Test 3 Flashcards

(426 cards)

1
Q

Motor Control definition

A
  • Ability to regulate and direct the mechanisms essential to movement
  • Study of postures and movements and also the functions of mind and body that govern posture and movement
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2
Q

Posture

A

static position of any body segment

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3
Q

Movements

A

Transition from one posture to another

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4
Q

Movement emerges from what?

A

interaction of individual, task, environment

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5
Q

3 constraints of movement

A

1) individual
2) task
3) environment:

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6
Q

Individual:Movement and action

A

Walking, Running, Talking Smile, Reaching
Study the systems that control action
Degrees of freedom

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7
Q

degrees of freedom

A

how many ways of movement

i.e: flex-ext, abd-add= 2

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8
Q

Individual: Movement and perception

A
  • integration of sensory impressions into meaningful info

- adds interpretation and meaning of afferent information

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9
Q

Individual: Movement and cognition

A
attention
planning
problem solving
motivation
emotions
intent
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10
Q

Task: Recovery of function

A

sensory/ perceptual impairments
motor impairments
cognitive impairments

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11
Q

Task constraints on movement

A
Recovery of function
sequence tasks to achieve movement
Functional task groupings
discrete vs. continuous tasks
stability vs. mobility
manipulation components
movement variablity
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12
Q

Task: functional task groupings

A

bed mobility
transfers
ADLs

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13
Q

discrete vs. continuous tasks

A

discrete: def beginning and end
concrete: variable beginning and end

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14
Q

discrete tasks

A

kicking a ball
throwing
striking a match

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15
Q

continuous tasks

A

running
swimming
steering a car

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16
Q

stability vs. mobility

A
  • non moving BOS vs moving BOS

- attention demands increase in mobility activities

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17
Q

manipulation components

A

adding manipulation increases task demands

- standing, standing lifting light load, standing lifting heavy load

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18
Q

movement variability

A

open movement: soccer/ tennis

closed movement: confined

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19
Q

factors that constrain movement in individual

A

movement and action
movement and perception
movement and cognition

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20
Q

Environmental constraints

A

regulatory

non-regulatory

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21
Q

regulatory constraint

A

size, shape, weight of cup

type of surface we walk on

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22
Q

non regulatory constraint

A

background noise

presence of distractions

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23
Q

Why study motor control

A

Pts retrain clients to move better

Intervention focuses on teaching typical motor patterns

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24
Q

Reflex theory of motor control

A
  • Sir Charles Sherrington- 1906
  • Reflexes are building blocks of complex behavior
  • reflexes work in sequence to create movement
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25
5 reflex theory of motor control limitations
1) Reflexes require external stimulus 2) Some movement occurs without sensory stimuli 3) Some movement occurs too rapidly for sensory feedback to trigger follow up movement 4) Chain theory does not account for need to override reflexes to achieve goal - withdrawal from hot stove vs. save child from fire 5) Reflex chaining does not allow for production of novel movement
26
Hierarchical theory of motor control
- Brain has higher, middle, and lower levels of control | - Top down control: brain controls everything
27
Hierarchical theory of motor control- Rudolf Magnus
- Found reflexes controlled by lower levels present only when higher cortical levels are damaged - Reflex testing
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Hierarchical theory of motor control- Georg Schaltenbrand
- explained development of mobility in children and adults | - appearance and disappearance of hierarchically organized reflexes
29
Hierarchical theory of motor control- Gesell and McGraw
- Maturation of infants - Normal motor development attributed to increased cortical control over the lower level reflexes - CNS is primary agent of change in development
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Cortex postural reflex development
equilibrium reactions
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cortex motor development
bipedal function
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midbrain postural reflex development
righting reactions
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midbrain motor development
quadrupedal functions
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brainstem and spinal cord postural reflex development
primitive reflex
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brainstem and spinal cord motor development
apedal function
36
Hierarchical theory of motor control limitations
- Cannot explain the dominance of reflex behavior in certain situations (safety) in normal adults - withdrawal reflex: stepping on nail; in a top down, the motor response could only be initiated by a higher cortical center not by reflexive lower level pain response - Bottom up control
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Clinical implications of hierarchical theory of motor control
- Brunnstrom: Pioneer in early stroke rehab - Used reflex hierarchical theory to describe disordered movement following motor cortex lesions - Bobath: Neurodevelopmental treatment
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Motor programming theory of motor control
Motor programs (CPG's) drive movement without the need for sensory input
39
Central pattern generator (CPG)
- concept emerged when the response was uncoupled from the stimulus - Sensory input as a stimulus was found NOT to be necessary to initiate a motor pattern - alteration in movement pattern
40
Rhythmic pattern generator
interrupting afferent input did not cease insects ability to beat their wings
41
Motor programming theories of motor control explore what?
- physiology of actions rather than the physiology of reactions
42
Motor programming theories of motor control may be used to represent what
- neural connections that are stereotyped and hardwired | - or to describe the higher- level motor programs that represent actions in more abstract terms
43
Motor Programming theories of motor control limitations
the same motor program can produce different results depending on the external forces at work - the same program for elbow flexion would produce different result if arm was extended at shoulder vs. being held at the side. the force of gravity is different in each position and would produce a different result.
44
Motor programming theories of motor control clinical implications
- Allow clinicians to move beyond a reflex explanation for disordered motor control - Suggests the importance of helping patients relearn the correct rules for action - Intervention should focus on retraining movements important to a functional task
45
Motor program defined
- Abstract representation of movement sequence that is stored in memory and consists of variant and invariant features - Higher level hierarchically organized neural processes that store the rules for generating movements
46
Motor program terminology
1) identify CPG - Represents neural connections that are stereotypical and hardwired - Neural network that produces rhythmic pattern outputs without sensory feedback : locomotion, respiration, swallowing 2) demonstration of CPGs 3) higher level motor programs that represent actions in more abstract terms
47
Systems theory of motor control
Look at whole body as a mechanical system and integrate all the forces acting on the body to control or influence movement - DF come into play - all of varied df in any given movement need to be coordinated in order for movement to be smooth and controlled. - use synergistic patterns to control movement
48
systems theory is a distributed model of what?
motor control
49
Systems theory-central commands modified by what
the forces acting upon the system
50
Systems theory of motor control - synergies serve to do what?
decrease the redundancy within the system | = decrease the degrees of freedom
51
System theory of motor control- What is the emergent property?
movement
52
Systems theory of motor control limitations
Does not focus as heavily on the interaction of the organism with the environment only the internal influences within the individual
53
Systems theory of motor control clinical implications
- Stresses the importance of understanding the body as a mechanical system - Examination and intervention must focus not only on impairments within individual systems but the effect of interacting impairments among multiple systems
54
Dynamic Action Theory of motor control
- Movement emerges as a result of elements in the environment as needed - not as a result of specific commands from the CNS or from premeditated motor programs.
55
Dynamic action theory of motor control is what type of system
Self Organizing: of individual components interact in an orderly manner to produce emergent behaviors - Higher centers are not needed - Loops within the system control activation of motor behavior
56
Dynamic action theory of motor control limitations
relegates CNS to a relatively unimportant role
57
Dynamic action theory of motor control clinical implications
- Movement is an emergent property - By understanding more about the physical or dynamic properties of the human body, clinicians make use of these properties in helping patients regain motor control
58
Motor program theory of motor control vs. Dynamic Systems theory of motor control
Motor Program - variability of movement is consequence of error in motor performance - Assumption is that as performance improves the errors have decreased thereby decreasing variability of movement Dynamic systems theory - variability is necessary condition of optimal function - Provides for flexibility, adaptability, adjustment to environmental changes > too little variability can lead to injury > too much variability can lead to impaired movement performance (ataxia)
59
What happens to stable patterns of movement when transitioning to a new movement pattern
become unstable - flex one finger, extend opposite index finger - variability in movement pattern may be precursor to change in patients
60
humans and equilibrium
- we are far from equilibrium all the time - this encourages self organization - learning in this sense involves the de-stabilization of one pattern so that a new pattern of stability may be found
61
When a system is pushed far from equilibrium, what is it seeking?
Stability; it adopts certain patterns which are locally stable - The water in the pain, when heated, adopted a different pattern; hexagons, then turbulence - Heat was a control parameter: an outside variable that can push the complex system into different behaviors - Also an order parameter: maroscopic description of the emergent behavior pattern (hexagon, turbulence)
62
Ecological theory of motor control
We detect information from our environment relevant to action and use that information to control movement - move in the environment to find food, run from predators, build shelter, etc. - Perception more important than basic sensation - being able to short sit in a variety of chairs
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Ecological theory of motor control limitations
research emphasis has shifted from the nervous system to the organism/ environment interface
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ecological theory of motor control clinical implications
1) individual is an active explorer of the environment 2) individual can develop multiple ways to accomplish a task 3) adaptability is important
65
order parameter
-macroscopic description of the emergent behavior pattern - behavior patterns are expressed by order parameters - it represents some relationship among the component parts of the system - The relationship changes when the control parameter alters so that the order parameter loses stability > the pattern always fluctuates due to oscillation of parts > when the fluctuation reaches a critical point, order is lost and a new pattern may emerge
66
Neurofacilitation
- retraining motor control through techniques designed to facilitate and or inhibit different movement patterns - Associated with both the reflex and hierarchical theories of motor control
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Underlying assumptions
- functional skills will automatically return once abnormal movement patterns are inhibited and normal movement patterns facilitated - repetition of these normal movement patterns will automatically transfer to functional tasks
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Task- oriented approach
- movement is organized around a behavioral goal and is constrained by the environment - Patients learn by actively attempting to solve the problems inherent in a functional task rather than repetitively practicing normal patterns of movement
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Memory
- acquisition of knowledge or ability - Product of learning process: STM, LTM - procedural memory
70
STM
working memory
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degrees of freedom
- number of variables of a system that corresponds to the number of parameters to fully describe the task - Ideal: the least number of independent coordinates needed to identify the position of an element or variable
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LTM
evidence of learning
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strategy
combination of the sensory information from the environment (afferent input) with the synergy (efferent output)
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synergy
muscles firing in a pattern (to return to equilibrium)
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Control parameter
- can cause change in the system and a new motor behavior. - increasing velocity of gait will transition one into a jog then into a run. - coordinated movement control variables (tempo, speed, force) that freely change according to the characteristics of an action situation
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Feedback
any form of augmented, post-response information about the achievement of a goal
77
feedforward
process of sending information to the cortex to prime the system and to provide information that may be used in a comparative fashion when a motor activity has been selected
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Order parameter
- incorporates and characterizes all the systems that cooperate to produce a movement - functionally specific variables that define the overall behavior of a system - enable a coordinated pattern of movement to be reproduced and distinguished from other patterns (i.e relative phase) - also known as collective variables
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according to the dynamic pattern view of motor control, when a control variable is systematically varied (speed, increased from slow to fast):
- an order parameter may remain stable or changes its stable state characteristic at a certain level of change of the control parameter
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steady state
homeostasis of system
81
why is motor learning important to clinicians
for retraining the patient with motor control problems
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Motor learning
- the study of the acquisition and/or modification of movement - recovery of function refers to reacquisition of movement skills lost through injury
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Motor learning has been described as a set of processes associated with what?
practice or experience leading to relatively permanent changes in the capability for producing skilled action
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what kind of changes in behavior does motor learning produce
relatively permanent
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motor learning is a process of what?
acquiring the capability for skilled action
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Motor learning results from?
experience or practice
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Can motor learning be measured directly?
No | - Changes may not be readily observable but inferred from performance improvement as a result of practice
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Motor learning emerges from a complex system of what?
perception/ cognition/ action processes | - Involves motor processes, learning new strategies for sensing as well as moving
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Task Solutions
new strategies for perceiving and acting
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Recovery of function
involves reorganization of both perception and action systems in relation to specific tasks and environments
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Relating performance and learning
- initial improvement in performance does not necessarily reflect changes in learning - Retention of those performance improvements reflects learning - Learning is a relatively permanent change - Performance is a temporary change in motor behavior seen during practice sessions - not solely a measure of absolute learning
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Performance
a temporary change in motor behavior seen during practice sessions - not solely a measure of absolute learning
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Forms of learning
- recovery of function following injury involves the reacquisition of complex tasks - simple forms of learning are the basis for the acquisition of skilled behavior
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Declarative memory (explicit)
involves association of information related to people or things, places, and meaning of these bits of information
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Much of motor learning is what type of memory?
nondeclarative (impicit)
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2 subtypes of nondeclarative learning | - each controlled by different parts of the brain
1) Non associative - habituation - sensitization * both reflex pathways 2) Associative - classical conditioning - operant conditioning
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Nonassociative forms of learning involve what kind of pathways?
reflex
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Habituation
decreased responsiveness that occurs as a result of repeated exposure to a nonpainful stimulus
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sensitization
increased responsiveness following a threatening or noxious stimulus
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Through associative learning, a person learns to predict what?
relationships
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Classical conditioning
consists of learning to pair 2 stimuli - initially weak stimulus (conditioned stimulus) becomes highly effective in producing a response when it becomes associated with another stronger stimulus (unconditioned stimulus)
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operant or instrumental conditioning
- trial and error learning - instrumental conditioning - associate response with consequence - behaviors that are rewarded tend to be repeated at cost of other behaviors - behaviors followed by aversive results are usually not repeated - "law of effect"
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Classical conditioning example
- conditioned stimulus (ringing bell) - unconditioned stimulus (food) always produces a response (drooling) - Repeatedly pairing the 2 stimuli produces a conditioned response to a conditioned stimulus
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Classical conditioning in therapy
- give verbal cue with physical assistance - over time reduce physical assistance keeping verbal cue - over time reduce verbal cue until patient has learned skill
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Declarative or Explicit Learning
- learning occurs in the medial temporal lobe areas and hippocampus - requires processes such as awareness, attention, and reflection - learning info related to people or things, places, and meaning of these - "first I button the top button, than the next one" - "nose over toes"
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Law of effect
frail elderly person falls at grocery store - less likely to repeat going to store - becomes less active - physical function declines - increases likelihood of falling - reinforce desire for inactivity - on and on
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Adam's Closed Loop Theory of motor learning
Sensory feedback aids in learning the skill to perform it better on subsequent trial.s - comparing the stored memory of intended movement - 2 types of memory important 1) Memory trace 2) perceptual trace
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Adam's Closed Loop theory: | Memory trace
used in the selection and initiation of movement (initiates movement)
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Adam's Closed Loop Theory: | Perceptual trace
knowledge of the correct or successful movement. learned with practice detects error in movements and corrects.
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Therapeutic implications for law of effect
- therapists can use intervention to reduce likelihood of falling - Desensitization- reduce anxiety and fear - use of praise to reinforce good performance
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Adam's closed loop theory limitations
Cannot explain loop movements made in absence of sensory feedback - It may be impossible for the brain to store a separate perceptual trace for every movement ever performed - Variability in movement practice may actually improve motor performance of the task
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Schmidt's Schema Theory of Motor Learning
- How motor programs are learned - novel movement is completed, we store: 1) initial movement conditions (position of body, etc) 2) parameters used in the motor program 3) outcome of movement (KR) 4) sensory consequences of the movement (how it felt, looked, sounded) - information stored in recall/motor schema, and recognition/sensory schema - Feedback and KR continually adapt the motor and sensory schema to adapt the motor program
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Procedural learning
- Learning tasks that can be performed automatically without attention or conscious thought: HABIT - Develops slowly through repetition of an act over many trials - Learning occurs in the striatum of the basal ganglia
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Schmidt's Schema Theory clinical implications
- by practicing specific motor tasks under varied conditions, motor learning will be enhanced - Learning consists of the ongoing process of updating the recognition and recall schemas with each movement made
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Declarative learning involves 4 different types of processing
1) encoding 2) consolidation 3) storage 4) retrieval
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Ecological Theory of motor learning
- concept of search strategies - during practice there is a search for the optimal strategy for completing the task - includes perception and action
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Adam's Closed Loop Theory Clinical implications
- it is essential to have the patient practice the same exact movement repeatedly, to one accurate end point - The more time spent practicing the movement as accurately as possible, the better the learning will be - Errors produced during learning increase the strength of an incorrect perceptual trace
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Ecological theory limitations
- has not been applied to specific examples of motor skill acquisition
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Theories related to stages of learning motor skills do what
- focus on motor learning from a temporal perspective | - attempt to more carefully characterize the learning process
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Fitts and Posner 3 stage model
1) cognitive stage (early): what to do, reach for glass, spill many times 2) associative stage (intermediate): how to do less spilling movement to reduce degrees of freedom allowing more joints to be involved in the task 3) Autonomous stage (final): how to succeed reach for glass while carrying on a conversation without spilling
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recall schema
same movement performed many times with varied force output- developing the memory to choose correct response
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Schmidt's Schema limitations
- lack of specificity of interaction with other systems during motor learning - Inability to account for the immediate acquisition of new types of coordination
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Ecological theory clinical implications
the patient learns to distinguish the relevant perceptual cues important to organizing action
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Systems 3 stage model
1) Novice: simplify task, reduced df 2) advanced: release some df 3) expert: releases all DF needed for task, task performed in most efficient way
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Gentile's 2 stage model
1) develop understanding of task dynamics 2) fixation/ diversification - refine movement - adapting movement - perform task consistently and efficiently
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Fitts and Posner: Cognitive stage
Learner: - develops understanding of the task - determines what to do by cognitive mapping - progresses: clumsy to organized - relies on visually guided movement Benefits most from/ facilitators - Constant, blocked and whole practice - precise and frequent feedback
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Fitts and Posner: Associative Stage
Learner: - determines a strategy - practice the strategy - makes necessary adjustments - works on how to do - Spatial and temporal aspects creates coordinated pattern - refinement of skills: decreased errors; increased consistency, decreased reliance on conscious attention Facilitators: - precise feedback - decreased frequency necessary
128
Fitts and Posner: Autonomous Stage
Learner: - practice and refines movement - works on how to succeed - performs equally well on closed/ stable and open/changing - spatial and temporal aspects are highly organized - move with increased autonomy and decreased cognitive monitoring of task
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Stages of motor program formation
hierarchical changes may occur in movement control as motor programs are assembled during the learning of a new task
130
Practical applications of motor learning research
different motor learning factors are important to consider when retraining patients with motor control problems
131
Practice levels
- most important factor in retraining motor skills | - rate of improvement during any part of practice is linearly related (on a log scale) to the amount left to improve
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intrinsic feedback
inherent | information from sensory systems received during or after a movement
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extrinsic feedback
augmented - supplemental information from external source - concurrent: given during the task - terminal: given at completion of task
134
Types of feedback
knowledge of results (KR) | knowledge of performance (KP)
135
KP examples
``` your elbow was bent that punch was a little too slow your tuck was not tight enough your backswing was too long your step was too short you did not lift your knees high enough ```
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Feedback provision: transitional
information provided to improve subsequent performance
137
faded
- giving more feedback early then fading out | - studies show this type of timing provided more retention over time
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delayed
feedback given after a period of time has elapsed following completion of trials
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concurrent
feedback provided as tasks are being performed
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Massed practice
time spent in practice greater than time resting between | fatigue
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distributed practice
``` rest periods scheduled throughout session may be better in cases of: - decreased motivation - decreased attention span - patient with motor planning deficit ```
142
constant practice
one task performed repeatedly over an over again
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variable practice
practice of several variations of the same task or category of movement(s)
144
Task order
1) blocked practice: predictable pattern- repeat same task 2) serial practice: predictable order of repetition of sequence of tasks 3) random practice: non-repeating, non-predictable sequence of tasks
145
Guidance vs. discovery learning
- learner is physically guided through the task to be learned - guidance should be used only at the outset of teaching a task
146
recovery of function
the reacquisition of movement skills lost through injury
147
effect of age
the brain reacts differently to injury at different stages of development
148
characteristics of lesion
- fairly strong relationship between injury severity and long-term functional outcomes - considerable variability in recovery even among individuals with sever brain injury
149
pre-injury neuroprotective factors
exercise environemental enrichment dietary restriction
150
post injury neuroprotective factors
effect of pharmacology neurotrophic factors effect of exercise and training
151
intrinsic feedback
inherent | information from sensory systems received during or after a movement
152
extrinsic feedback
augmented - supplemental information from external source - concurrent: given during the task - terminal: given at completion of task
153
Types of feedback
knowledge of results (KR) | knowledge of performance (KP)
154
KR
- knowledge of the outcome of the task - focus on success of outcome - terminal feedback about the outcome of the movement, in terms of the movement's goal - information that tells learners something about the success of their actions - provides temporary effects on the subject's ability to perform a task - number of trials to complete before giving KR varies depending on task
155
Dynamic systems theories
- ecological approach - Berstein, Thelen, Horak, Heriza, Shumway-Cook and Woollacott - Nonlinear development influenced by intrinsic and extrinsic factors - emphasizes process rather than product - genetics, nutrition, ethnicity, prenatal care, socioeconomics, trauma - all systems work together with varying degrees of influence on behavior - developmental change not a series of discrete stages but a series of states (stability, instability)
156
KR examples
you buttoned that button in less than 5 sec you were 2 meters off target that time you missed the ball
157
KP examples
``` your elbow was bent that punch was a little too slow your tuck was not tight enough your backswing was too long your step was too short you did not lift your knees high enough ```
158
Feedback provision: transitional
information provided to improve subsequent performance
159
feedback provision: manual guidance
provided during a task or movement while providing intervention - increases performance - decreases learning - decreases retention * ultimately want patients to own the movements * we can't go home with them and it's tiring to be hands on all of the time
160
feedback provision: observation
observe others through modeling, peers, videos; may also be self- assessment - increases performance - increases learning - decreases errors
161
Feedback timing
``` bandwidth summary faded delayed concurrent ```
162
bandwidth
- feedback is provided only when the performance of tasks falls outside of set parameters - small errors are not corrected
163
summary
- feedback provided at the end of a set number of trials | - study has shown this to be the best form for long term retention
164
faded
- giving more feedback early then fading out | - studies show this type of timing provided more retention over time
165
concurrent
feedback provided as tasks are being performed
166
Practice schedules
session length practice type task order type of task
167
practice conditions
massed vs distributed practice (session length) constant vs variable practice (session type) Random vs blocked practice: contextual interference - task order
168
Massed practice
time spent in practice greater than time resting between | fatigue
169
distributed practice
``` rest periods scheduled throughout session may be better in cases of: - decreased motivation - decreased attention span - patient with motor planning deficit ```
170
constant practice
one task performed repeatedly over an over again
171
Task order
1) blocked practice: predictable pattern- repeat same task 2) serial practice: predictable order of repetition of sequence of tasks 3) random practice: non-repeating, non-predictable sequence of tasks
172
Whole vs. part training
- components of a task defined in relationship to the goals of the task - components must be practiced within the overall context of the task - effective if task can be naturally divided into units that reflect inherent goals - if you can do the task in 2 different environments, you've learned it
173
Transfer
- amount of transfer depends on similarity between 2 tasks or 2 environments - critical aspect is similarity of neural processing demands in the 2 situations
174
mental practice
- mental practice is an effective way to enhance learning during times when physical practice is not possible - neural circuits underlying the motor programs for the movements are usually triggered during mental practice
175
Guidance vs. discovery learning
- learner is physically guided through the task to be learned - guidance should be used only at the outset of teaching a task
176
recovery of function
the reacquisition of movement skills lost through injury
177
Concepts related to recovery of function
``` function recovery recovery vs compensation sparing of function stages of recovery ```
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factors affecting recovery of function
endogenous (within the individual) factors exogenous (external to the individual) factors preinjury factors postinjury factors
179
effect of age
the brain reacts differently to injury at different stages of development
180
characteristics of lesion
- fairly strong relationship between injury severity and long-term functional outcomes - considerable variability in recovery even among individuals with sever brain injury
181
typical vs. normal
normal- varies from one individual to the next | typical- more accurately describes the developmental sequence
182
developmental theories of motor development
neural- maturational cognitive/behavioral dynamic systems
183
Birth to 1 month FINE MOTOR
- strong grasp reflex - holds hands in loosely fisted posture - visually attends to faces and black and white geometrical designs - closer to the end of one month, may still be blurry, recognize people
184
Behavioral theories of motor development
- pavlov, skinner, bandura, piaget - modification of behavior as result of specific environmental stimulus reinforcing the behavior ( + or -) - examples: quiet room - creeping hands and feet example
185
Spontaneous movements/ reflexes
building blocks of development - spontaneous movements - primitive reflexes - postural reactions - locomotor reflexes
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spontaneous movements
- do not result from specific stimulus - nonspecific and generalized movement - thelen studied spontaneous kicking in infants - noted rhythmical not random pattern - ankle, knee, and hip moved cooperatively with each other - resembled timing of adult step - central pattern generators: innate ability to take steps - kicks similar not identical; not enough strength to stand - increased variability of timing - joints move in unison rather than sequentially - cocontraction exists in infant kicking - adult gait alternate flexion and extension - by end of 1st year see increased flex/ext
187
primitive reflexes
- up to 70 have been described - some controversy over use of term primitive; can repress or work around them - during early infancy these reflexes are important for survival - responses to external stimuli and specific and localized - same stimulus elicits same response; startle, arms extend and come back - Rooting, sucking, withdrawal, moro, grasp, babinski, ATNR, STNR
188
ATNR
asymmetric tonic neck reflex | extension on face side, flexion on skull side, yawn in adults
189
STNR
symmetric tonic neck reflex | flexion and extension of upper and lowers
190
Postural reactions
- try to stay upright always - help infant automatically maintain posture in a changing environment - labrynthine righting (vestibular system) - optical righting - pull up - parachute - propping - neck righting - body righting
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Locomotor reflexes
stepping swimming crawling
192
Role of reflexes in development
- 3 explanations exist - Prenatal explanations - structural: wiring - functional: survival; fetal positioning for birth - postnatal explanations: applied - role of reflexes in volitional movement
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Role of reflexes: Mcgraw
reflexes needed to be inhibited by the CNS before infant could move voluntarily
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Role of reflexes: zelazo et al
found reflexes and voluntary movement related - elicit stepping reflex daily for 8 weeks - increased stepping reflex exhibited - earlier onset of walking - elicit stepping reflex by rubbing dorsum of foot on surface and step would come--> strengthening leg by lifting against gravity, will walk earlier
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Role of reflexes: Thelen
change constraints, change integration of reflex - increased weight of limbs without increased muscle strength reason for integration of reflex: do not move limb so no increased strength - 4-6 week old infants added weight to limbs and noted decrease of stepping reflex - older infants in chest deep water- reflex increased in frequency - 7 month old infants without reflex stepping did take steps on treadmill - differing constraints (rather than maturation) can account for integration of reflexes - reflex disappears due to increased strength; also we overprotect our young
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influences on human development
- internal- heredity/genetics - external- environmental, experiences, culture - maturation - normative vs. nonnormative
197
Culture and development
- a system of learned patterns of behaviors - socialization process - shared by others - ability to interact - ethnicity - race - some cultures push children to mature faster in motor and cogntion
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environmental/ cultural influences on motor development
- cultural/ ethnic beliefs, traditions, and practices - maternal handling: postural adjustment/ control, antibacterial, age of mom and dad - maternal expectations - socioeconomic variations in parenting style - childrearing/ childcaring practices: survival, discipline, value placed on childrearing - use of baby equipment - nutrition - home environment
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Socialization aspect of motor development
- social learning - socialization: critical for motor development - motor experiences are vital to full development of skills - helps to learn motor skills and increase proficiency
200
Social and personality development
gender typing cultural influences moral development family and peer issues
201
socializing agents
family members peers teachers coaches
202
social situations
urban vs. rural gender- typing toys
203
personal attributes
perceived ability self esteem motivation persistence
204
socialization in youth sports
non school sports increased number of children involved stereotypical behavior-gender
205
Stages of prenatal/postnatal development
``` germinal period: 0-2 wks embryonic pd: 2-8wks fetal period: 8-40 wks infant: birth-2yrs child: 2yrs-adolescence adolescent: transition to maturity ```
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embryonic period
- lasts 6 wks - organogenesis occurs: defining of cells - 3 weeks: cells differentiate into ectoderm, mesoderm, endoderm
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endoderm
digestive/ respiratory systems
208
mesoderm
``` muscles skeleton circulatory system reproductive system dermis ```
209
ectoderm
``` CNS PNS eyes ears outer skin ```
210
summary of embryonic development
by end of 8 weeks embryo is distinctly human in appearance head more round and erect but still large neck established eyelids more obvious auricles of ears begin to take shape
211
birth to 1 month
- flexion of knees and elbows - cannot extend because they were just in mommies belly - flexion contractures - cannot get head arms or legs to midline because of low strength: frog leg position - physiological flexion and limited ROM - active movt limited by available ROM - movements are random and total in pattern (all flex or all ext) - no graded motor control
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Birth to one month GROSS MOTOR (prone)
- physiologic flexion dominates - baby keeps head turned to the side - head preference is typical - head and neck extension begin to emerge (antigravity activation) - brings mouth to hand - UE adducted/flexed with shoulders elevated to the ears - LE flexed with elevated pelvis with weight shifted to face - weight bearing on face, head tilting is difficult - weight shift over time
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Birth to 1 month GROSS MOTOR (supine)
- head turned to one side - use gross swiping motions of UE (not much antigravity) - kicking patterns of LE range from rhythmical and reciprocal to random and variable
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Birth to 1 month GROSS MOTOR (sitting)
- requires full support to sit - fully rounded back, flexed neck, poor active control of head (head bobbing) - pull to sit: marked head lag, minimal UE traction noted
215
Birth to 1 month GROSS MOTOR (upright)
- requires full support at upper trunk - head bob in and out of vertical - visually tracks horizontal and vertical in very small ranges - positive support reaction: accepts weight briefly on lower extremities - automatic stepping seen
216
Birth to 1 month FINE MOTOR
- strong grasp reflex - holds hands in loosely fisted posture - visually attends to faces and black and white geometrical designs - closer to the end of one month, may still be blurry, recognize people
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Birth to 1 month ORAL MOTOR/ LANGUAGE
- cries characterized by sudden pitch changes - vegetative sounds (burping and feeding) - sounds are vowel like - sounds are produced primarily on exhalation
218
2 months
``` gravity can take hold of extremities period dominated by general hypotonia overall decreased flexion increased extension asymmetry baby appears to have less control of the body ```
219
2 months GROSS MOTOR (prone)
- UE have increased external rotation and abduction with elbows remaining behind the shoulders - hips are more extended with pelvis moving closer to surface - weights shift caudally to shoulders - lifts head to 45 degrees asymmetrically by end of this month - head lifting and activation may be motivated more by visual righting
220
2 months GROSS MOTOR (supine)
- UE held in increased external rotation and abduction (gravity assisted) - LE have increased extension as physiologic flexion reduces - head rarely held in midline due to influence of the ATNR
221
2 months GROSS MOTOR (supported sitting)
- continued head lag in pull to sit- baby now begins to initiate neck flexion - Can hold head erect briefly, continues to bob head
222
2 months GROSS MOTOR (upright)
- baby is unable to hold weight on legs - less control than at one mont - astasia-abasia exists - astasia: disorientation in standing - abasia: lack of stepping
223
2 months FINE MOTOR
- baby can swipe with hands; upper extremities work as one - hands are slightly fisted with thumbs out - involuntary release present
224
2 months ORAL MOTOR/ LANGUAGE
- increased vowel sounds - emerging consonant sounds including n,b,d,g,t,k - cooing begins - differentiated cries for pain, hunger, and discomfort - localizes to sounds - socially smiles
225
2 months REFLEXES/REACTIONS
- labrynthine righting reaction (12mo +) - hold infant vertically at chest - tilt child ant.,post., lat. - head orients to vertical position and steady - Body righting on body (12mo +) - flex on LE rotate across pelvis - infant will turn body segmentally - body righting on head (7mo)
226
3 months
- beginning of symmetry - bilateral control of neck musculature: allow them to be on stomach, playing, eye contact, interactions - antigravity flexor control emerges - midline orientation of head emerges - increased alertness/ awareness of environment
227
3 months GROSS MOTOR (supine)
- able to bring UE to midline on chest | - Hold LE with soles of feet together (frog leg)
228
3 months GROSS MOTOR (prone)
- pushes head up to 90 degrees and turns freely initiating weight shift - ability to turn head on forearms allows for initiation of subtle weight shift - UE have increased horizontal abd/add which supports forearm weight bearing - LE are positioned with pelvis to surface and wide base (frog leg) - weight shift, balance, crawling
229
3 months GROSS MOTOR (supported sitting)
- increased flexion control in pull to sit - visual attention to hands, cognitive what do my hands do, neural connections made - head held up, trunk leans forward with scapular retraction present
230
3 months FINE MOTOR
- hands together at midline in supine - hands held loosely fisted - begins to visually attend to objects
231
3 months ORAL MOTOR/ LANGUAGE
- responds to angry/ harsh vocal tones by crying - responds to pleasant tones by cooing - laughs out loud
232
four months
- where the fun begins - strong symmetry - bilateral control of extensor and flexor muscles; leads to increased control - head control much improved - emergence of controlled purposeful movement
233
four months gross motor prone
- increasing antigravity control emerging - increased extension through back and neck - can hold head in midline with neck elongation emerging- reduction in neck hyperextension - see forearm WB pushing up on extended arms; bears weight on palms - increased lumbar extension and anterior pelvic tilt with legs more in line with trunk - weight bearing more into the pelvis - swimming movements emerge
234
four months gross motor supine
- increased balance of flexors/extensors - increasing midline position of hands - emerging ability to reach for knees - active hip and knee flexion - emerging abdominal control, decreased hip abduction
235
four months gross motor sitting
- baby pulls to sit with increased symmetry - increased abdominal and LE activity - more straightening of the back, arms forward in ring sitting
236
four months fine motor
- hands to mouth regularly - hands to knee in supine - increased elbow extension with reaching, squeezing, and grasping - fine hand control remains undeveloped
237
four months oral motor/ language
- consistently produces combination consonant vowel combinations - emergent babbling - blows raspberries, smacks lips, snorting - yelling, squealing, low pitched growls - consonant sounds include m, p, l,v,f - responds to noise and sound by turning to the source
238
five months gross motor prone
- begin to see equilibrium reactions - bears weight on extended arms - weight shifts on propped forearms - pivot prone - rolls to supine
239
five months gross motor supine
- baby can bring feet to mouth - baby has increased weight shifting - increased weight shifting leads to increased proprioceptive feedback
240
five months gross motor sitting
- pulls to sit with active abdominals and arm assisting with pulling - increased active back extension, forward leaning at hips versus back in ring sit - abducted hips provide stability - may sit alone for brief periods
241
five months gross motor upright
takes almost full weight in hand held sitting
242
five months fine motor
- spontaneous dropping of objects - both arms approaching midline - palmar grasp - reaches to familiar people - retains small object in each hand
243
five months oral motor/language
- begins to sense inflection and intensity when spoken to - responds to pleasant speech by smiling and laughing - uses babbling to get attention to make requests - gives vocal expression of eagerness - vocalizes displeasure
244
five months reflexes and reactions
- parachute (12 mo): held above surface in ventral suspension. infant extends arms to protect fall - Landau (12mo+): support infant horizontally in air in prone position, head extends back, hip extend in sequence
245
six months gross motor prone
- shifts weight on extended arms | - unilateral reaching seen in close to ground prone postures
246
six months gross motor supine
- lifts head from surface independently | - rolls supine to prone with dissociation of LE
247
six months gross motor sitting
- pulls to sit, initiating the action with arms while tucking head and flexing legs - arms are free for play and protective extension - good sagittal plane trunk control (anteriorly) - poor transverse plane trunk control
248
six months gross motor upright
- takes full weight with assist at hands and bounces
249
six months fine motor
- overreaches for objects, excessive finger extension - radial palmar grasp - rakes small tiny objects - reaches unilaterally for objects - bangs objects on surfaces - transfers objects from hand to hand
250
six months oral motor/language
- increases awareness and response to environment - can say several syllables - reduplicated/ repetitive babbling
251
seven months gross motor prone
- attains quadruped, abdomen off floor, initiates rocking (increase proprioception) - brief crawling (commando)
252
seven months gross motor supine
- child spends very little time in supine by this age | - more interested in the other postures and readying self for increased mobility
253
seven months gross motor sitting
- can assume sit from the quadruped position - trunk rotation present in sitting position - transitions sitting to prone
254
seven months gross motor upright
- pulls self to stand against stable surfaces | - falls back into sitting: no controlled lowering ability
255
seven months fine motor
- inferior scissor grasp for small objects - drops one object when grasping another - releases objects from hands with assist from a surface
256
seven months oral motor/language
- sings tones - begins to use patterns of inflection - uses sounds in random vocalizations
257
eight months gross motor prone
- creeps on hands and knees (all fours crawling) | - may crawl backwards at first because of more UE strength
258
eight months gross motor sitting
less fixing with the LE
259
eight months gross motor upright
- pulls to stand thru kneel or 1/2 kneel - cruises on support surface - stands with one hand held - stepping gait with both hands held
260
eight months fine motor
- radial digital grasp with wrist extension - uses hands to throw, drop, and push/pull - clumsy release above surfaces - bangs 2 cubes held in hands - uses mature scissor grasp for small objects
261
eight months oral motor/language
- responds to specific people in specific ways - understands no - understands own name
262
nine months gross motor sitting
- sitting is the most functional and versatile position at this stage - protective extension backwards emerges
263
nine months gross motor upright
- can semi turn in standing | - 2 hand held walking with decreased BOS
264
nine months fine motor
- pokes with index finger - inferior pincer grasp: emerging finger thumb opposition - controlled release with straight wrist
265
nine months oral motor/language
responds to bye bye | echolalia begins
266
ten months gross motor sitting
- begins to use UE for more intricate fine motor activities | - results in increased stabilizing (fixing) of LE
267
ten months gross motor upright
- can lower self from standing to sit | - in 2 hand held walking, start to develop pelvic rotation and LE stride
268
ten months fine motor
- wrist extends on approach to object - places large objects between thumb and 2 fingers - finger thumb opposition on pads - clumsy release into small container - controlled release into large container
269
ten months language
shakes head yes and no to some questions | first word appears 10-12mos
270
eleven months gross motor sitting
- varied LE position - controlled trunk rotation - uses 1/2 kneel and kneel more
271
eleven months gross motor standing
- transitions stand to squat while holding on - stands alone with wide BOS and LE abduction - cruising is refined to reaching away from surface is seen
272
eleven months fine motor
- uses both hands freely, may show a preference for one | - puts objects in container
273
eleven months language
- follows simple instructions | - attempts to name objects when asked
274
twelve months gross motor
- can stand from the floor through quadruped without using hands at supporting surface - able to weight shift and lift one leg from the surface - may attempt ambulation with high guard UE and wide BOS in LE - may be able to move in and out of squat
275
twelve months fine motor
- holds crayon in palm and marks paper - forearm supination emerges - has neat pincer grasp at fingertips - combines objects: attempts to stack items but is generally unsuccessful - rolls balls - scoops with spoon - finger feeds
276
twelve months oral motor/language
- 5 to 6 word vocabulary - tries to repeat sounds - use intonation and jargon speech - directs sounds and gestures to objects and people
277
12- 15 months gross motor
- stands independently - squats to retrieve objects and returns to standing - transitions from floor to standing - walks independently - ambulation characterized by short stride length, wide BOS, UE in high guard - creeps up stairs
278
12-15 months fine motor
- precise controlled release of objects into small containers with wrist extension - can hold 2 cubes in same hand - can build a 2-3 cube tower - throws objects to floor - flings ball with elbow extension
279
12-15 months language
- actively explores the ways in which a new object can be used - hands objects back to person for repetition of activity - produces chains of sounds with varied consonant vowel combinations - speech development plateaus as the child is mastering ambulation
280
15-18 months gross motor
- carries objects while walking - creeps down steps backwards - places foot on ball stationary on ground - attempts to walk up steps using railing - BOS narrows while walking - reduces to mid guard position of arms - can take a few steps backward - rolls ball - running emerges: poorly coordinated - throws large ball overhead using 2 hands - hurls a tennis ball with ext. - climbs in and out of chairs
281
15-18 months fine motor
- turns multiple pages of books at once - scribbles - crayon held in fist with thumb up - can build 3-4 block towers - removes pegs from board and attempts replacement
282
15-18 months language skills
- gives objects to others for interaction - imitates new sound patterns and simple new words - vocabulary of approximately 5 words - classifies objects by shape, function, or action
283
18-24 months gross motor
- stands on one foot momentarily - steps over low barriers - ascends stairs with step-to (marking time) pattern and unilateral hand hold assist, railing, or wall - both speed and fluidity of running increasing: can run 10ft - attempts to jump from lowest step - kicks playground ball 3 ft with minimal deviation - attempts to negotiate 2 inch wide balance beam on level surface - jumps down from 8-10in - jumps vertically 2 in
284
18-24 months fine motor
- can build a 5-6 cube tower - places small pellet into bottle - separates pop beads - imitates motor activities
285
18-24 months language skills
- receptive language greater than expressive language - primitive grammatical system emerges - hear frequent repetition of words and syllables - uses nouns, very few verbs, and minimal adult pronouns - 20-100 word vocabulary - names objects in books
286
24-36 month gross motor
- stand on one foot for 1-3 seconds - walks five steps on tiptoes - walks backwards 10 ft - jumps down from 16-20in - descends stairs with rail, marks time - ascends stairs alternating pattern - pedals tricycle
287
24-36 month fine motor
- builds 6-7 block tower - turns pages of book one at a time - turns doorknobs - imitates straight, horizontal, and circular marks with marker - emerging tripod grip - can string large beads - rolls clay into snake shape - cuts paper with scissors - opens and closes jars - buttons large buttons - completes 12-15 piece puzzles - folds paper or clothes
288
24-36 month language
- rapid increase in language- up to 4 new words daily - frustrated when not understood - 2-3 word phrases emerge - can say full name - can recite simple nursery rhymes - begin to hear information and inflection in speech - has 250 word vocabulary
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3-4 years gross motor
- stands on 1 foot 5 sec - hops on one foot, few steps - uses a slide - steers and pedals a tricycle - catches ball - descends stairs with alternate pattern - skipping emerges - jumps over 1-2 inch hurdle - jumps forward several times in succession - walks on a line 10ft - running speed increase and can avoid obstacles
290
3-4 years fine motor
- controls crayon more effectively - copies circles and crosses - matches colors - cuts with scissors - draws recognizable human figure with head and 2 extremities - draws squares - puts together simple puzzles - builds tower of 9 blocks or more - may demonstrate hand preference
291
3-4 years language
- acquires adult syntax and grammar - has versatility of language - can be controlled by language - laughs and sighs - uses typical loudness and tone - 900 word vocabulary - uses language in imaginative play
292
5-8 years gross motor
- skips on alternate feet - gallops with either lead - plays hopscotch - balances on one foot - squats on single leg - jumps rope with rhythm - bounces large ball - kicks ball with greater control
293
5-8 yrs fine motor
- hand preference is evident - prints well starting to learn cursive writing - able to button small buttons
294
5-8 years language
- increasing sophistication and comprehension of language - increased speech and social interaction - vocabulary up to 4000 words - uses plurals, pronouns, tenses correctly
295
9-12 years gross motor
- see increased mature patterns of movement in throwing, jumping, and running - enjoys more competitive games - improving balance, coordination, endurance, and attention
296
9-12 yrs fine motor
- greater control in hand usage - learns to draw - handwriting is developed
297
development of upright posture
a) reflex stepping: flexed posture, elicited stepping b) static phase: can maintain supported upright posture c) transition: can stand in position- no progression d) deliberate stepping: attempts to step with hands held e) independent stepping f) heel-toe progression g) maturity of erect locomotion: developed by age 3-4 yrs
298
stages of locomotor development (11)
- early stepping - rolling - crawling - creeping - cruising - upright ambulation - running - jumping - hopping - galloping - skipping
299
early stepping
- reflexive at birth through one month | - is locomotion hard wired?
300
Rolling
- prone to supine or supine to prone - able to initiate due to the influence of righting reactions in infancy - earliest rolling occurs in utero - rolling occurs in four phases
301
4 phases of rolling
1) newborn phase 2) spinal extension 3) automatic rolling 4) deliberation
302
Rolling- newborn phase
- predominant flexion posture | - rolling, if occurs, spontaneous
303
rolling- spinal extension
- movement from sidelying to supine (1-2 mos) - sidelying to prone (4-5mos) - rolling without segmentation (log roll)
304
rolling- automatic
from 4-8 mos of age segmental rotation of the body initiated by UE, followed by trunk and LE
305
Crawling
- certain motor milestones must be achieved to allow for crawling to occur - adolph (1997) suggests that the environment must afford the infant a surface that allows appropriate weight shifts
306
creeping
all fours, quadruped, belly off surface | - need core strength, elbow strength, wrist strength
307
upright ambulation
- will my child walk? - measure of social independence and acceptance - 9-15mos (8-17 mos) - mature pattern by age 3 1/2 - typically independent by 1 year - early walking characterized by: steps independent of one another - short steps minimal leg/hip ext - flat feet, out toeing (increases BOS) - everted heels - no trunk rotation - high guard
308
refinement of gait: 9-15 mos
- stands with wide BOS - hips abd, flex, ext rotate - tibia in mild internal torsion and varus - CoM closer to head and upper trunk - High body fat- muscle weakness, muscles must work in antigravity position. functional weakness in hip flexors, knee extensors and ankle dorsiflexors - BoS wide- structural and stability - increased hip and knee flexion - full foot initial contact in plantar flexion - short stride, increased cadence - relative footdrop in swing phase - mediolateral stability is achieved
309
refinement of gait 18-24 months
- 18 mos: limb is straight, tibiofemoral angle is resolved - decrease in BoS: secondary to decrease in abduction, improved stability, dynamic balance and strength, increased AP movement - prolonged stance phase and decreased cadence - CoM descends to prox end of legs - heel strike develpps
310
Refinement of gait 3-3.5 years
- mature patterns - tibiofemoral angle: valgus alignment - decreasing femoral antetorsion of the hip - CoM closer to extremities - consistent heel strike with knee flexion
311
refinement of gait 6-7 years
- fully mature gait pattern - tibiofemoral angle returns to neutral - femoral antetorsion is resolved - heel position is neutral - CoM level of 3rd lumbar vertebra
312
aging effects on gait
- walking speed slower - decreased arm swing - reduced pelvic rotation - decreased hip and knee rotation - increased stride width
313
Stairclimbing/ stairwalking
- stereotypical reciprocal alternating movements of lower limbs
314
phases of stairclimbing
1) ascent: stance phase, weight acceptance, pull-up, forward continuance 2) swing phase: foot clearance and foot placement 3) descent: achieved through eccentric contraction of the same muscles work to control the body with respect to the force of gravity
315
Types of stairclimbing/ stair walking
marking time/ step to ascending vs descending adult stairclimbing- alternate foot pattern
316
running
similar LE movements as those seen in walking | mature running characterized by a period of "flight"
317
Running at 18 mos
early running modified walking limited ROM stride length is short
318
running at 2-3 years
smoother stride and run
319
running at 4-5 years
improvement in power and form
320
running at 5-6 years
advance to level of adult manner | can effectively use running skills in play
321
running at 6 years to adult
refining running age does not guarantee perfect running
322
jumping
- fundamental movement that occurs when the body is projected into the air by force generated in one or both legs and the body lands on one or both feet - momentary periods occur during which the child is not supported moving from a higher to lower level
323
jumping progression
- early: learn to step off a higher surface from one foot to the other - jumping off the floor with 2 ft - progressively jumps from higher levels with both feet - later jumping skills: forward jumps, long jump (3yrs), jumps over objects by school age, can perform jumping skills
324
types of jumping
step down from a higher level one foot jump down two footed jump long jump
325
hopping
- complicated version of the jump - elevation of the body from the ground by 1 ft and the successful landing on the same foot - early hopping: ineffective, momentarily lifts the support leg by flexing - static balance: 1 ft, 29mos - 3 or older become proficient hoppers - 6 yrs mastered hopping
326
galloping
first asymmetric gait pattern in child seen 20 months after 1st step by age 4, 43% of children can gallop by age 6.5, most children proficient
327
early galloping
``` done with stiff UE- usually held in high guard stride is short lands with flat foot minimal trunk rotation tailing limb land ahead of lead limb ```
328
advanced galloping
more rhythmic and relaxed arms in low guard arms swing rhythmically with LE increased trunk rotation- facilitates the reciprocal movements
329
ecological theory of motor control suggests what
the nervous system function is a perception acting system and not simply a sensory motor system
330
chair example for ecological theory of motor control
an individual who has difficulty rising to standing from a short chair will enter a room with a choice of seating options and choose the higher chair. - they have perceived that the higher chair will be easier to get into and out of and will choose to interact with their environment in this way.
331
example of closed loop theory
memory trace initiates reaching for a glass on the table. as the arm moves toward the glass the perceptual trace corrects the path of the arm and allows for accurate grasping of the glass
332
limitations to systems 3 stage model of motor learning
not many studies have been conducted at the autonomous or expert levels as it would take months to complete and be cost prohibitive
333
fixation
closed skill minimal environmental variability sit to stand from standard chair
334
diversification
open skills | changing environmental conditions require movement diversification
335
Neonate supine lying and pull to sitting
physiological flexion full head lag, pull to sit feet in air, no contact with surface posterior pelvic tilt
336
life span
maximum survival potential of a particular species
337
oldest old
age 85+ fastest growing segment of the population between 1960-1994, increased 274% 1994, 3 million or 1% of total population by 2050, 19 million or 5% of total population
338
variables affecting life span development
- biological: heredity, health (nutrition, pollution,etc.), anything physical - psychological: cognitive, emotional, behavioral, personality (temperament), and variables derived from those - sociocultural: social and cultural environment, ethnicity, religious beliefs and practices - life cycle: interaction of all the above with each life stage of each individual
339
Aging
all changes occurring with the passage of time growth development degeneration
340
senescence
degeneration that occurs after the age of peak functional efficiency
341
lead cause of death from 18-34
accidents homicides suicides AIDS
342
leading cause of death after 55
senescence related: cancer, stroke, diabetes, heart and lung disease
343
middle age
40-59 | old age is 60 and older
344
Do all organ systems degenerate at the same rate?
no | some changes not evident except under stress
345
prenatal period
conception to birth
346
infancy
birth to 18-24 months of age
347
early childhood
end of infancy to age 5
348
middle and late childhood
6-11 years
349
adolescence
child hood to adulthood
350
early adulthood
late teens through thirties
351
middle adulthood
starts 35-45 and ends 55-65
352
late adulthood
begins in 60's until death
353
adolescence
turbulent time charged with conflict and mood swings - puberty: period of rapid skeletal and sexual maturation - androgens: males, testosterone - estrogens: females
354
Growth spurts ages
boys: 12.5 girls: 10 dramatic increase in height and weight
355
body proportions in adolescence
boys: shoulders broaden, longer legs girls: hips broaden
356
muscle fat make up in adolescence
boys: gain more muscle mass (54% body mass) and aerobic efficiency girls: gain more fat
357
sleep habits in adolescence
sleep needs decline - 10 hours in middle childhood - 7.5-8 hours in adolescence Go to bed later: biological changes, social habits Daytime sleepiness: achievement, mood problems, more sleep disruption
358
primary sexual characteristics
maturation of reproductive organs girls- menarche boys- spermache
359
secondary sexual characteristics
breasts growth of pubic hair voice changes altered skin texture
360
psychological and emotional reactions to puberty
reactions to menarche and spermarche vary - preparation is key adolescent moodiness parent child conflict
361
Early maturing in boys
popular confident independent positive body images
362
early maturing in girls
``` unpopular withdrawn low confidence negative body image more deviant behaviro ```
363
late maturing in boys
unpopular anxious and talkative attention seeking negative body image
364
late maturing in girls
popular sociable lively positive body image
365
aging of skeletal system
- bone remodels throughout lifespan - early development: bone formed faster than resorbed - in adulthood, bone formation slows and does not keep pace with resorption - results in loss of bone tissue beginning early 20's with average loss of 1% per year - bone composition changes: - children have = organic and inorganic compounds - older adults have 7x more inorganic components - bones become brittle and susceptible to microfractures - osteoporosis: 2-3% bone mass loss per year - can lead to hip fractures - vertebral microfractures
366
factors affecting bone loss
- hormone level: decreasing levels of estrogen in postmenopausal women implicated in bone loss because estrogen stimulates osteoblastic activity - diet: deficiency of calcium - exercise: increases bone formation
367
aging of muscular system
- bone composition changes in early adulthood - lean body weight decreases with increase of fat weight - 10% of skeletal muscle mass lost between ages 25 and 50 because of changes in diet and exercise - additional 30% mass lost between ages 50-80 - number and diameter of muscle fibers decreases 5% lost by age 50 35% lost after age 50
368
cardiac muscle changes with age
in elderly, heart's ability to adapt to increased workload decreases - degeneration of heart muscle - decrease in elasticity - changes in fibers of heart valves Most changes in heart muscle due to lifestyle changes and the resulting pathology
369
nervous system development
rapid growth reflective of: -increasing size of neurons - increased branching as synapses formed - increase in glia and myelin Development affected by extrinsic factors - poor nutrition could stunt growth - injury to left cerebral cortex could cause impaired language development
370
What part of nervous system are more developed at birth
spinal cord and lower brain centers | - those responsible for vital tasks such as respiration and food intake mature
371
weight of brain at birth and 4 yrs old
25% of adult weight at birth | at age 4, 80% of adult weight
372
with initiation of intentional movements what occurs in nervous system development
- cortical areas mature: reaching at 4-5 months
373
PET scan studies of frontal cortex
5 days old: little activity 11 wks: increased activity 7-8 months: adult activity levels
374
spinal cord at birth
small, short marked increase myelination at 2-3wks post birth myelination occurs through age 2-3
375
myelination timing may explain developmental timing
- cervical portion first, followed progressively by lower portions - first in motor horns then in sensory horns - away from brain in motor tracts - toward brain in sensory tracts
376
Nervous system and aging
- decrease in: neurons dendrites synapses neurotransmitters myelin - motor response to stimuli decreases: older active adults not as much - motor coordination, intellectual function and STM suffer the most - ANS is less efficient at regulating body temperature and BP
377
cerebral and neuronal atrophy
from age 35 on, 100,000 brain cells die every day (not replaced) - brain weight 50% less by age 75 - cortex thinner, gyri narrower, fewer synapses and neuroglia, less neurotransmitters and receptors - degeneration of myelin slows down signal conduction
378
Aging of integumentary system
- wrinkles and sagging skin: wrinkles are obvious sign of aging, occurs when our deeper layers of skin lose their elasticity - hair: turns gray because less number of active pigment producing cells - balding more common in males, occurs when testosterone acts with genes to promote baldness
379
When does aging of integumentary system become noticeable
late 40's
380
intrinsic aging of integumentary system
gray, thinning, dry hair paper thin, loose skin that sags skin that bruises easily and heals slowly hypothermia in cold weather and heat stroke in hot - atrophy of cutaneous vessels, sweat glands, and subcutaneous fat
381
photoaging
degeneration in proportion to UV exposure- skin spots, skin cancer, wrinkling
382
adipose tissue development
- adipose accounts for 1.1lb of body weight at birth - rapid increase in fat tissue first 6mos of life - mass then gradually increases until age 8 - girls see more dramatic increase through adolescence than boys - adult females average 31lb fat weight - adult males average 22lb fat weight - childhood- visceral fat increases faster than subcutaneous fat
383
subcutaneous fat
decreases until age 7 increases from age 7-13 girls: increase through midadolescence in trunk and limbs (legs>arms) boys add more subcutaneous fat to trunk more than to limbs
384
adipose tissue development in adulthood
- both sexes gain weight in adulthood most likely due to changes in nutrition and activity levels - average body fat gains b/t 20 and 50 yrs - male: 18 lb, female: 26lb - total body weight declines after age 50 - loss of bone, muscle, increase fat
385
Body fat redistribution with age
- males have decreased limb fat and increased trunk and internal fat surrounding organs - females subcutaneous fat stabilizes at age 45 with increasing internal body fat continuing - difficulty exists in identifying typical distribution of adipose tissue as subjects tend to be skewed toward thinner adults - weight gain not inevitable
386
Vision and age
- as people reach middle age, vision impairs - as we age, changes in various parts of the eye reduce the ability to receive visual stimulation - older people need more light to perceive depth and to see clearly
387
hearing and age
- begins to decline in middle ages | - normal loss of hearing is termed presbycusis. hard to hear high pitched sounds
388
smelling and taste with age
-loss of taste caused by degeneration of the taste buds by a change in the way the brain perceives the information from the taste buds
389
touch and temperature with age
- with aging, lose some ability to regulate heating and cooling - have problems staying warm because of the loss of fatty tissue beneath the skin that helps insulate the body
390
aging of female reproductive system
- women go through menopause as their climacteric change - leads to end of monthly menstrual flow, cessation of ovulation, decline in the production of the female hormones (estrogen and progesterone)
391
the aging male
there is no male menopause | men may father children all the way through their 70's and 80's
392
aging of the heart
muscle atrophy | reduction of amt of blood pumped with each contraction
393
blood vessel changes with age
decreased elasticity | BP increases
394
hypertension and heart attacks
HTN occurs when arteries are clogged and no longer elastic | HTN leading to a heart attack is called hypertensive cardiovascular disease
395
factors contributing to HTN
``` genetics environment stress smoking obesity lack of exercise low SES ```
396
aging and cardiovascular system
- diminished HR - CO maintained by adaptive mechanisms such as cardiac dilatation and greater SV - isolated cardiac muscle appears to suffer little age dependent change in function - progressive rise in basal systolic BP, possibly due to a loss of compliance of the aorta and major arteries with age
397
Non modifiable aspects of aging
``` arterial wall rigidity cataract formation graying of hair kidney reserve thinning of hair elasticity of skin ```
398
modifiable aspects of aging
``` glu tolerance intelligence tests memory osteoporosis physical endurance physical strength pulmonary reserve reaction time serum cholesterol social ability skin aging elevated BP cardiac reserve dental decay ```
399
prehension
ability to use hands and UE effectively
400
primary components of prehension
``` visual regard reach (approach) grasp manipulation release ```
401
stabilization
trunk and UE require varied degrees of stabilization to afford us the ability to reach and grasp object
402
visual regard
- visual attention on the object - visual regard and perception: KEY ROLES - visual regard: accommodation (focus) convergence: observe location of object - visual perception -eye- head- trunk coordination
403
visual perception
ability to use visual information to recognize, recall, discriminate and understand what we see
404
approach (reaching)
- directing or adjusting of the hand towards an object - integrates perceptual anticipation with motor preparation - visual- motor control; eye hand coordination - hand is major interface with the external world - hand is transported to the scene of the action by reaching - involves all segments of the upper limb - arm and hand function as a single coordinated unit
405
postural adjustments to reaching
- depends on support conditions - arm plays a stabilizing and supportive role when balance is at risk - hand can be used to form new BOS
406
Reaching
- arm length- involves upper limb - beyond arms length movement of the trunk at the hips - reaching to grasp an object transportation, slower manipulation - vision initially important followed by tactile and proprioceptive input
407
pre reaching
birth to 4 months excited thrashing of the limbs no correction of reach once initiated
408
visually guided reaching
4-8 months increased use of vision to guide hands make corrections as they reach
409
visually elicited reaching
9+ months no longer needs to see hand to guide reach infant shapes hand correctly for the object
410
development of grasp
- we use any of a variety of grip patterns to secure objects - location, size, and shape of object determine type used power precision
411
power grip
- forcible activities of the fingers and thumb that act against the palm to transmit a force to an object cylindrical spherical hook
412
precision grip
- pinch/ pincer grips - forces are directed between the thumb and fingers without contacting the palm pad to pad prehension tip to tip prehension pad to side (lateral) prehension
413
opposition
movement by which the pad surface of the thumb is placed diametrically opposite the terminal pad of one or all digits - thumb contributes 40-70% of total hand function
414
other digits
- index finger second most important - index finger accounts for 20% of lateral pinch, 20% power grip (supinated), 50% power grip (pronated) - middle finger is longest and strongest - index and long finger's prehensile digits: most anatomically stable - small and ring finger most mobile and weakest
415
reflexive grasp
traction response | grasp reflex
416
transitional reactions
orienting response | instinctive grasp
417
purposeful grasp
squeeze grasp--> palmar grasp | radial palmar grasp --> radial digital grasp
418
development of grasp phases
reflexive transitional purposeful
419
catching
goal is to retain possession of object that is caught | hands only is much better than use of body
420
development of catching
child must learn to catch with hands and give with ball master ability to move left or right, forward or back to catch ball point fingers up when catching high point fingers down for catching low
421
throwing
ability to project an object accurately and with sufficient force through space - 6 mos crude, unrefined - 2 yrs immature, stiff, jerky
422
ball bouncing
fundamental movement used in a number of child and adult games
423
striking
propulsion skill | an object or body part used to project an object
424
early sidearm striking
``` chopping motion (elbow extension) little leg and trunk movement ```
425
proficient sidearm striking
- sideways preparatory stance and a long step - differentiated trunk rotation - horizontal swing through large ROM, with arm extended before contact - sequential movements
426
skipping
step hop step hop | 14% of children can skip by age 4