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OT Theory: Motor Control and Motor Learning

Terms in this set (68)

motor control
-ability to use one's body effectively while performing an occupation
motor control includes
-anticipating
-initiating
-generating
-coordinating
-maintaining
-terminating
Behaviors evidencing poor motor control:
-poor balance
-absent or partial movements
-unsteadiness, in-coordination, clumsiness
-difficulty moving out of a stereotypical movement pattern
-effortful compensatory movements
skill
-ability to bring about an end result
motor skill:
-requires movement
-is learned
-involves precision and accuracy
-is described as an act/end result
-is measured in terms of goals/accuracy
Neurodevelopmental approaches
-4 traditional approaches
-similar concepts and techniques
-goal of improving motor control
traditional hierarchical control models
-belief that there is no exception to the order in which things are learned
-ex. must crawl before you can walk
-but this is not always the case
Treatment under traditional models:
-movement control is hierarchical
-movement impairment is caused by higher CNS problems
-focus on normal movement not function movement
-did not want to teach people "abnormal" ways of moving even if they are functional
Rood's sensorimotor retraining program
-focus on reflexes
-OT should provide specific sensory stimulation in order to elicit particular motor responses
-very hands on, manipulation
facilitation
-icing
-brushing
-quick stretch
-proprioceptive stimulation
inhibition
-rhythmic movement
-rocking
-warmth
-sustained stretch
-special senses
Brunstrom's movement therapy:
-6 stages of post stroke recovery
-used for research
-proximal to distal
-gross to fine
Proprioceptive Neuromuscular Facilitation
-PNF
-diagonal movements are normal
-movement occur in combination planes
-not an effective treatment, but components are combined with other treatments
Bobath
-traditional NDT
-focus on trunk stability
-hand placement used to facilitate movement
-focus mainly on spasticity and flaccidity
Current NDT
-neurodevelopmental treatment
-used in context of occupation
-help weight shift of shoulder girdle and pelvic girdle
-importance of practicing normal task performance
-forced use of affected extremity
motor programs
-patterns of movement containing information about sequence, duration, speed, and direction of movement
-every pattern of movement has a distinct program
-stored in the CNS
In the 1970's therapist began to question the idea that:
-the brain stores a motor program for every single task
Contemporary approaches:
-focus on the interaction between persons and their environments
-suggest that motor behavior emerges from the person's multiple systems interacting with unique tasks an varying environmental contexts
Dynamic Systems Theory:
-behaviors emerge from the interaction of many systems
-because behavior is not designated it is self organizing
-stable patterns of motor behavior even with many options of performing a task
-preferred patterns change over lifespan
control parameters
-variables that shift behavior
-do not control the change
-therapeutic options
person
-client factors
-performance skills
-performance patterns
environment
-context and activity demands
-physical
-socioeconomic
-cultural
regulatory
-specific aspects of the environment shape the demands
-ex. shape, weight, temperature, lighting
non regulatory
-aspects that affect performance but do not shape the movements
-ex. noise, distractions
task relate approaches
-regaining ability to perform motor tasks is a learning process
-motor control is exercised in both anticipatory and ongoing modes
-control of a specific task is best regained by practice if the task in varied environments
motor learning
-processes associated with practice or experience leading to relatively permanent changes in the capabilities of the individual
What are the four motor learning principles that support learning in individuals with CNS dysfunction:
1. stage of learning
2. task characteristics
3. practice conditions
4. feedback
Stage theory of motor learning
-pre practice/preparation
-explain, demonstrate, model movements needed to understand task
-cognitive
-associative
-autonomous
cognitive stage
-performance is highly variable
-requires constant attention
-results in more effort and less efficient performance
-frequent feedback
-physical guidance
-client begins to identify right/wrong efforts
-purpose of variablity is to provide reference of correctness
associative stage
-motor skills become more refined and consistent
-move from declarative learning to procedural learning
-reduced feedback/attention
-encourage experimentation with refinement of control
-begin incorporating divided or switched attention
declarative learning
-saying the parts of the movement
-mentally rehearsing
procedural learning
-rules of movement are internalized
-no conscious thought required
autonomous stage
-little cognitive effort needed to perform the skill
-practice in a wide variety of situations
discrete task
-has a beginning and an end
-ex. opening a door, putting on socks
continuous task
-no recognizable beginning or end
-ex. walking, tweeting
serial task
-series of discrete tasks performed in a continuum
-ex. cooking a meal, driving a car
open environment
-unpredictable
-objects may change
closed environment
-predictable
-objects remain stationary
simple motor patterns
-straight plane movement
-smooth/constant speed
-shortest/most efficient path
complex motor patterns
-multi plane movement (diagonals)
-variable speed, stopping, starting
-incorporation of head, neck, trunk, and limbs
massed practice
-practice sessions are greater than rest periods
distributed practice
-rest periods of equal or greater duration incorporated into the treatment session
constant practice
-occurs under the same environmental conditions
variable practice
-occurs under a variety of environmental conditions
-enhances transfer of learning/generalizability
-development of rules for movement
-better problem solving in new situations
blocked practice
-repetition of same task before altering demands or changing to another task
-ex. AAA, BBB
random practice
-varying task demands over the course of an OT treatment
-no task repeated twice in a row
-ex. ABC, BAC, CBA
-places greater demand on learner
-greater retention and transfer of learning
whole practice
-practice motor skill in its entirety
-best for short duration or cyclical tasks
-learning the meaning of the task
part practice
-practice discrete portions of the task
-best for serial tasks
-must always bring it back to the whole
Practice principles based on research
-random practice is better than blocked practice
-practicing variations of the task and context is better than practicing same task in same context
-practicing the whole is better than the parts
-self controlled practice is better than instructor controlled practice
intrinsic feedback
-sensory feedback on performance
-goal: self monitoring/assessment
extrinsic feedback
-encouragement or cues
-regards the outcome of the task or the process
immediate feedback
-constant
-after every trial
summary feedback
-at the end of a set of trials
faded feedback
-immediate-->summary-->none
bandwidth feedback
-defined by a range of success
-feedback provided only if the performance is outside the range
Feedback Scheduling for the novice
-needs to understand the requirements of the task
-what do you want me to do
-think through each step
-cannot multitask
-initiate with blocked/whole practice
-provide lots of external feedback
feedback scheduling for the expert
-skills become habitual
-able to multi task
-random/part task practice to refine skills
-facilitate internal feedback
skilled performance measure
-rate of goal achievements (#of successes/attempts)
-accuracy of movements (errors/attempts)
-efficiency (time needed, speed, duration, multi-task)
-flexibility (performance under different conditions)
performance vs. retention
-performance is not learning
-motor learning is relatively permanent
-determine motor learning by testing retention
-grade the activity to optimize performance
transfer of skill
-the ability to perform a skill in a new environment
-skill is context bound when taught in single context
generalization of knowledge
-ability to apply information/skill to a new environment than where it was practiced
scaffolding
-provide support during the initial learning process
-gradually remove support to promote learners autonomy
-build on the client's current skill level
-feedback is faded
influence of the environment on learning
-combination of isolated and complex
-ex. violin orchestra vs. solo (need both to progress)
intervention principles
-help client's adjust to role and task limitations
-create environment that uses common challenges
-practice functional tasks
-provide practice opportunities outside of therapy
-minimize ineffective movement patterns
task oriented approaches
-achieve a motor skills
-not quality of movement
-provide client opportunity to solve a motor problem
-real tasks, real objects, natural context
-whole task practice
-summary or bandwidth feedback
Examples of treatment
-constraint induced movement therapy (CIMT)
-Neuromuscular electrical stimulation
-mirror therapy
Traditional:
-movement controlled by- upper motor neurons
-cause of movement dysfunctions- CNS
-Bottom Up
-Hands on intervention
-focus on quality of movements
Contemporary:
-movement controlled by- environment, pain, task
-cause of movement dysfunction- within systems
-Top Down
-Hands off
-Focus on function
THIS SET IS OFTEN IN FOLDERS WITH...