Facilitation of Movement

Define facilitation of movement.

hands on therapeutic interactions are essential to physiotherapy and are often used in combination with dialogue, adaptations of tasks and environments to optimize the relearning of movement in persons with neuro conditions

What are categories of disorders that can impact movement?

neuro, hypotonia, genetic

What 4 things can be used in conjunction to optimize learning or re- learning of a movement.

motor learning, motor control, task analysis and facilitation of movement

What is dynamic systems theory?

interaction of multiple sub- systems (person, task, environment) that self- organize, spontaneously to produce the individual’s most efficient movement solution

T/F DST changes happen in a linear pattern.

False

What are constraints?

variables that aid with modulating change in the entire system

What are 3 types of constraints?

subsystems of the individual, attributes of the task, and environment

What are examples of subsystems of the individual?

CNS, PNS, MSK

What are examples of attributes of the task?

shape, texture, and demanding manipulative or posture activity

What are examples of environmental constraints?

stable, unstable home/ training facility

What happens when constraints are manipulated (changed)?

the behavior of the system changes> self- regulation> improved motor performance

Why is variability of movement important?

allows for changes in motor behavior that allows the individual to be flexible in one’s movement patterns

Why is it important to analyze task and environment?

performance of the task may vary significantly, depending on the conditions under which it is performed

Describe 4 task and environment variations.

stationary individual: static sitting in a quiet environment

moving individual in a stationary environment: walking in a quiet environment

stationary individual in a moving environment: standing still in a crowd

moving individual in a moving environment: walking in a crowd

Of the different task environment scenarios, how do you know where to start as the PT?

patient goals and baseline

What is the process of determining the patient’s baseline for a task?

observational analysis> task analysis> impairments

What is the temporal sequence of task analysis?

initial conditions> preparation> initiation> execution> termination> outcome

What factors are necessary for initial conditions?

posture, ability to interact with the environment, environmental context

What factors are necessary to preparation?

stimulus identification, response selection, response programming

What factors are necessary for initiation?

timing, direction, smoothness

What factors are necessary for execution?

amplitude, direction, speed, smoothness

What factors are necessary for termination?

timing, stability, smoothness

What is facilitation as an intervention?

potentiates self- initiation of movement and creates necessary conditions for a movement experience that the patient cannot yet perform alone

What are the 3 phases for facilitation of movement?

1) make movement possible

2) make movement necessary

3) let movement happen

How is phase 1 of facilitation of movement achieved?

address systems or barriers to movement, thus optimizing handling; aids with self- regulation of the systems

What stages of task analysis are included in phase 1?

initial conditions

How is phase 2 of facilitation of movement achieved?

addressing joints, degrees of freedom, initiation of movement, adaptation in needed

What stages of task analysis are included in phase 2?

initiation

How is phase 3 of facilitation of movement achieved?

handling skills to allow for necessary muscle activation to achieve stability and allow for selective movement to complete the task (STS)

What stages of task analysis are included in phase 3?

execution and termination

What are the 2 steps in phase 1 of facilitation of movement?

1) recognize initial conditions 2) address/ manipulate the constraints

What is the PT role in phase 2 of facilitation of movement?

hands on with verbal cues; initiation of movement; seek to enable the patient to stabilize one part/ segment of the body and actively move another part/ segment thus creating selective movement (Ex: weight shift to allow for functional reaching)

What is the PT role in phase 3 of facilitation of movement?

enable the patient to move via functional movement; use of hands- on cueing/ facilitation (stability, mobility, rotation, compression)

In which phases is it appropriate for the PT to add verbal cues such as “hold it” or “activate this”

phases 2-3

Adding a therapy ball to facilitate APT for functional reaching changes which subsystem of the DST?

environment

What factors are necessary for motor learning to occur?

repetition, salient, specific, intensity