enhances specific primitive synergies to improve motor control through central facilitation

stages of brunnstorm

stage 1: flaccidity

stage 2: basic limb synergies and beginning of spasticity

stage 3: voluntarily performed synergies and marked spasticity

stage 4: decreased spasticity and movement not dictated by synergies

stage 5: decreased spasticity and selective control of movement

stage 6: isolated joint movements performed with coordination

stage 7: normal motor function

raimistes phenomenon

resisted uninvolved extremity causes increased activation in involved extremity

souques phenomenon

flexion of involved side >150º facilitates finger abduction and extension

homolateral synkinesis

response of the involved extremity elicits the same response from the same side extremity (ex: R UE flexion facilitates R LE flexion)

how would pt present with CNS/UMN impairment?

hypertonic, hyperreflexia, normal muscle, and absent fasciculations

how would pt present with PNS/LMN impairment?

hypotonia, flaccidity, diminished/absent reflexes, atrophy, and present fasciculations

dorsal column

light touch, vibration, joint position, stereognosis, graphesthesia, and 2 pt discrimination

spinothalamic

temperature and pain

what are considered facilitative treatment interventions?

light touch, fast brushing, quick icing, quick stretch, vibration, tendon tapping, compression, traction, resistance

what are considered inhibitory treatment interventions?

slow stroking, warming, prolonged cooling, prolonged stretch, tendon pressure

lift

start low, then involved UE is lifted into D2 flexion (guiding UE ends in D1 flexion)

reverse lift

start high, then involved UE is moved into D2 extension (guiding UE ends in D1 extension)

chop

start high, then involved UE is brought down into D1 extension (guiding limb ends in D2 extension)

reverse chop

start low, then involved UE is guided into D1 flexion (guiding limb ends in D2 flexion)

rhythmic rotation

active, active assisted, or passive ROM with gentle rolling to increase ROM and decrease tone

rhythmic initiation

PROM to AAROM to AROM to resisted ROM to initiate independent movement

hold relax active motion

passive or active assisted ROM, then isometric hold, relax, then have pt move further into the ROM to work towards initiation of movement in weak or hypotonic pts

slow reversal

pt AROM in direction that is impaired without any rest breaks and progress to resisted ROM to increase agonist motion/strength

agonistic reversal

resisted ROM concentrically and eccentrically to increase control throughout entire muscle contraction

slow reversal hold

isometric holds at different positions within ROM where pt has weakness

contract relax

resisted ROM into opposite direction, relax, then stretch passively into impaired direction to increase ROM

repeated contractions

quick passive stretch of weak muscle, then isotonic contraction into impaired direction to increase strength

alternating isometrics

resist agonist and antagonist so no actual limb motion occurs to increase stability

rhythmic stabilization

resisting all directions with speed to increase joint stability

resistive progression

progressive resistance distally through motion to improve proximal joint stability

timing for emphasis

variable resistance in strong and weak areas of a patterned motion

what interventions would increase ROM

contract relax, hold relax, distraction, and rhythmic rotation

what interventions would improve movement initiation

hold relax, distraction, repeated contraction, rhythmic initiation, and rhythmic rotation

what interventions would improve stability

alternating isometrics and rhythmic stabilization

what interventions would improve controlled mobility

agonistic reversal, slow reversal, and slow reversal hold

what interventions would improve a skill

timing for emphasis, slow reversal, and slow reversal hold

what interventions would improve strength

alternating isometrics, repeated contractions, and resisted progressions

what is a grade 0 on the modified ashworth scale for tone testing?

no increase in muscle tone

what is a grade 1 on the modified ashworth scale for tone testing?

slight increase, catch then release, or minimal assistance at end range

what is a grade 1+ on the modified ashworth scale for tone testing?

catch followed by minimal resistance through less than half of the end range of motion

what is a grade 2 on the modified ashworth scale for tone testing?

marked increase in tone through most of ROM

what is a grade 3 on the modified ashworth scale for tone testing?

considerable increase in tone causing PROM to be difficult

what is a grade 4 on the modified ashworth scale for tone testing?

rigidity into flexion or extension with possible clonus

what would test ankle strategy

SLS (normal=30s)

what would test hip strategy

sharpened romberg (normal=30s)

what would test stepping strategy

compensatory stepping test (normal=1-2 steps)

what systems are being tested with firm surface and eyes open

vision, somatosensory, and vestibular

what systems are being tested with firm surface and eyes closed

somatosensory and vestibular

what systems are available with foam and eyes open

visual and vestibular

what systems are available with foam and eyes closed

vestibular

CN I

olfactory - sensory

CN II

optic - sensory

CN III

oculomotor - motor

CN IV

trochlear - motor

CN V

trigeminal - motor and sensory

CN VI

abducens - motor

CN VII

facial - motor and sensory

CN VIII

vestibulocochlear - sensory

CN IX

glossopharyngeal - motor and sensory

CN X

vagus - motor and sensory

CN XI

spinal accessory - motor

CN XII

hypoglossal - motor