professional communication quiz 2

motor learning

set of processes associated with practice or experience leading to relatively permanent changes in the capability for skilled movement

two major approaches to motor learning are

computational and dynamic systems

what does computational approach emphasize

brain-based modeling and prediction

what does the dynamic approach emphasize 

emergent, self organizing nature of movement

which approach learns the specific details of how to perform the task, brain models plan predict and control movement, CNS processes sensory input and generates motor output

computational- ex: shows learner a video, multiple practice sessions reduces prediction error, no variation and thousands of reps

movement emerges from interaction of individual, task, and environment, movements are preplanned and controlled are dependent on context, does not require central controller, variability is essential 

dynamic systems approach, performance is affected by context factors, example: golf swing on different terrains with different clubs and different balls

what does use-dependent say

movement becomes more efficient and consistent through reps alone, without requiring correction, repeat task to promote changes in CNS, participant must understand task goal and make intentional changes, passive or overly guided does not lead to changes, takes time, improvement slower

ex: new swing technique

instructive learning says

change in motor behavior is achieved through intentional movement strategy with cues about error, knowledge of performance or how movement was performed to help develop an error-reducing movement strategy, high cognitive burden required conscious effort from learner, may see improvement rapidly

changing: hand grip

reinforcement motor learning 

improvement is driven by binary outcome based feedback, learning depends on external feedback about success or failure, learner doesn’t receive quality about movement

sensorimotor adaptation

change in motor behavior is driven by sensory prediction errors- mismatch between expected movement and actual movement, error correctly automatically and stored 

ex: car brake, lifting a bucket, walking on split belt treadmill

Fitts and Posner Three Stage Model

cognitive, associative, and autonomous stage

cognitive stage

high error, high cognitive demand, large initial improvements

associative stage

refining techniques, less error and more consistently, improvement more slowly

autonomous stage

automaticity of skill and low degree of attention required, paying too much attention can reduc performance

block practice

practice of the same reps

extrinsic cue example

box squat or mirror, superior for improving performance

intrinsic cues example

keep elbow parallel in shot, needs over toes in squats

developmental stage of 0-2

sensory motor- no counseling recommended

developmental stage 2-7

preoperational- unable to understand actions, use visual displays, cannot comprehend cause or effect

developmental stage 7-11

concrete operations- begin to understand disease, understand cocncrete examples

developmental stage over 12

formal operations- understand illness, logical reasoning, receive message same level as adult

gamification therapy

augment therapy and restore, 23% mpre excited, 4.4% greater time on task, 61% less refocusingin

for kids incorporate

gaming, music, humor

extrinsic motivation

doing something to earn reward or avoid punishment

goal attainment scale

-2 to +2, 0 is achievement of goal

what makes physical therapy so important for older adults

17% are 65 or older, 27% live alone, 9% below poverty level

percentage of people that self assessed their health as fair or poor

20% and increases to 27% after 75

normal cognitive changes with older adults

slower to find words, slower reaction times, process info more slowly, reduced problem solving, short term memory declines

speed of encoding, storing, and retrieving new info decreases

repetitions and reinforcement are helpful

successful aging

high physical, psychological, and social functioning in old age without major diseases

what percentage of adults 50+ are inactive

28%

6 steps of patient exam

examination, evaluation, PT diagnosis, prognosis, intervention, outcomes

most powerful sensitive and versatile instrument to health care

examination, 70-80%

portions of health history

age, sex, height and weight, hand dominance, medical diagnosis, past medical history, past surgical history, medications, past treatment

how does medical diagnosis used in PT

may affect understanding and belief of perceptions, may not be relevant to treatment

which medication can increase risk of fx

prolonged steroid

how does diabetes affect time of healing

slower

affect of diagnostic testing

48.4% of RC tears are asymptomatic, but changes peoples views

chief complaint

reason for visit, often on prescription if referred

if pain is specific and can be pinpointed 

might be structure like ankle ligament

aggravating factors

lumbar disc herinations typically worse with flex and rotation

knee meniscus are worse with weight bearing

bike might be better if walking doesn’t feel good

improvement in back and leg symptoms might indicate

trunk flexion activities are beneficial

in the morning OA tends to be

stiffer, if not related to time may be related to activity

severity of chief complaint

11 pt scale 0-10, current pain, worse and best

irritability

severity of pain, easy or difficult for symptoms to flare up, how long does it take to return to baseline

what percent of american is obese

35%

how does alcohol affect the body

negatively affects bone metabolsim, vascularity, and musculoskeletal healing process

what percent of adults don’t meet exercise requirements

75%

what are the exercise recommendations

150 minutes per week of moderate intensity and 2 days per week of strength training

what percent of patient experience anxiety

19.1%, 11.5-55% after injury

one of the most important questions is

patient goals and expectations