physiological basis of motor learning and recovery of function

how learning relates to rehabilitation: brain continuously ____, in new learning event there is some ____ and _____ change in NS that supports learning, the basis for _____ is similar to that of learning

remodels, necessary, sufficient, recovery of function

motor learning: set of ____ processes associated with _____ or ____ that lead to _____ changes in the capability for skill behavior

internal, practice, experience, permanent

motor plan: _____ motor program, set of skills or _____/____ combo of movements

complex, generalized, stereotypical

neurorecovery: _____/_____ changes at intial site of ____/____

CNS, PNS, impairment, injury

recovery of function: _____ of a movement skill

reacquisition

neurocompensation: ____/____ changes that ____ for loss/injury

CNS, PNS, loss, injury

compensation: use of _____ strategies to complete a task

alternative

learning: process of acquisition of ____ or _____

knowledge, ability

memory: _____ of learning; ____ and _____ of knowledge or ability

outcome, retention, storage

memory that operates unconsciously and automatically

implicit

memory that operates consciously

explicit

momentary attention to something

short term memory

lasting storage, structural changes

long term memoery

3 circuits of learning

unsupervised, reinforcement, supervised

unsupervised learning primarily in the ____

cortex un

unsupervised learning is highly dependent on ____ experience

sensory

reinforcement learning is primarily in the _____

basal ganglia

reinforcement learning ____ the situation, ___ a reward and ____ suitable action

processes, predicts, selects

supervised learning happens primarily in the _____

cerebellum

supervised learning: implementation of ____ and _____ loops, ____ and ____ learning

feedforward, feedback, trial, error

3 areas learning is processed

cortex, basal ganglia, cerebellum

two basic forms on long term memory

nondeclarative, declarative

non-declarative (_____) learning =

implicit, nonassociative, associative, procedural

declarative (____) learning =

explicit, facts and events

learning that is in a reflex pathway

non-associative - habituation and sensitization

nonassociative - habituation is the ____ form of ____ learning

simplest, implicit

non-associative - habituation: learned ____ of a response to a ____ stimulus

suppression, non-noxious

with non-associative - habituation ESPS amplitude ____ over time

decreases

habituation can be used to reduce a movement provoked _____

dizziness

non-associative - sensitization: ______ of a response to a stimulus

strengthening

with non-associative - sensitization ESPS amplitude ____ over time

increases

associative learning: help us adapt _____ to _____

actions, environment

associative learning: ____ neurons active at the same time, see changes in _____

2, synaptic efficiency

emotional responses of associative learning are localized in _____

amygdala

skeletal muscle responses of associative learning are localized in the _____

cerebellum and premotor cortex

classical conditioning: initial ____ stimulus becomes highly _____ in producing a response when becomes ____ with a _____ stimulus

weak, effective, associated, stronger

with classical conditioning, _____ is critical

timing

operant conditioning: learning involves development of ____ relationships, ie ____/_____

predictive, reward, punishment

classical and operant conditioning are examples of _____ learning

associative

procedural learning: responsible for ____ and ____

skills, habits

procedural learning only occurs when movement is performed by learners through _____ practice and within the ____ of actions that will be carried out in a normal setting

trial and error, context

procedural learning happens in _____

cerebellum

procedural learning - cerebellar inputs

climbing fibers, mossy fibers

signal error and help with correction of ongoing movement

climbing fibers

kinesthetic info about ongoing movement and help control movement

mossy fibers

procedural learning - cerebellar outputs

purkinje fibers

declarative learning can be expressed in a form ______

other than in the way it was learned

declarative learning requires ____ process such as ____ and _____

conscious, awareness, attention

structure that is critical for declarative learning

hippocampus

spatial map of areas in which we move

spatial memory

long term potentiation: ____ and ____ stimulus arrive in close succession, causes ____ ESPS

weak, strong, elevated

long term depression: neural connection is ____

weakened

there is modulation of the ____ cortex outputs when ____ knowledge is associated with _____ performance

motor, explicit, improved motor

shifting implicit to explicit is important when _____ someone a skill we know but they don’t; must be able to explain the ____

teaching, steps

memory shifts from explicit to implicit when there is _____

constant repetition of a task

shifting from explicit to implicit when learning how to _____, initially requires _____ to recall rules and procedures until the task becomes ____ and _____

drive, conscious effort, automatic, unconscious

implicit and explicit are used ____ with no exception

together

motor learning requires ____ and ____ formed of learning to acquire a new skill

simple, complex

with practice, changes in ____ cortical pathways increase efficiency of _____ pathways. after learning has occurred, need less ____ for the action

sensorimotor thalamocortical, sensory

initial learning of a motor skill - happens in widely distributed _____ areas (____ cortex, _____, ___ nucleus of BG and cerebellum)

cortical, prefrontal, sensorimotor, caudate latera

later stages of learning a motor skill - happens in ____ regions of the ____, _____ and _____; task is more ____; _____ areas of motor cortex become active and more ____

subcortical, cerebellum, thalamus, putamen, automatic, efficient

as automaticity of the task _____, motor task becomes ____ and it is easier to perform a ____ task simultaneously

increases, effortless, second attention demanding

two factors that make dual task difficult

age, parkinsons disease

ability of the cns to change

neuroplasticity

neuroplasticity short term changes in efficiency or strength of _____ connections and the unmasking of _____ connections

synaptic, underutilized

neuroplasticity long term changes in ____ organization and _____ of connections

cortical, numbers

initial or early recovery that occurs independent of external interventions

spontaneous recovery

changes in underlying neural structures occuring in the same time frame

neurological recovery

improvements associated with specific activites and training

activity induced recovery of function

mechanisms of recovery of function are either _____

restorative or compensatory

resolution of temporary changes and recovery of injured nerual tissue

restorative - direct

completely different neural circuits enable recovery of lost or impaired function

compensatory - indirect

compensatory recovery - cortical representation as a result of forced use

function enabling

compensatory recovery - cortical reorganization that result in phantom limb sensations

function disabling

wallerian degeneration - an active process of ___ degeneration of the ___ end of an axons as result of a _____

retrograde, distal, nerve lesion

wallerian degeneration occurs between ___ and___ days after the lesion

7, 21

loss of function in structurally intact brain area due to loss of input from injured area

diaschisis

compression of axons and physiologically block conduction of impulses

edema

nerves in the PNS can promote regeneration bc ____ have ____, while the CNS cannot regenerate because the ____ dont

schwann cells, nerve growth factor, oligodendrocytes

loss of input causes a neuron to be hyperactive to neurotransmitter

denervation supersensitivity

facilitate recovery with use of drugs such as amphetamines

unmasking of silent synapses

axons resprouting, can occur within 3-7 days

neural regeneration

neighboring axons sprout to innervate sites previously innervated my injured axons

collateral sprouting

neural regeneration can be ____ in the presence of depression or stress or can be ______ in an enriched environment

decreased, increased

cortical reorganization happens ____ in response to activity, behavior, and _____ acquisition, also have ___ or ____ injury

continuously, skill, peripheral ,CNS

changes in cortical maps after peripheral lesion

• immediately after = _____ activity

• after a few days = increased responsiveness of ____, ___ connections, and _____ of nearby receptive maps

• in severe injury, some part will remain ____

no, existing, weak, expansion, silent and unresponsive

phantom limb - ____ cortical areas expand into ___ regions - so touching the face may elicit ____ sensation of the UE

nearby, denervated, phantom limb

changes in cortical map after central lesions

• alterations in ____ and changes in ___ patterns

cortical maps, neural activation

after CNS lesions - cortical reorganization

• use of ____ pathways

• ____ areas take over

• ____ pathways or ____ areas take over

redundant, new, parallel, adjacent

after CNS lesion - contributions of ipsilateral motor pathways

• not well understood

• in children with sever epilepsy, can remove ____ and other one will take over

hemisphere

after CNS lesion - contributions of cerebellum

• related to role in ___ learning through establishment of _____

• new synapses associated with _____, not ____ activation in absence of learning

motor, automatic motor skills, complex skill learning, gross motor

after CNS lesion - contributions of cross modality plasticity

• when normal input _____, cortex becomes ____ to other ___ modalities

removed, sensitive, sensory

clinical relevance

• ____-dependent competitions

• ____ and ____ are constantly change our cortical maps

• ____ and ____ drive changes

use, experiences, environment, timing, inensity

cortical reorganization is associated with ____, but not isolated ____ (this is still an important ____ to ____)

learning a skill, strength, prerequisite, learning a skill

requirements for rehab to maximize learning or relearning

• ____ for CNS to change e

• ____/____ to gain function

• clinician who known how to intentionally drive change in ____ factors, ___, ____, ____ of neuroplasticity

capacity, desire, motivation, environmental, doage, feedback, 10 principles

neuroplasticity in msk

• consider how ____ the system changes based on ____ input

• modify ___ patterns very common with pain

• loss of ___ input post surgery

quickly, sensory, movements, sensory

neuroplasticity in neuro

• initial ____ may help w return of function

• but good ____ and outcomes is associated with ____ of activation patterns

reorganization, motor recovery, normalization

compensation

• changes in brain ____

• reallocation of ___ resources

• recruitment of additional ____

• can ____ with improvement

activation, hemispheric, brain regions, interfere

____ strongly influences neural mechanisms associated with recovery of function

experience