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Movement Principles

Principles of movement and movement disorders

Motor Learning Principle (stage 1) Skill Acquisition stage or Cognitive stage. Intentional instruction or practice of a skill
Motor Learning Principle (stage 2) Skill Retention stage or Associated stage. "carry over" of skill occurs.
Motor Learning Principle (stage 3) Skill transfer stage or Autonomous stage. Demonstration of skill in a new context.
Dysmetria under/over shooting of a target
Dyssynergia joints moving seperately
Athetosis inadequate timing, force, accuracy (worm-like writhing)
Chorea short duration of involuntary movement of face and upper extremities.
Hemiballismus unilateral chorea
Ashworth Scale: Level 0 No Increase
Ashworth Scale: Level 1 Normal Tone - slight increase at end range
Ashworth Scale: Level 2 Slight increase - at less then half range
Ashworth Scale: Level 3 More Marked increase - greater than half range (1/4 range)
Ashworth Scale: Level 4 Considerable increase - movement difficult
Ashworth Scale: Level 5 Rigid in flex/ext patterns
Increasing Strength High resistance - low repetitions. Isometric can create more forceful contractions, but is contraindicated for those with cardio problems.
Increasing Endurance Work at 50% of maximal resistance or less, increase repetitions and duration - NOT resistance.
Reducing Edema Elevation (contraindicated for cardio problems), Retrograde Massage - CENTRIPETAL motion (with extremity elevated), Compression Garments (wrap distal to proximal) - Coban best for ADL/Role activities, Cold Packs, & Contrast Bath (Heat contraindicated).
Scar Management Early ROM program, Massage (circle and friction), Compression (coban-digits, isotoner glove-hand and tubigrip-UE), Scar pad, Splinting & Edema control (acute phase).
Sensory Training (Desensitization post Scar) Periphery as tolerated then over scar, massage, textures, vibration, fluidotherapy. Compensation (cannot feel): Avoid use of Hands where vision is occluded & Observe Safety Precautions.
Energy Conservation / Work Simplification Short REST periods throughout day (5-10 min), alternate/balance heavy and light tasks, organize/simplify, eliminate, delegate and combine tasks as needed. Sit (high stool for counter-top work, adaptive equipment, slide rather than lift, & light tools.
Body Mechanics - Joint Protection Maintain max ROM and Strength, use strongest and largest joints/muscles for job completion, keep general ergonomics in mind to simplify or make a task easier (hold close at center, palms up...)
Benefits of Physical Agent Modalities (PAMs) Heat: -pain, extensibility, wound healing. Cryotherapy(Cold): -pain, -edema, muscle tone. Whirlpool: clean/debride. EStim: -pain, -swelling, stim. mus/ner. Ultrasound (NEVER used over growth plate): -pain, -inflammation, ^ROM(extensibility), -adhesions.
Improving Coordination GM working up to FM, ROM of activity should be challenging yet attainable, & FOCUS on accuracy and speed (slow-fast/precise).
Created by: hesselrach