Rehab-ch 6

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Author:
laneaustin
ID:
259560
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Rehab-ch 6
Updated:
2014-02-01 12:40:57
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examination coordination balance
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examination of coordination and balance
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examination of coordination and balance
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  1. Define motor control:
    the ability of the central nervous system to control or direct the neuromotor system in purposeful movement and postural adjustment through selective allocation of muscle tension across join segments
  2. what is included in motor control?
    • normal muscle tone
    • postural response mechanisms
    • selective movements
    • coordination
  3. What is coordination?
    • smooth, accurate, controlled movements
    • appropriate speed, distance, direction timing, muscular tension
  4. What are the categories of coordination?
    • intralimb
    • interlimb
    • visualmotor
    • eye-hand
    • eye-hand-head
  5. define dexterity as it relates to coordination:
    Skillful use of fingers during fine motor tasks
  6. Define agility as it relates to coordination:
    ability to rapidly and smoothly initiate, stop, modify movements while maintaining postural control
  7. In relation to coordination, what does visual motor include?
    eye-hand and eye-hand-head coordination
  8. What is the highest level of the motor system Functional contributions to motor control flexible hierarchal?
    • strategy
    • neocortex & basal ganglia
  9. In relation to the highest level of the overview of the motor system, what is strategy?
    the goal of the movement and the movement strategy that best achieves the goal
  10. What is the middle level of the overview of the motor system?
    • Tactics
    • motor cortex and cerebellum
  11. In relation to the middle level of the overview of the motor system, define tactics.
    the sequences of muscle contraction, arranges in space and time, required to smoothly and accurately achieve the strategic goal
  12. What is the lowest level in the overview of the motor system?
    • execution
    • brain stem and spinal cord
  13. In relation to the lowest level in the overview of the motor system, define execution?
    activation of the motor neuron and interneuron pools that generate the goal-directed movement and make any necessary adjustments of posture
  14. Describe the Primary Motor Cortex:
    • most specific cortical motor area
    • low intensity to evoke motor response
  15. Describe the Supplementary motor area:
    • UNCOMPLICATED MOVEMENTS
    • initiation of movement
    • simultaneous bilateral grasping
    • sequential tasks
    • orientation of eyes and head
  16. Describe the Pre-motor Area:
    • MORE INTRICATE MOVEMENTS (interlimb)
    • controls trunk and prox limb movements
    • contributes to anticipatory postural changes
  17. Where does the Pre-motor area receive information from?
    • periphery- via thalamus to primary motor cortex & primary somatosensory cortex
    • cerebellum- via thalamus to primary & premotor cortex
    • basal ganglia- via thalamus
  18. What is included in Brodmann's area 4?
    • Pre-Central Gyrus
    • Primary motor cortex
  19. What is included in Brodmann's area 6?
    • supplementary motor area
    • pre-motor area
  20. what are the descending motor pathways?
    • Corticospinal (pyramidal) tract
    • reticulospinal tract
    • vestibulospinal tracts
  21. What does the corticospinal (pyramidal) tract do?
    • transmits signals form motor cortex to spinal cord
    • the fibers cross in medulla before descending lateral corticospinal tracts
  22. What does the reticulospinal tract do?
    influences muscle tone and reflex activity
  23. What do the lateral Vestibulospinal tracts do?
    affect postural control and movements of the head
  24. what do the medial vestibulospinal tracts do?
    affect coordinated head and eye movements
  25. What does the cerebellum do?
    • regulates movement, postural control, and muscle tone
    • functions as an error correcting mechanism
    • processing info in context to the environment and other stimulation
  26. What is the Closed Loop system?
    • part of the cerebellum
    • CNS analysis of:
    • movement info
    • determination of level of accuracy
    • provision for error correction
  27. What is the Open Loop System?
    stereotypical movements that are rapid& short duration which doesn't allow time for feedback to occur so preprogrammed instructions to an effector are needed
  28. What is a motor program?
    memory, preprogrammed pattern for coordinated movements which has required practice to be established
  29. What are stored motor programs?
    • central pattern generator
    • programmed set of coordinated movements
  30. Describe the Basal ganglia
    • collection of nuclei at the base of the cerebral cortex
    • takes part in planning and execution of complex motor responses
    • facilitation of desired motor response
    • inhibiting unwanted responses
  31. Describe Dorsal (Posterior) Columns:
    • selection or modification of appropriate movement strategy based on task demands and environment
    • large, myelinated fibers for rapid conduction of sensory info to medulla and thalamus to sensory cortex
  32. Cerebellar dysfunction:
    • asthenia
    • dysarthria
    • dysdiadochokinesia
    • dysmetria
    • dyssynergia
    • asynergia
    • gait ataxia
    • hypotonia
    • nystagmus
    • rebound phenomenon
    • tremor
  33. Define asthenia:
    • generalized weakness
    • associated with cerebellar lesions
  34. Define dysarthria:
    motor component of speech articulation, scanning speech, word use intact, quality of speech altered
  35. define dysdiadochokinesia:
    rapid alternating movements
  36. define dysmetria:
    • inability to judge the distance or range of a movement
    • (overshoots or undershoots)
  37. Define Dyssynergia:
    movements performed in a sequence of component parts rather than a single smooth activity
  38. Define Asynergia:
    inability to associate muscles together for complex movements
  39. Define Gait Ataxia:
    • broad base of support
    • high guard arm position
    • slow initiation of LE
    • unsteady, irregular, staggering
  40. Define Hypotonia:
    • decrease in muscle tone
    • diminished resistance to passive movements
  41. Define Nystagmus:
    rhythmic quick, oscillatory back-and-forth movements of the eyes
  42. Define Rebound Phenomenon:
    halts forceful movements when resistance is stopped
  43. Define Tremor:
    involuntary oscillatory movement resulting from alternate contractions of opposing muscle groups
  44. what are two types of tremors?
    • intention tremor
    • postural tremor
  45. Give examples of lesions of the Basal Ganglia:
    • Akinesia
    • athetosis
    • bradykinesia
    • chorea
    • choreoathetosis
    • dystonia
    • hemiballismus
    • hyperkinesia/hypoknesis
    • rigidity
    • tremor
  46. What is likely with a + Romberg sign?
    • coordination &/or balance problems will be exaggerated in poorly lit areas or when eyes are closed
    • typically over-step or over-reach
  47. what can be seen with a pathology of the Dorsal (posterior) Columns?
    • equilibrium and motor control disturbances due to lack of proprioception
    • wide based gait
    • swaying uneven gait with excessive lateral displacement
  48. give a few examples of age related changes affecting coordinated movement
    • decreased ability to execute smooth accurate and controlled motor responses
    • slowed reaction time
    • decreased ROM
    • postural changes
    • impaired balance
  49. what is included in the decreased ability to execute smooth, accurate, and controlled motor responses.
    • decreased strength
    • sarcopenia
    • loss of alpha motor neurons
    • loss or atrophy of fast twitch fibers (type IIb)
    • reduced number and diameter of muscle fibers
    • diminished oxidative capacity of exercising muscle
    • reduction in ability to produce torque
  50. what is the typical posture associated with age related changes?
    • forward head
    • rounded shoulders
    • altered lordotic curve
    • increased hip & knee flexion
    • wide BOS
  51. Describe gross motor movements:
    • body posture
    • balance
    • extremity movements involving large muscle groups
  52. Describe fine motor movements:
    utilizing small muscle groups that involve skillful, controlled manipulation of objects
  53. In relation to coordination testing, define equilibrium:
    • assess the ability to maintain the body in equilibrium with gravity both statically and dynamically
    • BALANCE
  54. In relation to coordination testing, define nonequilibrium:
    consists of limb movements/coordination activities
  55. What are the features of coordination tests?
    • motor movements
    • coordination tests
    • movement capabilities with nonequilibrium coordination examination
    • progress of difficulty of coordination tests
  56. what is a part of movement capabilities within non equilibrium coordination examination?
    • alternate or reciprocal motion
    • movement composition
    • movement accuracy
    • fixation or limb holding
  57. what is included in the progression of difficulty of coordination tests?
    • unilateral tests
    • bilateral symmetrical tasks
    • bilateral asymmetrical tasks
    • multi-limb tasks
  58. Describe nonequilibrium coordination tests:
    • static, mobile components of movements in supine/prone, supported sitting
    • tests done with eyes open
  59. What are the nonequilibrium coordination tests assessing?
    • quality of movements
    • precision
    • easily reversed
    • speed
    • bilateral control
    • affects of fatigue
    • extraneous movements
  60. In relation to equilibrium coordination, what are limits of stability?
    the max distance an individual is able/willing to lean in any direction withouth LOB or changing the BOS
  61. What are the movement strategies for balance?
    • Right Reactions
    • Equilibrium reactions
    • fixed support strategies
    • change in support
  62. explain Right Reactions
    orient the head in space and the body in relation to the head and support surface
  63. explain Equilibrium Reactions:
    • tilting
    • protective reactions
    • muscles closest to the BOS are important in maintaining balance
  64. Explain Fixed Support Strategies:
    • ankle strategy
    • hip strategy
  65. Explain change in support strategies:
    • stepping strategy
    • reaching movements
  66. give a few examples of standardized instruments for Postural control and balance:
    • Berg Balance Scale
    • Performance-Oriented Mobility Assessment
    • Reach Tests
    • Timed Get Up and Go Test
    • Timed Walking Test
    • Dynamic Gait index
    • Dual-task test
    • Perceived Balance Confidence
    • Activities-Specific Balance Confidence Scale
    • The Balance Efficacy Scale
  67. What is included in Motor Task Requirements?
    • Mobility
    • Stability
    • Controlled Mobility
    • Skill
  68. Define mobility:
    initial movement with a functional pattern
  69. Define Stability:
    Steady position in a weight bearing position, antigravity posture
  70. Define Controlled Mobility:
    Maintain balance with weight shifting and changes in position
  71. Define Skill:
    highly complex coordinated activity or movements that allow interaction with the environment

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