DPT 721 Advanced Topics
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- Control and organization of processses underlying motor behavior
- (millisecond time frame)
- Acquisition of skill thru practice and experience
- (Hours, days, weeks time frame)
Factors within individual that constrain movement
Action, Percetption, Cognition
Stability, Mobility, Manipulation of objects
Regulatory and Nonregulatory
something that a movement MUST conform to in order to carry out the movement effectively and efficently (i.e. size, shape, weight)
Something that may affect performance but movement doesn't have to conform to it. (i.e. background noise or presence of other distractions)
Why is knowing theory so important?
It helps us to interpret actions or behaviors of patients, then apply strategies to help return them to function.
Complex movement behaviors are explained by combined actions of individual reflexes chained together
Limitations to Reflex Theory
- Doesn't allow for behavior of movment if stimulus is an intrinsic factor. In other words, all movement must be stimulated from an outside sensory modality.
- There is no explanation for differences in response to stimuli or rapid movements.
Reflex Theory: Clinical Implications
Use of reflexes and reflex patterns to facilitate wanted movement or inhibiting those same pathways to control unwanted movement.
Top down control- higher levels of CNS exert control over lower levels.
The lower the input from above the more strong the reflex pathway
Hierarchical Theory: Limitations
Doesn't explain how a bottom up strategy works in the body (e.g. crossed extention reflex when you step on a tack)
Hierarchical Theory: clinical implications
Helps to determine the level of lesion and expected recovery a patient might achieve.
Righting reactions (head verticle and protective responses)
Motor Programming Theory
Use of CPGs to facilitate repetitive movements or higher level programs to represent movements globally rather than in one part only. (i.e. writing right or left handed)
Motor Programming Theory: Limitations
CPGs were not intended to replace sensory input as an influencing factor of movement
Doesn't explain how other factors influence movement
Motor Programming: Clinical implications
- Broadens prospective on dysfunction in the motor behavior.
- Allows for task specific movement patterns
Whole system is analyzed for problems to asses dysfunction in motor behavior
Systems Theory: Limitations
- Many degrees of freedom to control
- Makes for a very long evaluation which led to the development of the HOAC
Dynamic Systems Theory
- System is:
- have nonlinear properties
- influenced by control parameters
output is not proportional to the input
variable that regulates change in the behavior of the entire system
small amounts of variability indicates a highly stable behavior
Dynamic Systems Theory: Limitations
- Gives less importance to the CNS than it deserves
- complex application in the clinic
Dynamic Systems Theory: Clinical implications
predicts motor behavior better than other theories because it incorporates the other body systems in addition to the CNS.
Variablility can indicate readiness to learn or need for training to decrease errors.
- Explains the role environment plays on motor behavior
- Motor control evolved so that animals could cope with their environment
Ecologic Theory: Limitations
Doesn't aknowledge the CNS in motor behavior
Ecologic Theory: Clinical Implications
- There are more than one correct solution to solving the problem
- Explore multiple ways that a task can be done in the environment so that the patient can easily adapt to different surroundings.
Neurofacilitation approaches: underlying assumptions
Functional skills will automatically return once abnormal patterns are inhibited and normal patterns are facilitated
Repetition of normal patterns will automatically transfer to functional tasks
Neurofacilitation appproaches: Clinical implications
- Exam should focus on the presence of normal reflexes
- Intervention should focus on modifying reflexes to facilitate movement
- Stimulating sensory information suggests modifying CNS thought the stimulation
- Normal movement emerges as interaction among many different systems
- Each contributing different aspects of control
- movement organized around behavioral goal
- Constrained by environment
- Sensation is essential to predictive and adaptive control of movement, not just stimulus for a resoponse
Task-oriented approach: clinical implications
- Work for identifiable functional tasks
- Work with the task in different environments
- Solve the problem in multiple ways
Reflex Theory: People
Hierarchical Theory: People
Dynamic Systems Theory: People
Ecologic Theory: People
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