Map of Essential Concepts Definition and levels of analysis Neurofacilitation Approaches Motor Hierarchy Theories of Motor Control Task-Based Approaches Map of Essential Concepts Complex Systems Theory Reflex Theory Fall 2006 DM McKeough

Theories of Motor control Definition and levels of analysis Reflex theory Hierarchical theory Complex systems theory Neurofacilitation Approaches Motor Re-learning, Task-Based Rehabilitation Motor Hierarch Last Viewed Concept Map Exit

Description The discipline of Motor Control is the study of human movement and the systems that control it under normal and pathological conditions. Levels of analysis (study) Environmental result of the movement (Outcome) Movement pattern Neuromotor processes underlying movement Last Viewed Theories Concept Map Exit

Reflex Theory Reflex Theory (Charles Sherrington, early 1900s) Complex behavior (movement) is controlled by a series of chained reflexes (e.g. Frog) Last Viewed Theories Concept Map Exit

Hierarchical Theory Hierarchical Theory (Hughlings Jackson 1930s) Movement is controlled by a system consisting of 3 levels with a rigid top down organization Higher centers control lower centers via inhibition “Disinhibition” “Release phenomenon” Last Viewed Theories Concept Map Exit

Complex Systems Theory 1/3 Movement emerges spontaneously from the interaction of the individual, the task, and the performance environment Individual Task Environment Movement Last Viewed Theories Concept Map Exit

Factors within the Individual, Task, and Environment 2/3 Sensorimotor Psychosocial Cognitive Stage of Motor Learning Taxonomy of tasks Discrete/ continuous Attentional demands Physical Socioeconomic Cultural Last Viewed Theories Concept Map Exit

Factors within the Individual, Task, and Environment 3/3 Cognition Perception Action Mobility Stability Manipulation Regulatory Nonregulatory I T E Last Viewed Theories Concept Map Exit

Neurofacilitation Approaches 1/7 Developed during the 1950-1960s in parallel with increasing knowledge of anatomy and physiology of the nervous system Bobath (NDT); Brunnstrom; Kabat, Knott & Voss (PNF); Ayers (Sensory Integration Therapy) developed the “Neurofacilitation Approaches” that replaced the muscle re-education approach used to treat the effects of Polio during the 1940-1950s Neurofacilitation approaches were designed to treat the movement effects of stroke (UMN lesion) by attempting to affect the CNS directly through the manipulation of sensory input Last Viewed Theories Concept Map Exit

Neurofacilitation Approaches 2/7 Assumptions Normal movement Results from a chain of reflexes organized hierarchically within the CNS (Control of movement is top down – cortex controls brainstem and spinal cord) Normal development Characterized by the emergence of behavior organized at sequentially higher levels of the nervous system Driven by sensory input Last Viewed Theories Concept Map Exit

Neurofacilitation Approaches 3/7 Assumptions Abnormal movement Caused by disruption of normal reflex mechanisms Cortical lesions cause the release of abnormal reflexes organized at lower levels of the central nervous system Release of abnormal reflexes constrains the patient’s ability to move normally Abnormal movement is the direct result of lesion not secondary or compensatory actions** Last Viewed Theories Concept Map Exit

Neurofacilitation Approaches 4/7 Assumptions Abnormal movement In both children and adults, movement is dominated by primitive reflexes In children, cortical lesions interrupt normal corticalization thus motor control is dominated by primitive reflexes organized at lower levels of the CNS (primitive reflexes are never constrained) In adults, with acquired motor cortical lesions, damage to the higher levels of the CNS release lower levels and movement is dominated by primitive reflexes (primitive reflexes are constrained then released) Last Viewed Theories Concept Map Exit

Neurofacilitation Approaches 5/7 Assumptions Recovery of function Requires that higher centers once again control lower centers Recapitulates normal development, therefore, intervention should proceed along a developmental sequence Functional skills will automatically return once abnormal movement is inhibited** Repetition of normal movement patterns will automatically transfer to functional tasks** Last Viewed Theories Concept Map Exit

Neurofacilitation Approaches 6/7 Clinical Implications Examination should identify abnormal reflexes controlling movement Intervention should modify abnormal reflexes Intervention modifies the CNS through sensory input Last Viewed Theories Concept Map Exit

Neurofacilitation Approaches 7/7 Current changes to Neurofacilitation Approaches Increased emphasis on directly training functional tasks as opposed to “normal movement” Decreased emphasis on inhibiting abnormal reflexes Increased consideration of motor learning principles (stages of motor learning, feedback, practice schedules, etc…) Last Viewed Theories Concept Map Exit

Motor Re-learning Task-Based Rehabilitation 1/2 Assumptions Normal movement Performer + Task + Environment Abnormal movement results from impairment in one or more of the systems controlling movement Abnormal movement pattern is the performer’s best solution to the task given the systems remaining after damage not just the result of the lesion itself** Last Viewed Theories Concept Map Exit

Motor Re-learning Task-Based Rehabilitation 2/2 Assumptions Recovery of function Recovery is produced by plastic reorganization of undamaged control centers (neural plasticity) Clinical Implications Recovery is best produced by practice of purposeful, goal-oriented tasks that are meaningful to pt’s goals (task specificity) Last Viewed Theories Concept Map Exit

Motor Hierarchy MC system consists of 3 levels Highest level: association cortex, sensory, and motor areas Concern: select movement goal and strategy Middle level: BG, Cb, and brainstem motor centers Concern: specifying spatial, temporal, and force parameters of the motor plan Lowest level: LMNs, motor plant, FB about sensory consequences of the movement Concern: producing the movement pattern and supplying sensory FB S1 Click to Animate Last Viewed Theories Concept Map Exit

The End © DM McKeough 2009 Last Viewed Concept Map