Neuro - Motor Control, Motor Learning, and Coordination

The study of the acquisition and/or modification of movement

Motor learning

What three major factors influence motor learning?

The individual, the environment, and the skill/task

Performance vs. Learning

Performance: Behavior observed at a specific moment in time.

Learning: A relatively permanent change in behavior

What factors besides learning can influence performance?

Fatigue

Anxiety

Motivation

What are the characteristics of improved task performance?

Improvement

Consistency

Stability

Persistence

Adaptability

Reduction of attentional demands

What does improvement mean as a characteristic of performance?

The ability to perform the task better over time

What does consistency mean in task performance?

The ability to perform the skill similarly across attempts

What does stability mean in task performance?

Performance remains effective despite temporary changes or disturbances

What does persistence mean in motor performance?

Improvement is retained over time

What does adaptability mean in motor performance?

The ability to modify performance to meet changing task or environmental demands

What happens to attentional demands as a motor skill improves?

Attentional demands decrease

What are the three stages of learning according to Fitts and Posner?

Cognitive

Associative

Automatic

What is intrinsic feedback?

Feedback that comes from the individual's own sensory systems

What is extrinsic feedback?

Feedback provided from an external source, such as a physical therapist

What is knowledge of performance (KP)?

Information about how the movement was performed

What is knowledge of results (KR)?

Information about the outcome of the movement

Feedback provided immediately after or during performance

Immediate feedback

Feedback provided as a summary after multiple attempts

Summary feedback

Feedback provided when performance falls outside a predetermined acceptable range

Bandwidth feedback

Feedback that is gradually reduced over time as the learner becomes more independent

Faded feedback

What two clinical factors should be considered when providing feedback?

Selection and timing

Massed vs distributed practice

Massed: Practice periods are relatively long compared with rest periods

Distributed: Rest periods are relatively long compared with practice periods.

Constant vs variable practice

Constant: Practicing a skill under the same conditions repeatedly

Variable: Practicing a skill under different conditions

Blocked vs random practice

Blocked: Practicing one skill repeatedly before moving to another skill

Random: Practicing different skills or task variations in an unpredictable order

What is contextual interference?

The interference created when multiple skills or task variations are practiced together

Whole vs Part practice

Whole: Practicing the entire skill

Part: Breaking a skill into smaller components and practicing individual parts

The study of postures and movements and the functions of the body that govern those postures and movements

Motor control

What three aspects make up motor control?

Physical

Neural

Behavioral aspects of movement

What three individual factors influence movement?

Action

Perception

Cognition

What is the relationship between perception and action?

Movement arises from the interaction of perception (sensory) and action (motor) systems

What psychological factor should be considered when analyzing individual factors?

Motivation

Characteristics of a task that influence how movement must be performed

Task constraints

Questions to consider include:

· Is there a high perceptual component?

· Is object manipulation required?

· What body movements are required?

· Must the task be performed under a variety of conditions?

· Or is it performed under the same conditions each time?

What task attributes are considered in motor control?

· Discrete vs. continuous

· Stability vs. mobility

· Manipulation

· Attention

· Open vs. closed

A skill involving very precise movements, usually using smaller musculature

Fine motor skills

A skill that places less emphasis on precision and typically involves multi-limb movements

Gross motor skills

A movement with a clearly defined beginning and endpoint.

Discrete movement

What are examples of discrete motor skills?

Turning on a light, hand-to-mouth movement, and sit-to-stand

A movement composed of a series of discrete skills whose integrated performance is important for achieving a goal

Serial movement

What are examples of serial motor skills?

Typing a sentence, dimming a light, and eating a meal

A movement with arbitrary starting and ending points.

Continuous movement

What are examples of continuous motor skills?

Walking, swimming, and steering a car

A skill performed in a stable and predictable environment that does not change from trial to trial

Closed motor skill

Are closed skills internally or externally paced?

Internally

Are closed skills predictable or unpredictable?

More predictable

How much monitoring do closed skills require?

Low or variable monitoring.

What are examples of closed motor skills?

Picking up a cup, writing, and shooting a free throw

A skill in which the performer must adapt to an ever-changing environment

Open motor skill

Are open skills internally or externally paced?

Externally paced

Are open skills predictable or unpredictable?

More unpredictable

How much monitoring do open skills require?

High and constant monitoring

What are examples of open motor skills?

Driving, catching a thrown ball, and walking on a crowded sidewalk

What does Fitts's Law describe?

The tradeoff between speed and accuracy in rapid, aimed movements

According to Fitts's Law, what does A represent?

The distance or amplitude of movement

According to Fitts's Law, what does W represent?

The width of the target

What are the three major ways motor skills can be classified?

Size of the musculature required

Specificity of where the action begins and ends

Stability of the environmental context

What is Gentile's multidimensional classification system used for?

The analysis of goal-directed behavior

What three things must be understood when using Gentile's classification system?

Demands of the environment

Needs of the individual

Elements of the task

What are the two major dimensions of Gentile's Taxonomy?

Environmental context

Action function

What four questions can be used to classify a task using Gentile's Taxonomy?

Is the environment stationary or moving?

Is there intertrial variability or no variability?

Is the body stable or transported?

Is there object manipulation or no manipulation?

First Dimension on Gentile's Taxonomy: Environment

Regulatory conditions:

• Is environment stable ?

• OR

• Is it moving?

• Is there intertrial variability?

• Done the same way?

• Environment dictate changes in motor performance?

2nd Dimension on Gentile's Taxonomy: ACTION/ TASK/SKILL

• What's going on with the body

• Moving→ body transport

• Stable → no change in body location

Is object manipulation occurring?

- Holding or using an object

The ability to select the right muscle at the right time with proper intensity to achieve the proper action

Coordination

Skillful use of the fingers during fine motor tasks

Dexterity

The ability to rapidly and smoothly initiate, stop, or modify movement while maintaining postural control

Agility

The ability to integrate visual and motor abilities with the environmental context to accomplish a goal.

Visual-motor coordination

Dysfunctions seen with a cerebellar pathology

Generalized muscle weakness

Asthenia

Loss of the ability to associate muscles together for complex movements.

Asynergia

Increased time required to initiate voluntary movement

Delayed reaction time

A disorder of the motor component of speech articulation

Dysarthria

Impaired ability to perform rapid alternating movements

Dysdiadochokinesia

Inability to judge the distance or range of a movement

Dysmetria

Movement performed as a sequence of component parts rather than one smooth activity; movement decomposition

Dyssynergia

What gait pattern is associated with cerebellar pathology?

Ataxic gait with a broad BOS and postural instability

What else can be seen with cerebellar pathologies?

Hypotonia

Hypermetria/Hypometria

Nystagmus

Rebound phenomenon: Inability to halt forceful movements after resistance removed: patientunable to stop sudden limb motion

Tremor ((Intention (kinetic) and/or Postural (static))

Titubation: Rhythmic oscillations of the head; axial involvement of the trunk

What is seen with a Basal Ganglia Pathology?

Akinesia

Athetosis

Bradykinesia

Chorea

Choreoathetosis

Dystonia

Hemiballismus

Hyperkinesis

Hypokinesis

Rigidity

Resting tremor

What test can assess dysdiadochokinesia?

Finger-to-nose

Knee flexion/extension

Alternating nose-to-tester's finger

Alternating foot tapping

Pronation/supination

Walking while changing speed/direction

What tests can assess dysmetria?

Pointing/past-pointing

Drawing a circle or figure 8

Heel slide on shin

Placing feet on floor markers

What tests can assess dyssynergia?

Finger-to-nose

Finger-to-therapist's finger

Alternate heel-to-knee

Toe-to-examiner's finger

How can hypotonia be assessed?

Passive movement and DTRs

How can intention tremor be assessed?

Observe during functional activity or use finger-to-nose; tremor generally increases as the target is approached or speed increases

How can resting tremor be assessed?

Observe at rest; tremor decreases significantly or disappears with movement

How can postural tremor be assessed?

Observe steadiness of normal posture in sitting and standing

How can asthenia be assessed?

Fixation/position holding of the UE or LE and application of resistance to determine ability to maintain the position

How can rigidity be assessed?

Passive movement

How can bradykinesia be assessed?

Observe speed and timing during fine motor tasks

It is a carefully planned series of exercises designed toovercome incoordination & proprioception loss by the use of PRACTICE and visual and auditory feedback

Co-ordination exercise

A group of graduated exercises for the LE and designed toovercome the incoordination and proprioception loss byvisual feedback and repetition

Frenkel's Exercises

Frenkel's Exercises principles

Start unilateral then bilateral

Start fast then slow movement

Start by proximal then by distal joints

Start by symmetrical then asymmetrical movement

The patient must see the movements and verbal feedback is very important

What are non-equilibrium coordination tests?

Tests assessing static or dynamic movement when the patient is not standing or balance is not stressed

Ex of non-equilibrium coordination tests for both LE and UE

LE:

Tap heel on cone

Tennis ball and roll it to a specific target

UE:

Sit and reach with target on wall (but do not reach outside BOS)

Picking up a cup and stacking

What are equilibrium coordination tests?

Tests performed with the patient standing or while challenging balance

Ex of equilibrium coordination tests for both LE and UE

LE:

Y-Balance

Kicking a ball

Standing on foam with blaze pods

Walk alternating speed

UE:

Standing and reaching out of BOS

Finger opposition

Standing reaching toward my hand

Coordination focuses on FIVE main areas

1. Alternating or reciprocal movement

2. Movement composition or synerg

3. Movement accuracy

4. Fixation or limb holding

5. Equilibrium and posture holding