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Neuro Development/Tx

09.02.09

QuestionAnswer
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
Created by: djbari