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Neuroplasticity & Motor Control/Learning Flashcards

1
Q

Motor Learning

A

-learning new strategies from moving
-permanent changes in behavior
-increases activity of thalamocortical pathways
-parallel pathways aid in efficiency and redundancy

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2
Q

Performance

A

-temporary change in motor behavior

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3
Q

Classical Conditioning

A

-1 stimulus to conditioned response
-weak stumulus and response paired with stronger stimulus
-pavlov

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4
Q

Operant Conditioning

A

-behavior to consequences
-trial and error: behavior shaped by internal throughts and motivation
-consequences: reinforcement to strengthen behavior and punishment to weaken

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5
Q

Implicit Procedural Learning

A

-skills and habits performed without attention
-must be performed by learner
-basal ganglia loops
-riding a bike

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6
Q

Explicit Learning

A

-conscious processes with end product of acquiring knowledge
-prefrontal cortex, limbic
-learning to code

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7
Q

Early Cognitive Phase

A

-high attention
-activation inc then dec in dorsolateral PFC, sensorimotor corticies, parietal and cerebellum
-sesnory feedback
-performance with rapid improvement
-lots of error

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8
Q

Associative Phase

A

-motor/sensory pathways active but less
-inc in cerebellar activity and basal ganglia
-executive function needed
-new skills, compare results
-refine skill
-slower improvements

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9
Q

Autonomous Stage

A

-primary cortex remains active but decreased
-more automatic basal ganglia
-increased accuracy, less attention
-stable performance

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10
Q

Degrees of Freedom

A

-coordination of movement
-start with a little and increase overtime as mmt becomes habitual

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11
Q

Movement Schema

A
  1. Initial Movement Conditions: where
  2. Parameters in Motor Program (KOP): how to
  3. Knowledge of Results: How did i do
  4. Sensory Consequences
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12
Q

Instability

A

-lots of instability following brain injuries
-need instability to form new patterns of stability

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13
Q

Gordon’s Investment Principle: Task-Oriented Theory

A

-plateau using old strategy
-new strategy will increase performance

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14
Q

Newell’s Theory of Learning

A

-during practice optimal strategies to solve the task
-Perception as prescriptive: understanding of goal and movements
-Perception as feedback: knowledge of performance and knowledge of results

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15
Q

Knowledge of Results

A

-extrinsic feedback about outcome
-given after pt has thought about their performance

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16
Q

Knowledge of Performance

A

-during task, analyzing performance
-movement parameters

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17
Q

Massed vs Distributed

A

Masses: same time
Distributed: spaced out (better for learning)

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18
Q

Constant vs variable

A

Constant: same circumstances
Variable: different (better for learning)

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19
Q

Contextual Interference

A

-doing something different in between breaks

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20
Q

Learned Non-use

A

-pt can use arm, they just havent learned not to use it
-from overuse of other limbs or learning compensations

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21
Q

Prior to Practice Considerations

A

Consider:
-stage of learning
-goal
-environment
-instructions

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22
Q

During Practice Considerations

A

Consider:
-task specific activity
-time allowances
-mental practice
-trial and error

23
Q

Levels of Movement Analysis

A

Action Level: behavioral outcome; could it be done

Movement Level: movement strategy to accomplish outcome; how was it done

Neuromotor Level: underlying process contributing to movement; why was it done

24
Q

Organization of Movement: Individual

A

-cognition
-perception
-action

25
Organization of Movement: Task
-mobility -stability -manipulation
26
Organization of Movement: Environment
-regulatory -nonregulatory
27
Gentile's Taxonomy
-system to classify tasks to understand demands on person -environment -function
28
Gentile's Taxonomy: Environmental Context
-mmt matches environ features Stationary: timing not specified Motion: -occurs independently of person -must match movements of environment -compensatte for delays -predictions
29
Intertrial Variability
-changes in conditions between tasks As movement variability decreases -less attention paid -pattern, schema, less late practice -closed skill ex: turning on the same light everyday As movement variability increases -more attentiveness -new movement pattern generated -open skill -requires continued late practice ex: working with a different patient each day
30
Gentile's Taxonomy: Task Categories
Closed Task: stationary objects -don't change each trial -least interaction with environment Ex: pick up a phone off a desk Variable Motionless Tasks: stationary objects -task may vary from one attempt to next Ex: pick up a differing cup off of a desk Consistent Motion Tasks: motion of object remains constant -most interactiton with environment Ex: getting on an escalator Open Tasks: most interaction -most complex Ex: running in an obstacle course
31
Gentile's Taxonomy: Function of Action
Body Orientation: -stabilizing or transporting tasks Manipulation: usually with hands -w/o manipulation, arms are part of postural system
32
Principles of Neuroplasticity
Use it or lose it Use it and improve it Specificity Repetition Intention Salience Time Since Onset Age Transference Interference
33
Grading Functional Tasks: LE
-speed -loading -assistance -Intensity -error -AD -Cardiovascular factors -Accuracy
34
Grading Functional Tasks: UE
-position of patient (describe) -objects being manipulated (position, weight, size) -AD -Time -Unilateral vs Bilateral -Accuracy
35
Factors that Influence Neuroplasticity
Sleep: storage of earlier learning -plasticity cotinues in sleep Mood: -Depression: reduces hippocampus, neuronal loss, decreased conentration/memory -Stress: mild=enhances learning and memory; chronic can cause neuronal loss Cardiorespiratory Funtion: -decrease of dementia -improves....everything
36
Predictors of Walking Recovery Post Stroke
80% walk post stroke 98% walked at 6m IF: -(I) sitting balance in first 3 days -LE strength of 1/5 in first 3 days 27% walked if criteria was unmet in 3 days 10% if unmet in 9 days -Berg balance <20/56 % FIM 1 or 2= 20x more likely for only home ambulation
37
Predictors of UE Funcgtional Recovery Post Stroke
AROM of shoulder and middle finger predictted function at 3m -if not at 3 months, likely wont have functional use
38
AVERT Study
Control= standard of care Experimental= -1st mobilization within 24hrs -upright 2x/d -BID -14 days total Significant Differences: -time in PT -time to first mobilization -cost of care -function
39
Standing Balance and Gait Study
-standing feedback traininer -no significant differences -ie, dont train gait using body weight supports
40
Gait Speed
-6th vital sign Unlimited Household Ambulation: 0.27m/s Limited Community Ambulation: 0.58m/s Unlimited Community Ambulattion: 0.8m/s Cross Commercial Street: 2 m/s Non-stroke Community Ambulation: 1.2m/s
41
Neurology of Walking: Essential Neuroanatomy
-muscles and peripheral nerves -spinal cord pattern generators -Anteriolateral/medial SC pathways -Medullary Reticular Formation -Mesencephalic Locomotor Region -Subthalamic Locomotor Regions
42
Neurology of Walking: Important Neuroanatomy
-sensation -Posteriolateral SC pathways -Pontomedullary Locomotor Strip -Cerebellum (vermis) -Red nucleus -Lateral Vestibular Nuclei -Basal Ganglia -Limbic Cortex (hippocampus) Function: -timing of swing vs stance phase -coordination -motivation (hippocampus)
43
Neurology of Walking: Accessory Regions
-Motor cerebral cortex -Pyramidal Tract Functions: -influence initiation, timing, transition of gait, positioning of the foot
44
Spinal Cord Central Patern Generators
-intrinsic circuits located in grey matter that produces and repeas a functional behavior -switches between flexors and extensors -can react to sensory input -can recover and learn
45
Medial Medullary Reticular Formation
-final inttegrattive center for locomotion before spinal cord -driving center for locomotion -descends in anterolateral cord to provide drive to CPG -treadmil training can create new CPG when forcing symmetrical mmts
46
Mesencephalic Locomotor Region
-region of midbrain -when stimulated, lococmotion is initiated with speed of movement consistent -modulates speed of walking -involved in exploratory walking
47
Subthalamic Locomotor Region
-responsible for spontaneuous goal-directed locomotion
48
3 Key Sensory Inputs for CPG
Sretch of hip flexors: -resets CPG -hip ext during mid stance triggers swing from muscle spindles -stopping extension stops walking Unweighting of triceps surae: -initiates step Weight Bearing to facilitate extensor tone
49
Lokomat
-Pt in suit that thelps them move -max speed of 2mph
50
Contraint Induced Movement Therapy (CIMT)
-learned non-use -cortical reorganization can happen with aggressive treatment Principals: -increased arm use -Massed practice -High motivational drive 1. Learned non-use 2. increased motivation 3. Use 4. Reinforcement 5. More Practice 6. Cortical reorg 7. Reversal of Learned non-use
51
Candidates for CIMT
-raise arm 45deg -extend elbow 30deg with shoulder flxed 90 -extend wrist 10-20deg , slightly extend at least 2 fingers and extend thumb 10deg** -Stand for 2 min -B/B continence -understand and follow directions** -Medically stable and highly Motivated
52
CIMT Protocol
Repetitive, Task-oriented training: -shaping -task practice Adherence-enhancing behaviors: -behvaior contract -diary -log Constraining use of less affected: -Mitt restraint of less involved UE -remind Pt to use involved limb
53
EXCITE Trial
-stroke survivors recieving CIMT -significant inprovements -unmasked an ability already present

Neuromuscular (36 decks)

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