Test 1- part 2

mobility

first stage of motor control

stability

second stage of motor control

controlled mobility

third stage of motor control

static dynamic

4th stage of motor control

skill

5th and last stage of motor control

increase ROM, initiate movement

2 goals for mobility

passive and active

two ways to increase ROM

joint mobilizations/ distractions, stretching, modalities, rhythmic rotation, pressure

5 ways to passively increase ROM

hold relax, contract relax, rhythmic stabilization

3 ways to actively increase ROM

Replication, repeated stretch, rhythmic initiation

3 ways to initiate movement

hold and maintain

2 goals for stability

shortened held resisted contractions ,stabilizing reversals, rhythmic stabilization

techniques to increase stability

weight shifting

goal of controlled mobility

dynamic reversals, dynamic reversal hold, combination of isotonics

3 techniques to increase controlled mobility

distal mobility with proximal stabiility

goal of static dynamic

dynamic reversals, dynamic reversal hold, combination of isotonics

techniques to improve static dynamic

consistancy, coordination, accuracy, timing, speed, sequencing,

6 goals of skill

resisted progression, timing for emphasis, normal timing

3 techniques to improve skill

hands before commands, no relax

2 rules for controlled mobility

commands before hands, no relax, hands are on the same side of body at a time for stabilizing reversals and shortened held resisted contractions, hand placement is alternating each time for rhythmic stabilizations

4 rules for stability

resisted progression

in gait, stresses timing and coordination of the foot, knee, and hips/pelvis

skill

is required for creeping and gait

skill

is required for reciprical movement

overflow

timing for emphasis uses this principle

normal timing

promotes distal to proximal movement

normal timing

when working on gait, you block the motion of the hip to encourage the pt. to dorsiflex the foot first

static dynamic

standing at the bathroom sink and brushing your teeth

controlled mobility

hands simultaneously with commands or before

stability

commands come before hands because we want the patient to prepare for the movement

controlled mobility

the commands come after hands because we want the patient to adjust quickly

shortened held resisted contractions (SHRC)

Is the easiest stability technique

Rhythmic stabilization (RS)

is the hardest stability technique

Rhythmic stabilization (RS), stabilizing reversal (SR), shortened held resisted contractions (SHRC)

order of stability techniques from HARDEST to EASIEST

rhythmic stabilization

mobility: your hands stay on same side of the body

stabilizing reversals

your hands alternate sides (posterior and anterior) with hands staying on the same side

rhythmic stabilization

stability: your hands are on opposite sides from one another (one anterior, and one posterior) and alternate

rhythmic stabilization

in stability stage, trying to rotate with goal of pt. to remain still/stable

after tx

when can a pt. relax for controlled mobility and stabilization: during tx or after tx?

stability and controlled mobility

which stages of motor control have techniques that do not allow relaxation during tx?

replication

start with the muscle in a shortened position

shortened range

what range should the muscle be in for the start of replication?

replication

pt. will hold in shortened range, relax, muscle passively moved to opposite side, and actively pull back across to shortened range

replication

old name is “hold relax active movement” (which makes more sense)

repeated stretch

start in a lengthened or neutral position

strengthen

what does replication do to a muscle to make it initiate movement?

strength, endurance

what does repeated stretch work on with a muscle to make it initiate movement?

repeated stretch

start in a lengthened or neutral position, add resistance and make pt. pull across, and then relax to move back to starting position.

repeated stretch

is a quicker technique to promote endurance

rhythmic initiation

start passive, more to active assist, and end in active

hold relax

uses autogenic inhibition

contract relax

uses reciprocal inhibition

autogenic inhibition

neurological principal used in the hold relax technique

reciprocal inhibition

neurological principal used in the contract relax technique

below the level of pain

with hold relax and contract relax, where do you start the technique?

antagonist

which muscle do you want to contract in hold relax?

agonist

which muscle do you want to contract in contract relax?

isometric

what type on contraction will the antagonist have in hold relax?

isotonic concentric

what type on contraction will the agonist ave in contract relax?

ROM

In mobility, rhythmic stabilization improves ____?

mobility

rhythmic stabilization being used to tire out a muscle: mobility or stability?

stability

rhythmic stabilization being used to promote co-contraction: mobility or stability?

fatiguing

In mobility, rhythmic stabilization increases ROM in a muscle with pain by ____ it.

mobility

key words: initiate movement, increase ROM (tightness, spasticity), changing postures (sit to stand, other transfers)

stability

key words: hold, maintain, stabilize, stable (you are NOT moving at all)

controlled mobility

key words: dynamic (dynamic balance), Weight Shifting, safely, controlled, stand to sit (controlled motion, eccentric contraction)

skill

key words: gait, ambulation, timing, endurance, sequencing

stability

“Patient will be able to maintain correct posture in sitting without support.”

controlled mobility

“Patient will demonstrate improved weight shift for lower body dressing at EOB,”

static dynamic

“Patient will perform basic ADLs standing at the sink”

static dynamic

brushing teeth, brushing hair, and putting on makeup are ADLs that fall under:

stability

“Patient will demonstrate single limb stance for 10 seconds without loss of balance.”

static dynamic

“Patient will ascend four steps using a handrail and no AD.”

static dynamic

“The patient will be complete 3 sets of 10 stool taps.”

no

does ascending and descending the stairs require as much skill as ambulation?

skill

“The patient will ambulate 100 feet with no AD.”

skill

“Patient will demonstrate proper step length during ambulation.”

retention

the ability of a learner to demonstrate a learned skill after a period of no practice

adaptability/ generalizability

ability to apply a learned skill to the performance of other or related skills

resistance to contextual change

the ability to perform a learned skill in an altered/new environment

resistance to contextual change

also called adaptability of context

the individual

What should we modify first: the environment or the individual?

the environment

If we cannot change the individual, what can we change to promote independence?

mobility

If a Parkinsons pt. has decreased pelvic rotation during gait, which stage of motor control should you work on?

controlled mobility

If a patient is unable to cross their legs in sitting, what should you work on?

controlled mobility

An amputee is learning to bear weight through a prothesis. What are they working on?

controlled mobility

A patient has trouble grabbing their drink while laying in prone on elbows. What should you work on?