Neuroplasticity: Exam 1 Flashcards
(84 cards)
1
Q
CNS pathology
what happens?
A
- damaged area OR areas connected by damaged path. STOP working normally
- Result depends on what part is damaged
2
Q
Recovery
what happens?
A
-
Sparing
- lack of observable deficit
-
Compensation– a way to get better
- accomplish goal in NEW and DIFF way
-
True Recovery–neuroPT’s goal!!!
- gradual return of lost function
- end result==> accomp. goal in same manner as was done prior to CNS injury
3
Q
What contributes to recovery ?
A
- Plasticity—reorg. of CNS
-
reversal of Neural Shock
- shock is right after injury
- Denervation hypERsensitivity
- activation redundant systems
4
Q
Capacity of the CNS to adapt to functional demands and therefore to the system’s capacity to reorganize
A
Neural Plasticity
5
Q
Neural Plasticity
A
Capacity of the CNS to adapt to functional demands and therefore to the system’s capacity to reorganize
6
Q
Capacity for Neuroplasticity:
2 types
A
- Functional–Short-term
- Structural–Long-term
7
Q
Capacity for Neuroplasticity:
Functional (short-term)
A
changes in efficiency or strength of synaptic connections
*short term because just affects the already existing conections
8
Q
Capacity for Neuroplasticity:
Structural (Long-term)
A
changes in organization and numbers of connections among neurons
*long term because changes in the numbers and organization
9
Q
Plasticity:
2 types
A
- ReACTIVE Synaptogenesis
- Regenerative Synaptogenesis
10
Q
Plasticity:
Reactive Synapto.
A
Think Sprouts!!!
- collateral sprouting
- axons sprout NEW synapses
- sprouts typ. from SAME neural system
11
Q
Plasticity:
Regenerative Synapto.
A
*Think Neuron heals!!!
- neural regen.
- occurs when injured axons sprout NEW dendrites
12
Q
Research on Neuroplasticity
3 conclusions:
A
- Phys rehab after stroke is a potent modulator of plasticity process
- happens because of DEMAND
- demand leads to angiogenesis and synaptogenesis
- new blood vessels
- new neural connects.
- Int of training shown to INC recovery!!!
13
Q
Neural Shock
Explain…
A
- Temp abolition of excitability in areas related to damaged area from:
- dec blood flow
- reduction in metabolism
- Lesion==swelling==dramatic LOSS of function==rapid RETURN of function
14
Q
Therapeutic implication of Neural Shock
A
- Goal of early PT:
-
disinhibit system
- STOP inhibition and let system function again
-
disinhibit system
15
Q
Denervation Hypersensitivity
A
occurs when neuron loses normal input, results in hypersensitivity of post-synaptic membrane to neurotransmitters
*Injury==rapid LOSS function==function restored because neurons become MORE sensitive
16
Q
occurs when neuron loses normal input, results in hypersensitivity of post-synaptic membrane to neurotransmitters
*Injury==rapid LOSS function==function restored because neurons become MORE sensitive
A
Denervation Hypersensitivity
17
Q
Ischemic Penumbra
A
- cells bordering ischemic region
- neurons are viable, but NOT functional
- lost connects OR insuff. blood flow
- improved thru tx w/ amphetamines and PT
18
Q
System Redundancy
A
- recruitment of previously silent/unused synapses
- suggests presence of synapses that do not normally function due to neuronal competition
- training may lead to unmasking these silent synapses ALONG W/ amphetamines
- facilitates activation
19
Q
Recruitment of previously silent/unused synapses
A
System redundancy
*includes neuronal competition
20
Q
What happens during recovery?
A
COMBO of processes occurring simultaneously OR sequentially
*NOTE: PT’s must understand these processes!!!
21
Q
CNS Pharmacologic interventions
*remember goal to DISinhibit system
A
- prevent scarring
- prevent swelling
- stimulate growth
- Disinhibit inhibited regions
22
Q
Spontaneous recovery occurs due to _______ when?
A
Nat. processes AFTER lesion
23
Q
When is recovery considered spontaneous?
A
- Much of the recovery in first 3-4 wks after insult are spont.
- normalize edema, circ, and/or neural shock
NOTE: changes after 3-4wks are due to other mech’s
24
Q
Spontaneous recovery and PT research?
A
was it the PT intervention OR spont. recovery that was going to happen anyway?
Need control vs. experimental groups
25
What are some influences on recovery?
* age
* lesion characters.
* environment/experience
* amt practice time/training provided
* NEED
* therap. recovery is **goal driven!!!**
26
Recovery and age
Initial sparing, BUT deficits may develop **as organism matures**
27
Aging effects on deficits
## Footnote
**maturational status of area damaged**
**how "mature" is the damaged area**
* If area is **functionally mature**
* ****damage is comparable
* if area is **not mature**
* ****may be no INITIAL deficit, BUT one might develop **as that region matures**
28
Aging effects on deficits other than Maturational status (2)
1. **Functional status** of remaining system
2. Size of the lesion AND location
(golf ball size as child vs. adult two diff scenarios!!)
29
Lesion characteristics
varies by _____ and \_\_\_\_\_
size AND location
\***Bigger + proximal == WORSE**
30
Lesion characteristics
\***speed of lesion growth**
Consider **serial lesion phenomenon**
* problem develops **slow** and thus the body **compensates** around it
* **evidence of plasticity !!!**
31
Experiential factors on recovery
**Pre and post-injury** experience and environment can influence **outcome**
32
How does Training differ from Experience?
refers to **specific tasks** rather than **general activity**
**\*Appropriate practice results in improvement**
**\*perfect practice makes perfect!!!**
33
NEED in terms of recovery
* NEED to use a poorly functioning body part will drive recovery
* IF indiv does not NEED to use that body part---unlikely recovery will occur
34
Learned non-use or....
no drive to use that side
35
What has led to the theory of **Constrained Induced Mvmt Therapy (CIMT)**
## Footnote
**\*forced to use affected extremity**
**although the initial loss of function is neural cause....**
MANY pts continue to NOT USE involved side
this is what has led to CIMT...
36
What is Motor Control?
using motor **memory** and **current** sensory input to coordinate effective and efficient mvmts and **govern posture**
37
using motor memory and current sensory input to coordinate effective and efficient mvmts and govern posture
Motor learning
38
Perception-Action cycle
Note: where strength is in this...
see pic
39
What is Motor **Control?**
ability to **regulate** or **direct** the mech's **essential to mvmt**
40
ability to **regulate** or **direct** the mech's essential to mvmt
Motor Control
41
Theories of Motor Control (6)
Remember...**motor control** is ability to regulate or direct the mech's essential to mvmt
1. Reflex
2. Hierarchial
3. Motor Programming
4. Systems
5. Dynamical Action
6. Ecological
42
Theories of Motor Control
## Footnote
**Reflex**
* Reflexes==building blocks of complex behavior
* aka theres a reflex for everything
* **work tog. for common purpose**
* **chaning**
* **stim--resp--resp**
43
Limits of **Reflex Theory**
## Footnote
**Does NOT explain what?**
* mvmt in ABSENCE of stimuli
* fast mvmts
* Mult. resp's to SAME stim
* production of **novel mvmts**
44
theories of motor control
## Footnote
**Hierarchial**
**\*basically...Higher lvls control Lower lvls**
* Control is **top down**
* Higher lvls exert control on Lower lvls
45
Limits of Hierarachial reflex approach
Does NOT explain
* Dominance of reflex behavior in adults
* balance and righting
* swallowing
* bottom up control
46
Hierarchial Approach and Signe Brunnstrom
used reflex/hierarchial theory to describe **abnorm mvmt following a motor cortex lesion**
47
Theories for motor control
## Footnote
**Motor Programming**
**includes what?**
* mvmt controlled by **centralized program**
* ****activated **externally**
* **stimulus**
* **centrally**
* ****volunt/involunt
* EX: locomotion spinal cats
* Central Pattern Generators (CPGs)
48
In regards to Motor Programming theories of Motor control...
Explain Central pattern generator
* area contains data for **stereotyped mvmt**
* ****neuronal circuit---**stereotyped and hardwired**
* body wt supported gait/TM training
EX. Cat experiment==\> front legs getting back legs to work on TM after SC cut
49
Limits of **Motor programming theory**
## Footnote
**Does NOT explain**
* MSK and environmental variation in motor task performance
50
Theories of motor control:
**Systems theory**
* systems work **cooperatively** to achieve **mvmt**
* HIGHER lvls activate LOWER lvls
* LOWER lvls activate **synergies**
51
Limits of Systems theory
Does NOT...
emphasize interaction of **individual** and **environment**
52
Motor control theories
**Dynamical Action**
* mvmt control evolves into **preferred patterns of mvmt**
* **ex.** throwing a ball
* "here is HOW you do it"
* **\*\*\*Attractor sites**
* ****certain patterns you always follow to achieve mvmt
* stable steady state of motor control system that leads to behavior according to preferred coordination states
53
Limits of Dynamic Action
does NOT explain..
* **importance of NS in motor control**
* ****presumption that NS has an unimportant role
54
theories of motor control
## Footnote
**Ecological**
* motor control enables us to **cope w/ environment**
* **perception** is an important component
* CONSIDERS **environmental factors**
55
Limits of Ecological theory
Does NOT:
* emphasize function of NS
56
Motor control theories
## Footnote
**Current theory**
* Mvmt is a result of **dynamic interplay of:**
* ****perception
* cognition
* action systems
57
Movement emerges from interaction of 3 things:
1. Individual
2. Task
3. Environment
58
Components **W/in** the **Individual** are: 3
1. Perception
2. Cognition
3. Action
59
Importance of Action
Motor control is studied in relation to\_\_\_\_\_\_\_
Action
\*study of one area may provide insight as to the control of other mvmts
what systems control action?
60
**Perception** is the integration of _________ into psychologically meaningful info
Sensory impressions
\***Essential**
61
3 types of Perception
1. Visual
2. Kinesthesia
3. Vestibular
\*Info about **body, environment**
62
why is Cognition essential?
Movement is PURPOSE DRIVEN!!
63
Processes of Cognition
Attention
Motivation
Emo. aspects
64
Mvmt emerges from 3 things
1. Individual
2. Task
3. Environment
65
Diff components of movement
in relation to **Task**
1. **manipulation**
**2. mobility**
**3. stability**
66
Task Constraints have impact on what?
Control of mvmt
67
Task constraints following CNS damage....
pt must redevelop what?
Redevlop mvmt patterns
68
Task constraints:
**task grouping**
* bed mobility
* transfers
* ADLs
69
Task Analysis
Discrete vs. Continuous
* **Discrete**
* ****has beginning/end
* **Continuous**
* ****ongoing
70
Task analysis
## Footnote
**Stability vs Mobility**
* **Stability**
* ****holding
* **Mobility**
* ****moving
71
task analysis
**manipulation continuum**
* Is there manipulation or none at all?
* ex. picking up pen
* are you writing w/ it?
72
Task analysis
**Attention continuum**
* focus to the activity
* how MUCH attn to the task are you giving?
73
Task analysis
## Footnote
**Open vs. Closed**
* **Open**
* ****NO control
* ex. "Catch the ball"
* you know NOTHING about the ball, you just want to catch it
* **Closed**
* ****person has control over the variables of the activity
* "Throw me the ball"
* you throw the ball so you control the act.
74
Gentile's Taxonomy of Mvmt Tasks
Categorizes functional mvmt based on what?
Goals of task
75
Gentile's Taxonomy of mvmt tasks incorporates THREE areas:
what are they?
1. body stability OR mobility
2. manipulation
3. environmental context
**\*NO formal application proposed\***
76
Gentile's Taxonomy
See pics
77
Considering the **Environment**
**Regulatory features**
* **shapes the mvmt**
* ****ex. size, shape, wt of cup to be lifted, walking surf, texture
78
Considering the Environment
**Non-regulatory features**
* MAY affect performance, **BUT the mvmt need not conform to these features**
* ****ex. background noise and distraction
* aka **DOES NOT COMMAND A RESPONSE** ****
79
Feat's of the environment can do what to performance?
support OR hinder it
* EX's
* walking in well-lit environment==easier vs. walking in low light or dark==harder
* Easier to balance while sitting on **firm surf** vs. **soft or mobile one**
80
Analyzing Mvmt
We are looking @ the **analysis of 3 things**
* analysis of **Action lvl** ****
* analysis of **Mvmt lvl**
* analysis of **Neuromotor lvl**
81
Analyzing Mvmt
## Footnote
**@ the Action lvl**
**examines what?**
* Examines **behavioral outcome**
* **Did you execute the task?**
82
Analyzing mvmt
@ **the Mvmt lvl**
**analyzes what?**
* analyzes **mvmt strategy used**
* **HOW did you do task?**
83
Analyzing mvmt
## Footnote
**@ Neuromotor lvl**
**examines what?**
* Examining **subsystems involved**
* **What mm's are acting and HOW?**
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