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Neuro Development/Tx
09.02.09
Question | Answer |
---|---|
Hierarchy of development | tradtional, specific path - cortex (higher motor) |
hierarchy order of development | mobility, stability, controlled mobility, skill |
mobility stage of control | random, erratic, reflexive |
stability stage of control | steady position, weight bearing, co contractions |
controlled mobility stage of control | distal fixation, dynamic, weight shifting, "painful practice" |
skill stage of control | distal movement, maintain posture |
milestones | pre preprogrammed set of ages when skills appear |
extenal variables | skills arise as a result of environment & pracitce, not all children will share exact age of maturity |
DEVELOPMENT IS DEPENDENT ON...... | CONTROL!! |
systems theory of motor control development | postural control, predictive set, motor coordination, eye head stabilization, sensory organization |
postural control | limit of stability (COG in BOS, shift w/o moving, seat/stand), environ adaptation, musculoskeletal system ( mechanical component) |
predictive set | anticipate movements needed |
motor coordination | sequence, maintain posture |
eye head stabilization | despite movement, input must be stable |
sensory organization | vision, vestibular system, somatosensation |
motor control | mechanical process of managing posture & movement control - control movement, learn to control in varied situations |
motor control requires? | sensation, cognition & motor |
motor contorl involves? | sequence, speed (time), force |
motor learning | practice to develop control |
perfection of tasks | increase in complexity w/age |
feedback | where & how often is input taking place, effects of fatique, anxiety, medications and pt motivation |
motor development cannot develop w/o | motor control |
motor control cannot occur w/o | postural control |
cognitive or acquisition state of motor learning | brand new info, learning/re-learning w/frequent practice & feedback, clear & concise input for a "reference of correctness", a "map" of "what to do" - TOSS THE REST, allow for self input in stable environ w/o distraction |
associative or refinement stage of motor learning | running program, need to decrease errors, couple movement w/failure or success, less visual input, more proprioceptive, entered the "how to..." stage, less feedback, more feed forward (speed, efficiency, force, frustration?), "how can I do it on my own" |
autonomous or retention stage of motor learning | complete the program in multiple environments w/less focus. "how to succeed" |
practice context of motor learning | method of teaching. make sure pt is practicing correct patterns to avoid incorrect ADL movement |
whole learning | practice by completing entire task from beginning to end (sit to stand), cue all the way thru, start to finish |
pure-part learning | break down complete task into components (rocking in sit to stand) |
progressive/sequential part learning | break down into parts, practicing them in sequence (lock chair, move foot rests..) do all in a row but the pt knows it is 4 different steps |
mass practice practice schedule | frequency practice where rest time is much less (ie rolling baby) |
distributed practice | increase rest time to ~ = to that of activity. consider attention span & endurance (able to take time to think about what they are doing) |
intermittent/schedule practice | program is available to CNS/PNS but not yet committed. schedule determined by PT (ie outpatient). achieve greater independence |
random practice | independent w/o schedule or specific task. encourage patient to incorporate HEP into ADLs |
blocked practice | scheduled as above but focused on one task |
mental practice | use no matter what. Visualization (start with) or a mental rehersal. helps decrease anxiety and increase neural mapping. (have them visualize what went wrong & what they'll do in the AM to do different) |
motor program requires a lot or a little thought? | little or none ( walking) |
motor program - does it change? | won't change unless external variables change "memory" (tree in the road) |
motor program is structured to ........ | train according to patient's needs (tile floor @ home, similar surface in clinic) PRACTICE IN A SETTING APPROPRIATE OR YOUR PATIENT |
when does SEQUENTIAL DEVELOPMENT learning occur? | continuous process occurring betw conception & t/o life |
Development has what two components? | cognitive & social |
stages of development -infancy | birth - 2 |
childhood | 2-10 |
adolescence | 10-19 |
adulthood | 20-64 |
late adulthood | 65 & over |
growth development occurs how? | height, weight, strength |
maturation development occurs how? | pre programmed physical changes, nerve, bone, organs (develops b/c brain says so) |
adaptation development occurs how? | environmental influence |
stages of motor learning | 1) cognitive or acquisition stage, 2) associative or refinement state, 3) autonomous or retention stage |