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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
what is included in motor control?
- normal muscle tone
- postural response mechanisms
- selective movements
What is coordination?
- smooth, accurate, controlled movements
- appropriate speed, distance, direction timing, muscular tension
What are the categories of coordination?
define dexterity as it relates to coordination:
Skillful use of fingers during fine motor tasks
Define agility as it relates to coordination:
ability to rapidly and smoothly initiate, stop, modify movements while maintaining postural control
In relation to coordination, what does visual motor include?
eye-hand and eye-hand-head coordination
What is the highest level of the motor system Functional contributions to motor control flexible hierarchal?
- neocortex & basal ganglia
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
What is the middle level of the overview of the motor system?
- motor cortex and cerebellum
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
What is the lowest level in the overview of the motor system?
- brain stem and spinal cord
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
Describe the Primary Motor Cortex:
- most specific cortical motor area
- low intensity to evoke motor response
Describe the Supplementary motor area:
- UNCOMPLICATED MOVEMENTS
- initiation of movement
- simultaneous bilateral grasping
- sequential tasks
- orientation of eyes and head
Describe the Pre-motor Area:
- MORE INTRICATE MOVEMENTS (interlimb)
- controls trunk and prox limb movements
- contributes to anticipatory postural changes
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
What is included in Brodmann's area 4?
- Pre-Central Gyrus
- Primary motor cortex
What is included in Brodmann's area 6?
- supplementary motor area
- pre-motor area
what are the descending motor pathways?
- Corticospinal (pyramidal) tract
- reticulospinal tract
- vestibulospinal tracts
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
What does the reticulospinal tract do?
influences muscle tone and reflex activity
What do the lateral Vestibulospinal tracts do?
affect postural control and movements of the head
what do the medial vestibulospinal tracts do?
affect coordinated head and eye movements
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
What is the Closed Loop system?
- part of the cerebellum
- CNS analysis of:
- movement info
- determination of level of accuracy
- provision for error correction
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
What is a motor program?
memory, preprogrammed pattern for coordinated movements which has required practice to be established
What are stored motor programs?
- central pattern generator
- programmed set of coordinated movements
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
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
- gait ataxia
- rebound phenomenon
- generalized weakness
- associated with cerebellar lesions
motor component of speech articulation, scanning speech, word use intact, quality of speech altered
rapid alternating movements
- inability to judge the distance or range of a movement
- (overshoots or undershoots)
movements performed in a sequence of component parts rather than a single smooth activity
inability to associate muscles together for complex movements
Define Gait Ataxia:
- broad base of support
- high guard arm position
- slow initiation of LE
- unsteady, irregular, staggering
- decrease in muscle tone
- diminished resistance to passive movements
rhythmic quick, oscillatory back-and-forth movements of the eyes
Define Rebound Phenomenon:
halts forceful movements when resistance is stopped
involuntary oscillatory movement resulting from alternate contractions of opposing muscle groups
what are two types of tremors?
- intention tremor
- postural tremor
Give examples of lesions of the Basal Ganglia:
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
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
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
what is included in the decreased ability to execute smooth, accurate, and controlled motor responses.
- decreased strength
- 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
what is the typical posture associated with age related changes?
- forward head
- rounded shoulders
- altered lordotic curve
- increased hip & knee flexion
- wide BOS
Describe gross motor movements:
- body posture
- extremity movements involving large muscle groups
Describe fine motor movements:
utilizing small muscle groups that involve skillful, controlled manipulation of objects
In relation to coordination testing, define equilibrium:
- assess the ability to maintain the body in equilibrium with gravity both statically and dynamically
In relation to coordination testing, define nonequilibrium:
consists of limb movements/coordination activities
What are the features of coordination tests?
- motor movements
- coordination tests
- movement capabilities with nonequilibrium coordination examination
- progress of difficulty of coordination tests
what is a part of movement capabilities within non equilibrium coordination examination?
- alternate or reciprocal motion
- movement composition
- movement accuracy
- fixation or limb holding
what is included in the progression of difficulty of coordination tests?
- unilateral tests
- bilateral symmetrical tasks
- bilateral asymmetrical tasks
- multi-limb tasks
Describe nonequilibrium coordination tests:
- static, mobile components of movements in supine/prone, supported sitting
- tests done with eyes open
What are the nonequilibrium coordination tests assessing?
- quality of movements
- easily reversed
- bilateral control
- affects of fatigue
- extraneous movements
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
What are the movement strategies for balance?
- Right Reactions
- Equilibrium reactions
- fixed support strategies
- change in support
explain Right Reactions
orient the head in space and the body in relation to the head and support surface
explain Equilibrium Reactions:
- protective reactions
- muscles closest to the BOS are important in maintaining balance
Explain Fixed Support Strategies:
- ankle strategy
- hip strategy
Explain change in support strategies:
- stepping strategy
- reaching movements
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
What is included in Motor Task Requirements?
- Controlled Mobility
initial movement with a functional pattern
Steady position in a weight bearing position, antigravity posture
Define Controlled Mobility:
Maintain balance with weight shifting and changes in position
highly complex coordinated activity or movements that allow interaction with the environment