Motor Control/Motor Learning

What is reactive motor control?

movements are adapted in response to ongoing feedback

Example of reactive motor control

throwing a ball too far the right, next throw is adjusted

What is anticipatory motor control?

movements are adapted before a movement is performed

Example of anticipatory motor control

bracing your core before lifting something

What are the four stages of motor control?

static postural, dynamic postural, transitional mobility, skilled movement

True or False: you do not need to develop static stability before doing dynamic tasks

false: static stability is required before dynamic tasks are introduced

What is static postural control?

ability to maintain COM over BOS in stationary position

Example of static postural control

sitting, standing

What is Dynamic postural control?

ability to maintain COM within BOS while body is moving

Example of dynamic postural control

weight shifting

What is transitional mobility?

ability to move between different positions independently and safely

Example of transitional mobility

transitioning between stages of 4-stage balance test, transfers

What is skilled movemet?

ability to move through environment consistently performing coordinated movement sequences

Example of skilled movement

walking, running, stairs

True or false: a permanent change in skilled movement must occur for motor learning

true

What stage of learning is related to “what to do"?”

cognitive stage

True or false: the cognitive stage is characterized by needing visual feedback and conscious attention, and using trial and error

true

What stage of learning is characterized by “how to do?”

associative stage

What are some key characteristics of the associative stage of learning?

less errors and extraneous movements, performance becomes consistent, less reliance on visual feedback

What stage of learning is characterized by “how to succeed?”

autonomous stage

True or false: the autonomous stage is error-free and automatic

true

At what stage can a therapist introduce environmental changes and challenges?

autonomous stage

During which stage of learning is feedback most needed?

cognitive stage

How can you measure motor learning?

performance changes, retention, adaptability/generalizability, resistance to contextual change

What is motor recovery?

regaining movement that had been lost through injury or illness

What is spontaneous recovery?

Restoration of function in neural tissues due to natural repair processes of the CNS

What is the primary goal of all rehabilitation?

optimal functional recovery

True or false: the patient must perform a skill exactly how they used to in order to have motor recovery

false: recovery is highly variable and individualized and complete recovery is not always possible

What is motor compensation?

completion of a skill in a new way that was previously completed

What is the goal of restorative intervention strategies?

promote motor recovery

What are the 3 basic elements of restorative interventions?

repetitive/intense practice of task-oriented functional activities, strategies to enhance active motor learning, strategies that encourage use of impaired body segments

What is the goal of compensatory interventions?

Promote early function by using alternative means either short-term or long-term

What are augmented intervention strategies?

hands on approach that uses guided or assisted movements for people in early recovery that have limited motor function

identify what type of intervention approach would primarily be utilized: recovery-based, compensatory-based, or a blended approach.

65-year-old female who is 6 months s/p L MCA CVA

Setting: Outpatient

Current Abilities: No active motor control of right upper extremity; good voluntary motor control throughout right lower extremity but some weakness; decreased coordination affecting ability to ambulate independently

Goals: improve independence with light meal preparation and improve ambulation independence with least restrictive device

blended approach: compensatory for UE, restorative for LE

What are some examples of task variations in order to progress or regress?

base of support, speed, perturbation, cogitive demand

What are some examples of environmental variations in order to progress or regress?

surface type/height, cueing, physical assistance, external support

Movement construct examples: alignment

valgus/varus, scoliosis, plumb line

Movement construct examples: amplitude

reduced arm swing, asymmetric step length

Movement construct examples: speed

time to complete task

Movement construct examples: symptom provocation

change in o2 sats, HR, patient reported pain/fear

Movement construct examples: coordination (sequence/timing)

delayed initiation and stepping strategy

Movement construct examples: smoothness

tremor, ataxia, dysmetria

Movement construct examples: postural control verticality

lateral trunk lean

Movement construct examples: postural control stability

increased sway, loss of balance