Term
| Contemporary Task Oriented Approaches to Motor Control Training |
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Definition
Reject reflex-hierarchical model and traditional neurophysiologic therapies
Remediation of client factors and environmental modifications
Motor is determined by interactive systems, behavior and adaptive mechanisms
Movement is controlled by integration of environmental, sensorimotor, musculoskeletal, regulatory and behavioral/emotional goals
control over kinematic variables |
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Term
| Interventions for Task-Oriented Approach |
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Definition
Helping pt.s adjust to role and task limitations
creat environment of everyday challenges
practice functional tasks
opportunities for practice outsid etherapy time
remediating a client factor
minimizing inefficient/ineffective movement
adapt environment
modify task
use assistive technology |
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Term
| Principles of Motor Learning |
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Definition
| The goal is acquisition of functional skills that can be generalized to multiple situations and environments |
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Term
| Motor Learning - Skill Acquisition Stage - Cognitive Stage |
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Definition
Develops understanding of task
Cognitive mapping
task demands
identifies stimuli
Contacts memory
selects response
performs initial aproximations of task
Structures motor program
Modifies initial response |
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Term
| Skill Acquisition Stage - Cognitive Stage Training Strategies |
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Definition
Hightlight purpose of task
Demonstrate performance of task
pt.s verbalize task
point out similiarities
select intrinsic and extrinsic feedback (vision, knowledge of performance and of results
pt. evaluates performance
use reinforcement
Feedback is used
Organize initial practice (stress controlled movement, rest periods, guidance, break down, bilateral transfers used and blocked practice, use variable and mental practice)
Assess, modify arousal levels
Structure environment
empasize closed skills then to open
reduce environmental stimuli |
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Term
| Skill Retention Stage - Associated stage |
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Definition
Practices movements
Refines motor programs
spatial and temporal organization
decreases errors
extraneous movements
visual feedback decreases
increase of proprioceptive feedback
decrease cognitive monitoring
HOW TO DO decisions |
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Term
| Skill Retention Stage - Associated Stage Training Strategies |
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Definition
Select appropriate feedback
Provide knowledge of performance and knowledge of results
improve self evaluation and decision skills
facilitation techniques
Organize feedback
positive feedback
Avoid excessive feedback
Focus on variable feedback
organize variable practice
Structure environment ( progress toward open/changing)
prepare for home/community environments |
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Term
| Autonomous Stage - Skill Transfer stage |
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Definition
Practices movement,
Refines motor responses,
Spatial and temporal highly organized
Movements are largely error free
minimal level of cognitive monitoring |
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Term
| Autonomous Stage - Skill Transfer stage Training Strategies |
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Definition
Assess conscious attention, & automaticity of movements
Select appropriate feedback,
demonstrates appropriate self-evaluation
provide feedback when errors are evident
Organize practice in variable environments and open skills
High level of practice (massed practice)
Vary environments
Ready for home
competitive sports |
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Term
| Random or variable practice |
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Definition
| practice of several tasks that are presented in random order |
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Term
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Definition
| repeated performance of the same motor skill |
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Term
| Variable conditions practice |
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Definition
| practice in various conditions |
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Term
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Definition
| cognitive rehearsal of a skill without moving |
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Term
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Definition
info. received by learner as result of performing task
Info. received from tactile, vestibular and visual after doing task. |
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Term
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Definition
feedback provided from outside source (theerapist or mechanical device)
knowledge of performance verbal feedback
knowledge of results (therapists provision of about the outcome) |
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Term
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Definition
| activities which the environment is stable |
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Term
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Definition
| tasks with stable predictable environment |
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Term
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Definition
| tasks with environment that is in motion and the motion is predictable |
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Term
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Definition
| tasks where make adaptive decisions about unpredictable events |
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Term
| Neurophysiologic or Traditional Frames of Reference |
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Definition
controlled movement is preceded by sterotypic reflex responses
sensory input regulates motor output, sensation necessary for movement to take place
Normal movements are governed by hierarchical centralized movement patterns
when basic movements are normalized skilled movement follows
Reflex model control
use of facilitation and inhibition techniques |
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Term
| NDT (Bobath Technique) Evaluation procedures |
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Definition
observe malalignments
evaluate abnormal tonal patterns
pt.s' placing response
presence of associated reactions (ie: flexion synergy)
postural control (righting, equilibrium reactions, protective responses and weighshifting activities
Evaluate abnormal coordination patterns (timing, sequencing of movements and coordination
volitional movements |
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Term
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Definition
Handling techniques
provide external stability
normalize movement patterns
facilitate inhibit muscle groups
inhibit abnormal patterns of control
provide sensory input
increase range of motion
dissociate body segments
normalize tone
utilize key points of control
inhibition techniques
normalization of tone (weightbearing, trunk rotation, scapula mobilization, pelvic alignment & weightshifts, slow and controlled movements, proper positioning)
retraining
bilateral movement patterns |
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Term
| PNF Proprioceptive neuromuscular facilitation evaluation procedures |
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Definition
developmental sequence proximal to distal
respiration, swallowing, voice, oral/facial are evaluated for weakness
determine which visual auditory and tactile stimulation reinforces movement
head/neck patterns observed
DI and D2 extremities are evaluated
functional tasks observed
Observe (tone, midline alignment, stability, head, neck, trunk patterns, ROM, quality and timing of movements) |
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Term
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Definition
Diagonal patterns are utilized
Patterns chosen to remediate missing components
flex. ext. major components
manual contacts over agonist muscles
quick stretching of of direction opposite
traction manual separation of joint space and manual compression
max. resistance given
repeated contractions of agonists are utilized
rhythmic initiation is utilized
promote reversals of antagonists
isometric stabilization of antagonists
contract-relax, then passive movement
Hold-relax then active movement
rhythmic rotation |
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Term
| Brunnstrom's movement therapy evaluation procedures |
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Definition
Stage 1 - flaccid, no voluntary/reflexive
Stage 2 - minimal voluntary movement, spasticity develops
Stage 3-marked spasticity, synergies
Stage 4 - movements begin from synergy
Stage 5 - movement differ
Stage 6 Spasticity absent
Stage 7 - normal motor function
Move against synergy patterns, flexion and extension for intervention |
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Term
| Rood's Approach Evaluation |
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Definition
Distribution of muscle tone
clinical obs. of which muscles require inhibition or facilitation
determine level of motor control
determine therapeutic activity of choise
Four phases of motor control
Reciprocal inhibition/innervation
Co-contraction
heavy work
Skill |
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Term
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Definition
Normalize tone via sensory stimulation
Fast brushing for facilitation
Stretch/tendon tapping
High Frequency vibration
quick icing to stimulate
Weightbaring
Resistance
Inhibition techniques include
gentle rocking
slow stroking
slow rolling
tendinous pressure over muscle insertion
maintain stretch
neutral warmth
prolonged icing
engagement in functional activities |
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Term
| Ashworth Scale assess spasticity |
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Definition
1 - normal tone
5 - severe hypertonus/rigidity |
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Term
| Modified Ashworth Scale assess spasticity |
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Definition
0 - no increase in muscle tone
4 - affected part is rigid in flexion or extension |
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Term
| Quick Stretch assess spasticity |
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Definition
Minimal rating is given if a CATCH is felt at the end range
and severe range is given if CATCH is felt at beginning range |
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Term
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Definition
A response to stimulus is termed POSITIVE
No response to stimulus is termed NEGATIVE |
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Term
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Definition
Grasp
Flexor w/d
Crossed extension
ATNR
STNR
Tonic labrinthine
Positive supporting reaction
Associated reaction
Neck rightin
Body righting
Optical righting
protective extension
Equilibrium reactions |
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Term
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Definition
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Term
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Definition
| undershooting (hypometria)or overshooting a target (hypermetria) |
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Term
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Definition
| decomposition of smooth movements |
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Term
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Definition
| imapired ability to perform rapid alternating movements |
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Term
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Definition
| loss of motor control, tremors, dysdiadocho., dyssynergia, and visual nystagmus. |
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Term
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Definition
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Term
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Definition
| increased resistance to passive movement |
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Term
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Definition
| slowing of movement patterns |
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Term
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Definition
| inability to initiate movements |
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Term
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Definition
| dyskinetic condition, inadequate time, force, accuracy of movements |
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Term
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Definition
| involuntary sustained distorted movement or posture involving contraction of groups of muscles |
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Term
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Definition
| involuntary movement of face and extremities spasmodic and short time |
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Term
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Definition
| unilateral chorea, forceful movement of proximal muscles |
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Term
| Purpose of splints for neuromotor dysfunction |
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Definition
prevent deformity
control spasticity
prevent contractures
correct biomechanical malalignment
position hand in functional posture
Compensate for weakness to allow intact muscle groups to function
provide proximal support
support painful joint
promote distal mobility
enhance function - feeding
immobilize joints
prevent scarring |
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Term
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Definition
external support
prevent motion
streching
aligning joints
resting
reducing pain |
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Term
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Definition
increase passive motion
assist weak motions
substitute for lost motion |
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Term
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Definition
wrist in 10-20 extension
to support flaccid writst
allows digits to function
prevent contracture |
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Term
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Definition
need to have hand in functional position for long periods
when developing contractures of long flexors |
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Term
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Definition
may be long or short
support thumb in aBduction and opposition
functional activities for weakness |
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Term
| Inhibitory tone normalizing splints |
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Definition
aBduction splint (finger spreader)
positions digits and thumb in aBduction
Cone - reduced flexor spasticity
Orthokinetic - elastic bandages used for tactile input
Spasticity reduction - places digit on submaximal stretch |
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Term
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Definition
overhead suspension sling - w/ muscle grades 1 - 3/5
Balanced forearm - mobilie arm support
Shoulder slings
Lap boards, arm troughs, etc. |
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Term
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Definition
ROM, strength, tone of lips, cheeks, tongue
sensation
integrity of teeth
Oral control of bolus
Swallow reflex (laryngeal elevation, soft palate elevation, pharyngeal peristalsis)
Airway protection (gag reflex, cough, vocal fold, reflexive inhibition)
Relaxation of esophageal sphincter
Primitive reflexes (rooting, jaw jerk, bite reflex, ATNR/STNR)
Cranial nerve testing
Objective Testing |
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Term
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Definition
Modification
Postural interventions
Chin tuck, head tilt, head turn
Swallowing adaptations
Supraglottic swallow technique and Mendlesohn's maneuver
Thermal stimulation
Reflex facilitation
Strengthening, coordination
airway adduction procedures
positioning |
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Term
| Constraint Induced Movement Therapy |
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Definition
wrist ext. 20 and finger ext. 10
or
wrist ext. 10, thumb aBd. 10, any two digits ext. 10
or
use hand in functional way
uses motor learning principles |
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Term
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Definition
ages 4-8
requires certification
tactile and vestibular-proprioceptive
Form and space and visual motor coordination
practic ability
bilateral integration and sequencing |
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Term
| DeGangi-Berk Test of SI (TSI) |
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Definition
ages 3-5
focus on vestibular function
bilateral motor coordination
postural control and reflex integration |
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Term
| Test of sensory function in Infants |
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Definition
| standardized test 1-18 months |
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Term
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Definition
school aged children
visual, auditory, tactile, olfactory, gustatory, proprioceptive, vestibular, praxis and social participation |
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