OCTH 5101 week 9 2024_ Motor Control FOR
Week 9 - Motor Control FOR
Presenter: Felicia Chew, MS, OTR/L, FAOTA
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Motor Control FOR details provided.
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Source: Cole MB, Tufano R. Applied Theories in Occupational Therapy: A Practical Approach © 2020 SLACK Incorporated.
Page 3: Theorists
Neurodevelopmental Theory (NDT) - Bobath, 1990
Sensorimotor Approach - Rood, 1954
Proprioceptive Neuromuscular Facilitation (PNF) - Knott and Voss, 1968
Movement Therapy - Brunnstrom, 1970
Page 4: Brunnstrom
Normal development involves a progression of reflex modification.
Dysfunction occurs due to conditions like CVA leading to lower levels of motor control.
Recovery sequence: from flaccid to voluntary isolated joint movements.
Page 5: Proprioceptive Neuromuscular Facilitation (PNF)
Focuses on alternating balanced movements of antagonistic muscles.
Development follows an orderly sequence and proceeds:
Cephalocaudally (head to tail)
Proximodistally (from center to extremities)
Engages natural movement patterns combined with facilitation techniques.
Page 6: Rood
Developed for individuals with CP and motor control problems.
Normal movement arises from subcortical reflex patterns, supporting voluntary control.
Sensory stimulation has both inhibitory and facilitatory effects.
Importance of repetition in reinforcing learning.
Page 7: Neurodevelopmental Therapy (NDT)
Aims to restore skilled voluntary movement in individuals with
Cerebral Palsy
Hemiplegia from CVA
Theory emphasizes reductionism and normal growth/milestones.
Focus on reflex hierarchies, attitudinal reflexes, and protective reflexes.
Page 8: Basic Assumptions of NDT
Movement control progresses:
Cephalocaudal
Proximal to Distal
Gross to Fine
Children develop control over primitive reflexes.
Recovery requires internalizing movement sensations, prioritizing stability over mobility.
Normalizing tone must precede recovery.
Page 9: Philosophical Tenets of NDT
Functional treatment integrated into ADLs.
Continuous evaluation and problem-solving incorporation.
Respect for client and family needs is crucial.
Knowledge of normal movement and biomechanics is essential for treatment strategies.
NDT is holistic and individualized, requiring interdisciplinary approaches.
Page 10: Function & Dysfunction
Functional motor control: Ability to perform voluntary skilled movements necessary for daily life.
Dysfunction characteristics:
Lack of postural control
Abnormal muscle tone
Generalized spasticity
Difficulties inhibiting nonfunctional movements and sensory disturbances.
Page 11: Change & Motivation
Change facilitated through specific techniques:
Handling
Inhibition techniques
Facilitatory methods
Placement strategies
Reflex-inhibiting patterns.
Motivation factors are not distinctly addressed.
Page 12: Evaluation & Intervention
Evaluation
Assess functional movement abilities through observation and handling.
Collaborative goal setting with clients and families.
Intervention strategies
Focus on occupations for both practice of movement and achievement of goals.
For developmental disabilities, handling and facilitation methods are used.
Page 13: Motor Learning and Task-Oriented Frames
Reference: Cole Chapter 21
Page 14: Motor Learning Theories
Combines psychological, behavioral, and neurological theories.
Focuses on the direct relationship between learning and task performance.
Client-centered and task-oriented approaches.
Page 15: Focus of Motor Learning
Objective: Restore functional movement across various health conditions.
Engagement in meaningful tasks enhances motivation for recovery.
Page 16: Theoretical Base
Incorporates:
Nonlinear science
Neuroplasticity and brain self-organization
Social Cognitive Theory for motivation.
Page 17: Learning Theory (Timmerman)
Types of learning:
Associative learning: Procedural and declarative.
Nonassociative learning: Habituation and sensitization.
Importance of task-oriented training in recovery.
Page 18: Function & Dysfunction Dynamics
Continuum of function from:
Cognitive stage to autonomous stage.
Functionality increases with degrees of freedom.
Recognizing need for compensatory strategies.
Page 19: Change & Motivation Understood
Change involves:
Learning motor strategies through trial and error.
Practice and refinement are vital for skill enhancement.
Motivation is linked to social roles and meaningful tasks.
Page 20: Evaluation & Intervention
Dynamic evaluation during occupational tasks.
Holistic intervention strategies:
Remediation for motor and cognitive skills.
Adaptation for task demands and environment.
Compensation for task modification.
Page 21: Example Interventions
Weight Bearing Strategies for OP
Goals:
Normalize muscle tone.
Dynamic and weight-bearing patterns for upper and lower extremities.
Constraint Induced Movement Therapy (CIMT)
Focuses on forced use of affected side post-CVA.
Repetitive and functional task practice.
Page 22: Additional Interventions
Cognitive Orientation to Occupational Performance Approach (CO-OP)
Targets children with motor-based learning issues.
Objectives include skill acquisition, strategy use, generalization, and transfer of learning.
Page 23: Cognitive Behavioral FOR
Introduction to Cognitive Behavioral Frame of Reference.
Page 24: Cognitive Behavioral FOR - Theoretical Base
Grounded in cognitive development theory (Piaget) focusing on:
Hierarchical levels of cognition through stages.
Emphasis on qualitative changes in knowledge understanding.
Page 25: Continuation of Cognitive Behavioral FOR - Theoretical Base
Emphasis on behavioral theories for change focusing on observable behaviors using:
Operant conditioning (Skinner) and classical conditioning (Pavlov).
Learning occurs through behavioral connections and social observation.
Page 26: Main Constructs of Cognitive Behavioral Theory
Focus on:
Influence of thinking on behavior.
Self-regulation in thoughts and behavior.
Developing coping skills and altering thinking patterns.
Applicable populations include those with:
Developmental disorders, neurological diseases, mental illness, and stressors.
Page 27: Function & Dysfunction in Cognitive Behavioral Theory
Focus areas include:
Cognitive abilities, stress management, self-regulation, behaviors, and motivation.
Page 28: Evaluation in Cognitive Behavioral Theory
Assessment methods:
Medical and social history analysis, clinical observations, and cognitive tests.
Page 29: Change in Cognitive Behavioral Theory
Change principles emphasize the link between belief systems and behavior alteration.
Useful for addressing anxiety, phobias, and motivation.
Recommendations to use alongside occupation-focused models for improved understanding.
Page 30: Intervention in Cognitive Behavioral Therapy
Common practices include:
Psychoeducational groups and self-regulation programs targeting coping, goal-setting, and relaxation strategies.
Page 31: Introduction to Social Cognitive FOR
Establishes connections with occupational therapy.
Page 32: Focus of Social Cognitive Theory
Encompasses all occupations with a strong emphasis on:
Thought processes, social participation, and prevention.
Effective for groups facing mental health issues.
Page 33: Concepts from Social Cognitive Theory
Key elements include human agency, intentionality, and self-efficacy.
Underlines learning through observation and internal motivation.
Page 34: Function & Dysfunction in Social Cognitive Theory
Emphasis on personal agency, health management, and goal setting in functional individuals.
Page 35: Change & Motivation in Social Cognitive Theory
Transtheoretical stages of change emphasize:
Motivation supported by competence, autonomy, and relationships.
Page 36: Evaluation in Social Cognitive Theory
Informal assessments and creative media are utilized to evaluate behavior.
Page 37: Intervention Strategies in Social Cognitive Theory
Focuses on strengthening self-identity and life goals through therapeutic methodologies such as:
Acceptance and Commitment Therapy (ACT) and Dialectical Behavior Therapy (DBT).