Exam 3: Motor Relearning Program

Question 1

What is MRP?

Answer 1

The newest rehabilitation approached based on movement science theory and research

Question 2

What pt population was MRP originally developed for?

Answer 2

Stroke

Question 3

What style of approach is MRP?

Answer 3

Task Oriented

Question 4

What four theories/principles is MRP based on?

Answer 4

1. Dynamic Systems Theory of Motor Control
2. Principles of Plasticity
3. Motor Learning Theories
4. Biomechanics

Question 5

How is movement produced through the lens of the Dynamic Systems Theory?

Answer 5

Interaction within the person, task, and environment. Is a non-linear process

Question 6

What is plasticity?

Answer 6

The ability of the CNS to adapt and reorganize

Question 7

How does plasticity occur in an intact brain?

Answer 7

Through learning

Question 8

How does plasticity occur in a lesioned brain?

Answer 8

Spontaneously and through reorganization. Recovery of function

Question 9

What is a task-oriented approach to treatment, and what approaches does it emerge from?

Answer 9

Use of functional tasks to target neuromuscular and musculoskeletal systems to acquire and re-acquire behaviors. Emerged from dynamic systems and motor learning theories

Question 10

When will re-learning occur according to MRP?

Answer 10

With opportunities for extensive, meaningful, and task oriented training in a stimulating environment

Question 11

What are the four key components of MRP?

Answer 11

1. Early initiation
2. Rehab environment
3. Motivation
4. Education and consistency

Question 12

What primary method is MRP based on?

Answer 12

Task analysis

Question 13

What three components should be included when structuring interventions with MRP?

Answer 13

1. Task oriented exercise
2. Restoration of optimal functional performance
3. Opportunities for practice

Question 14

What were the original 7 “critical actions” with MRP?

Answer 14

1. UE function
2. Oral-facial function
3. Motor tasks in sitting
4. Motor tasks in standing
5. Standing up
6. Sitting down
7. Walking

Question 15

What are the current four “critical actions” of MRP?

Answer 15

1. Standing up and sitting down
2. Walking
3. Reaching and manipulation
4. Balance

Question 16

True or False: MRP uses functional training within the four critical actions of everyday life to analyze each task, determine what is missing, train patient in missing aspects, and put the missing pieces together to train the entire daily activity

Answer 16

True

Question 17

What are the four steps of implementing MRP?

Answer 17

1. Observation or analysis of task
2. Practice of missing components
3. Practice task
4. Transference of training

Question 18

When you are practicing the missing components through MRP, what three techniques are included?

Answer 18

1. Practice
2. Verbal and visual feedback
3. Manual guidance

Question 19

When practicing the whole task with MPR, what are important things to consider?

Answer 19

Identifying a goal, practicing under similar conditions, and re-evaluation.

Question 20

When working on transference with MRP, what 5 components are required?

Answer 20

1. Opportunity to practice in and out of context
2. Consistency
3. Organization of self-monitored practice
4. Structured learning environment
5. Involvement of family and staff

Question 21

What 6 impairments are acknowledged by MRP?

Answer 21

1. Strength
2. Coordination
3. Somatosensory
4. Proprioception
5. Perceptual-Cognitive
6. Soft tissue flexibility

Question 22

Does MRP acknowledge spasticity?

Answer 22

Yes, but it is called intrinsic stiffness or adaptive shortening

Question 23

True or False: MPR based intervention works through the use of early and repetitive upright postures in task oriented practice in both sitting and standing

Answer 23

True

Question 24

What are the three principles for muscle strengthening according to MRP?

Answer 24

1. Task oriented, concentric and eccentric
2. Intensive to mild fatigue
3. Resistance and repetition to patient ability and focus area (strength, endurance, power)

Question 25

How does MRP address soft tissue flexibility?

Answer 25

Passive and active strething

Question 26

How can MRP be applied to somatosensory training?

Answer 26

Direct attention to sensory aspects of tasks and manipulate the tasks to provide different sensory experiences

Question 27

How can MPR be applied to perceptual cognitive training?

Answer 27

Focus attention on cues, scan the environment, integrate moving objects, open environment

Question 28

What instruction and demonstration is appropriate for early learners?

Answer 28

Frequent, cue the most critical missing aspect in detail within the context of the goal, and use demos

Question 29

What instruction and demonstration is appropriate for late learners?

Answer 29

Cue the goal and decrease instruction and demo

Question 30

What are some important characteristics to consider when providing feedback with MRP?

Answer 30

Extrinsic vs intrinsic, visual/auditory/tactile, and specific to pt needs Focused, deliberate, decreased over time

Question 31

What are factors to consider about practice and intensity with MRP?

Answer 31

Specificity of learning, transference, blocked vs random, repetitions, mental practice

Question 32

Why is standing up and sitting down a critical action with MRP?

Answer 32

Repetitive practice of LE flexion and extension using body weight resistance. Strengthens both concentric and eccentrically while actively stretching. Carryover to gait, stairs, squat

Question 33

Why is walking a critical action with MRP?

Answer 33

Emphasis on training support and push off, balance of COM over changing BOS, ankle and knee control during swing phase

Question 34

When working on the critical phase of walking, what four interventions should be prioritized with MRP?

Answer 34

1. Functional strength training to load limbs equally 2. Treadmill training both unweighted and fully weighted 3. Over ground walking 4. Environmental modifications

Question 35

What two types of training are important to incorporate to work on the critical phase of reaching and manipulation?

Answer 35

Functional strength training and training of bi-manual activities