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Theories ofTheories ofMotor ControlMotor Control
ComplexSystemsTheory
Definition and levels of analysis
Task-BasedApproaches
Neurofacilitation Approaches
Motor Hierarchy
ReflexTheory
Map of EssentialMap of EssentialConceptsConcepts
Fall 2006DM McKeough
Theories of Motor controlTheories of Motor control
Definition and levels of analysis Reflex theory Hierarchical theory Complex systems theory Neurofacilitation Approaches Motor Re-learning, Task-Based Rehabilitation Motor Hierarch
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DescriptionDescription
The discipline of The discipline of Motor Control Motor Control is the study is the study of human movement and the systems that of human movement and the systems that control it under normal and pathological control it under normal and pathological conditions.conditions.
Levels of analysis (study)Levels of analysis (study) Environmental result of the movement Environmental result of the movement
(Outcome)(Outcome) Movement patternMovement pattern Neuromotor processes underlying movementNeuromotor processes underlying movement
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Reflex TheoryReflex Theory
Reflex TheoryReflex Theory (Charles Sherrington, early 1900s) (Charles Sherrington, early 1900s) Complex behavior (movement) is controlled by a Complex behavior (movement) is controlled by a
series of chained reflexes (e.g. Frog)series of chained reflexes (e.g. Frog)
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Hierarchical TheoryHierarchical Theory
Hierarchical Theory Hierarchical Theory (Hughlings Jackson 1930s)(Hughlings Jackson 1930s) Movement is controlled Movement is controlled
by a system consisting by a system consisting of 3 levels with a of 3 levels with a rigidrigid top down organizationtop down organization
Higher centers control Higher centers control lower centers via lower centers via inhibitioninhibition
““Disinhibition”Disinhibition” ““Release Release
phenomenon”phenomenon”
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Complex Systems Theory Complex Systems Theory 1/31/3
Individual
Task Environment
Movement
Movement emerges Movement emerges spontaneously from the spontaneously from the interaction of the interaction of the individual, the task, and individual, the task, and the performance the performance environmentenvironment
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Factors within the Factors within the Individual, Task, and Environment Individual, Task, and Environment 2/32/3
Individual
Task Environment
• Sensorimotor• Psychosocial• Cognitive• Stage of Motor Learning
• Taxonomy of tasks• Discrete/ continuous• Attentional demands
• Physical• Socioeconomic• Cultural
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Factors within the Factors within the Individual, Task, and Environment Individual, Task, and Environment 3/33/3
Cognition
Perception Action
Mobility
Stability Manipulation
Regulatory
Nonregulatory
I
T E
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Neurofacilitation Neurofacilitation Approaches Approaches 1/7 1/7
Developed during the 1950-1960s in parallel with Developed during the 1950-1960s in parallel with increasing knowledge of anatomy and physiology of the increasing knowledge of anatomy and physiology of the nervous systemnervous system
Bobath (NDT); Brunnstrom; Kabat, Knott & Voss (PNF); Bobath (NDT); Brunnstrom; Kabat, Knott & Voss (PNF); Ayers (Sensory Integration Therapy) developed the Ayers (Sensory Integration Therapy) developed the “Neurofacilitation Approaches” that replaced the muscle re-“Neurofacilitation Approaches” that replaced the muscle re-education approach used to treat the effects of Polio during education approach used to treat the effects of Polio during the 1940-1950sthe 1940-1950s
Neurofacilitation approaches were designed to treat the Neurofacilitation approaches were designed to treat the movement effects of stroke (UMN lesion) by attempting to movement effects of stroke (UMN lesion) by attempting to affect the CNS directly through the manipulation of sensory affect the CNS directly through the manipulation of sensory input input
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Neurofacilitation Neurofacilitation Approaches Approaches 2/7 2/7
AssumptionsAssumptions Normal movementNormal movement
Results from a chain of reflexes organized Results from a chain of reflexes organized hierarchically within the CNS (Control of movement is hierarchically within the CNS (Control of movement is top down – cortex controls brainstem and spinal cord)top down – cortex controls brainstem and spinal cord)
Normal developmentNormal development Characterized by the emergence of behavior Characterized by the emergence of behavior
organized at sequentially higher levels of the nervous organized at sequentially higher levels of the nervous systemsystem
Driven by sensory inputDriven by sensory input
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Neurofacilitation Neurofacilitation Approaches Approaches 3/73/7
AssumptionsAssumptions Abnormal movementAbnormal movement
Caused by disruption of normal reflex mechanismsCaused by disruption of normal reflex mechanisms Cortical lesions cause the release of abnormal Cortical lesions cause the release of abnormal
reflexes organized at lower levels of the central reflexes organized at lower levels of the central nervous systemnervous system
Release of abnormal reflexes constrains the patient’s Release of abnormal reflexes constrains the patient’s ability to move normallyability to move normally
Abnormal movement is the Abnormal movement is the directdirect result of lesion not result of lesion not secondary or compensatory actions**secondary or compensatory actions**
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Neurofacilitation Neurofacilitation Approaches Approaches 4/74/7
AssumptionsAssumptions Abnormal movementAbnormal movement
In both children and adults, movement is dominated In both children and adults, movement is dominated by primitive reflexes by primitive reflexes
In children, cortical lesions interrupt normal In children, cortical lesions interrupt normal corticalization thus motor control is dominated by corticalization thus motor control is dominated by primitive reflexes organized at lower levels of the primitive reflexes organized at lower levels of the CNS (primitive reflexes are never constrained)CNS (primitive reflexes are never constrained)
In adults, with acquired motor cortical lesions, In adults, with acquired motor cortical lesions, damage to the higher levels of the CNS release lower damage to the higher levels of the CNS release lower levels and movement is dominated by primitive levels and movement is dominated by primitive reflexes (primitive reflexes are constrained then reflexes (primitive reflexes are constrained then released)released)
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Neurofacilitation Neurofacilitation Approaches Approaches 5/7 5/7
AssumptionsAssumptions Recovery of functionRecovery of function
Requires that higher centers once again control lower Requires that higher centers once again control lower centerscenters
Recapitulates normal development, therefore, Recapitulates normal development, therefore, intervention should proceed along a developmental intervention should proceed along a developmental sequencesequence
Functional skills will automatically return once Functional skills will automatically return once abnormal movement is inhibited**abnormal movement is inhibited**
Repetition of normal movement patterns will Repetition of normal movement patterns will automatically transfer to functional tasks**automatically transfer to functional tasks**
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Neurofacilitation Neurofacilitation Approaches Approaches 6/7 6/7
Clinical ImplicationsClinical Implications Examination should identify abnormal reflexes Examination should identify abnormal reflexes
controlling movementcontrolling movement Intervention should modify abnormal reflexesIntervention should modify abnormal reflexes Intervention modifies the CNS through sensory Intervention modifies the CNS through sensory
inputinput
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Neurofacilitation Neurofacilitation Approaches Approaches 7/7 7/7
Current changes to Neurofacilitation Current changes to Neurofacilitation Approaches Approaches Increased emphasis on directly training Increased emphasis on directly training
functional tasks as opposed to “normal functional tasks as opposed to “normal movement”movement”
Decreased emphasis on inhibiting abnormal Decreased emphasis on inhibiting abnormal reflexesreflexes
Increased consideration of motor learning Increased consideration of motor learning principles (stages of motor learning, feedback, principles (stages of motor learning, feedback, practice schedules, etc…)practice schedules, etc…)
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Motor Re-learningMotor Re-learningTask-Based Rehabilitation Task-Based Rehabilitation 1/21/2
AssumptionsAssumptions Normal movementNormal movement
Performer + Task + EnvironmentPerformer + Task + Environment Abnormal movement results from impairment Abnormal movement results from impairment
in one or more of the systems controlling in one or more of the systems controlling movementmovement
Abnormal movement pattern is the Abnormal movement pattern is the performer’s best solution to the task given performer’s best solution to the task given the systems remaining after damage not the systems remaining after damage not just the result of the lesion itself**just the result of the lesion itself**
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Motor Re-learningMotor Re-learningTask-Based Rehabilitation Task-Based Rehabilitation 2/22/2 AssumptionsAssumptions
Recovery of functionRecovery of function Recovery is produced by plastic reorganization of Recovery is produced by plastic reorganization of
undamaged control centers (neural plasticity)undamaged control centers (neural plasticity) Clinical Implications Clinical Implications
Recovery is best produced by practice of purposeful, Recovery is best produced by practice of purposeful, goal-oriented tasks that are meaningful to pt’s goals goal-oriented tasks that are meaningful to pt’s goals (task specificity)(task specificity)
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Motor HierarchyMotor Hierarchy MC system consists of 3 levelsMC system consists of 3 levels
Highest levelHighest level: association cortex, : association cortex, sensory, and motor areassensory, and motor areas
Concern: select movement goal Concern: select movement goal and strategyand strategy
Middle levelMiddle level: BG, Cb, and : BG, Cb, and brainstem motor centersbrainstem motor centers
Concern: specifying spatial, Concern: specifying spatial, temporal, and force parameters temporal, and force parameters of the motor planof the motor plan
Lowest levelLowest level: LMNs, motor plant, : LMNs, motor plant, FB about sensory consequences FB about sensory consequences of the movementof the movement
Concern: producing the Concern: producing the movement pattern and supplying movement pattern and supplying sensory FBsensory FB
S1
Click to Animate
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The EndThe End
© DM McKeough 2009© DM McKeough 2009
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