Neuro Final

Relationship between body segments and between body and environment

postural alignment (orientation)

Best test for identifying cognitive impairments

MOCA

higher ceiling with MOCA or MMSE

MOCA

Cut off score for dementia in MOCA and SLUMS

MOCA - 19 SLUMS - 20

Pts dependent on vision for balance would become unstable in which conditions

2,3,5,6

TUG under ____ seconds shows independent for basic transfers

20

Cut off score for MMSE dementia and cognitive impairment

24

Absolute versus relative frequency of feedback

absolute: number of trials accompanied with augmented feedback relative: performed with augmented feedback

When perturbation is small or slow, which strategy recruited first?

ankle strategy

Cognitive impairments

attention, orientation, movement, problem solving

manual guidance is what kind of feedback

augmented feedback

9 hole peg what part of ICF? What does it test? higher or lower score better?

body structure and function, tests dexterity and UE function, lower score better

Weakness in UMN and LMN?

both

Summary versus average delayed feedback

summary: after every trial average: after series of trials

Cut-off score for mild cognitive impairment MOCA and SLUMS

under 26

Cognitive phase

understanding what to do, declarative, error ridden

respond to muscle contraction or passive tendon stretch

GTOs

Forward perturbation at ankle causes what sway? What muscles activated?

backward sway; ant tib, quads, abs

At hip, forward perturbation causes what sway? Which muscles fire?

backwards sway, MA from paraspinals and hamstrings

vestibulospinal reflex travels what tracts

lateral and medial vestibulospinal

Fractionated contralateral movement of extremities from

lateral corticospinal tract

Motor pool responsible for fractionated movement and upper limb extension

lateral motor pool

Lateral or medial nociceptive system with fast pain? What type of fibers? What tract? End where?

lateral; AB fibers; spinothalamic; end in mediaal thalamus

Does linear motion, linear acceleration, gravity sensitive

otoliths

Vision absent in which conditinos

2 and 5

Dose angular motion and velocity

SSCs

Fasciculations in UMN and LMN?

only LMN

Outcome of motor learning

memory

Calculating dual task effect

(Dual-Single)/Single * +/-100

Cut off walking speeds

0.4 m/s - household walker 0.4-0.8 limited community 0.8-1.2 m/s community

Normal value for gaze

1

Grip most likely used for holding a pencil

3 jaw chuck

TUG over ____ seconds shows dependent for transfers

30 seconds

MCID for FGA and community dwellers?

4

Pts dependent on somatosensory would become unstable in which conditions

4,5,6

pts with vestibular loss would become unstable in which conditions

5,6

Floor to stand movement strategies ranking for %

50% do side sit to half kneel pivot 35% quadruped push up 15% sit up and roll over

Modulates force generation

BG

Does perception of touch and proprioception

DC/ML

tracts involved in conscious relay

DC/ML, spinothalamic

FGA or Berg harder? Which has higher ceiling?

FGA both

Knowledge of results versus knowledge of performance?

KR: outcome in relation to external focus and goal KP: feedback in movement quality for internal

reflexes and tone comparison in UMN and LMN

UMN - increased LMN - decreased

DC/ML travels where in thalamus

VPL

Are motor behaviors volitional? What does motor control treatment model say for yes or no

Yes: consider fear avoidance or intentional motor response NO: consider operant conditioning or reflexive pain resposne

Are suboptimal tissue loading occurring? What does motor control treatment model say for yes or no

Yes: focus on mechanics no: less focus on mechanics

characteristics of skilled movement include

ability to execute optimally, accuracy, conservation of energy, organized, purposeful

If task involves grasping, is acceleration or decelaration shorter? Is movement duration longer or shorter?

acceleration; movement duration is longer

Condition 1 CTSIB

accurate: all 3 inaccurate: none

Condition 5 CTSIB accurate, inaccurate, absent

accurate: vestibular inaccurate: somatosensory absent: vision

Condition 6 CTSIB accurate, inaccurate, absent

accurate: vestibular inaccurate: vision and somatosensory

Condition 2 CTSIB accurate, inaccurate, absent

accurate: vestibular, somatosensory inaccurate: none absent: vision

Condition 3 CTSIB accurate, inaccurate, absent

accurate: vestibular, somatosensory inaccurate: vision

Condition 4 CTSIB accurate, inaccurate, absent

accurate: vestibular, vision inaccurate: somatosensory

quiet stance

activation of antigravity muscles in steady state

TUG and 10MWT at what ICF level

activity

FGA at what ICF level? Higher or lower score better?

activity, higher

What is cingulate cortex responsible for? What lobe?

affect, attention, social cues frontal

Firm and large BOS in ankle or hip strategy

ankle

dual or complex: standing on one foot while saying ABCs

dual

reticulospinal tract activates for what muscles? Where does it originate from? Ipsilateral or contralatera?

bilateral postural and proximal limbs, brainstem; ipsilateral

Timing, coordination, error correction

cerebellum

movement pattern detection deficit likely from injury to

cerebellum

What makes up a closed versus open environment in Gentile's taxonomy?

closed: low variability, non-moving, high predictability open: moving, variable, low predictability

need the most feedback and attention in what stage

cognitive

3 core components of executive function

cognitive flexibility, behavioral inhibition, working memory

Three stages of motor learning according to Fitts and Posner

cognitive, associative, autonomous

Dual or complex: walking while carrying glass of water

complex

Concurrent and immediate feedback

concurrent - feedback given during task immediate - after performance

High fidelity in which relay system

conscious relay

Types of power grips?

cylindrical, spherical, hook

Timing of feedback most effective for motor learning

delayed

Descriptive vs. prescriptive feedback

descriptive: describing successes and errors prescriptive: including suggestions on how to correct errors

ankle strategy happens distal to proximal or proximal to distal?

distal to proximal

Highest level of attention

divided attention

What is lateral vestibulospinal tract responsible for? Where does it originate?

does postural muscles and extensor activity; from vestibular nuclei

Autonomous phase

doing it well, few errors, all implicit

Visual action stream, the where stream

dorsal

3 principles of OPTIMAL theory

enhance expectancies, support learner autonomy, promote external focus of attention

3 components of Gentile's taxonomy

environment, task, object manipulation

Immediate feedback can degrade learning because it interferes with

error detection

More stability and force requirements in which movement strategy for sit to stand

exaggerated flexion

Bandwidth feedback

feedback comes in ranges of acceptable performance

With a R head turn, neural firing occurs where? Where is it decreased?

fires more on R, decreases on L

4 phases of momentum strategy of sit to stand

flexion momentum/weight shift momentum transfer (thigh off) extension/vertical lift stabilization

contralateral reciprocal inhibition for stepping pattern generators

flexor on one side activated, flexor on other side inhibitted

Being able to respond discretely to specific visual or tactile stimuli

focus attention

more LE force in this movement strategy of sit to stand

force control

under 3+ to 4/5 MMT, 1 primary joint affected, deterioration of ROM with this movement diagnoses

force production deficit

Backward perturbation at ankle causes what sway? What muscles activation?

forward sway; MA from gastroc, hamstrings, paraspinals (posterior)

At hip, backward perturbation causes what sway? What muscles activated?

forward; MA from abdominals and quads

FITT

frequency, intensity, type, time

Amygdala located what lobe? What is it responsible for?

frontal; emotion and learning

Hippocampus in what lobe? What is it responsible for?

frontal; encoding learning and memory

Berg higher or lower score better? What part of ICF?

higher; activity

Small BOS, which strategy?

hip

Which perturbation strategy is used for fast and large perturbations?

hip

inability to grade forces appropriately, impaired speed and distance for each task

hypermetria/dysmetria

rapid movements are usually too large and slow movements too small for their intended purpose in this diagnosis

hypermetria/dysmetria

Slowness in initiating and executing movements and causes freezing up

hypokinesia

What to do if motor inhibition or facilitation according to motor control treatment model

inhibition: focus on activation facilitation: focus on relaxation

plasticity in response to one experience can harm the acquisition of another

interference

What to do if motor adaptations are interfering or not in motor control treatment model

interfering: reduce non-protecting adaptations non-interfering: maintain

Performance and learning enhanced by internal or external focus of attention

internal

Vision, prioception, vestibular all what types of feedback

intrinsic

Reaching to ipsilateral side or contralateral side is faster and more accurate?

ipsilateral

Vertical movement in thigh/off begins with

knee extension

Associative phase

knowing how to do it

manual guidance has what effect on error and motor learning and transfer

less error, but also less motor learning and transfer

impairments associated with perception

limb apraxia, R L discrimination, unilateral neglect

4 general stages of UE movement

locate target, reach, grasp, manipulate

Central sensitization very similar to what process?

long term potentiation

Massed vs. distributed practice

massed: work more than rest distributed: rest more than work

bilateral activation in the VOR occurs via what tract

medial longitudinal fasciculus

Motor pool doing postural muscles, stepping movements, extensors of neck and trunk

medial motor neuron pool

Lateral or medial nociceptive system with slow pain? What type of fibers? Localized or non-localized?

medial; C fibers; non-localized

Most efficient movement strategy for sit to stand

momentum strategy

more stability needed at momentum transfer or extension/vertical lift?

momentum transfer

Vertical GRFs about 150% of BW in what stage of sit to stand

momentum transfer (thigh off)

Deficit in timing and sequencing in this movement deficit

movement pattern coordination deficit

Has the best prognosis for high function in this movement diagnoses

movement pattern coordination deficit

What is medial vestibulospinal tract responsible for?

moves neck bilaterally; from the vestibular nuclei

Respond to quick or prolonged stretch

muscle spindle

Origin of force production deficit

muscle, neuromuscular junction, peripheral nerve, CNS dysfunction

Higher levels of motor learning seen when combining what with physical practice

observational practice

Atrophy in UMN and LMN?

only LMN

Cut off time for moderate fall risk in 5 times sit to stand

over 15 seconds

Practice that might be best for serial order of movements

part practice

integration of sensory impression into psychologically meaningful information

perception

types of precision grips?

pincher, lateral prehension (key grip), and 3 jaw chuck

Ability to control COM in relationship to BOS

postural stability (balance)

Finger and thumb pads directed towards palm in this grip

power grip

Need a period of no ______ for retention test

practice

Motor learning

practice or experience leading to permanent changes in responding

forces directed between thumb and fingers in this grip[

precision

origin of lateral corticospinal tract

primary motor cortex

Preparation for practice that can enhance brain derived neurotrophic factors and motor learning and neuroplasticity

priming

medial corticospinal tract responsible for

proximal muscles and trunk

hip strategy happens distal to proximal or proximal to distal?

proximal to distal

Type of practice order with the most contextual interference and the worse performance expected

random

Rank the types of practice orders from best results

random > serial > blocked

retention or transfer is same task and same environment

retention

tract that adjusts strength of muscles contractions for posture and gross limb movements

reticulospinal

Attention - the ability to maintain a behavioral or cognitive set in the face of distracting or competing stimuli

selective attention

Small and large meaningful change

small = .05 m/s large = .13 m/s

Movement diagnosis: non-equilibrium coordination, poor timing, slow and clumsy, can show some improvements with visual guidance

sensory detection deficit

Show lack of hand function without visual guidance, need to ambulate with AD, difficulty in conditions of poor lighting

sensory detection deficit

nature of the training experience dictates the nature of the plasticity

specificity

tracts on sub/unconscious relay

spinocerebellar

tracts involved in divergent path

spinomesencephalic, spinoreticular, spinolimbic

Does fast pain and temperature

spinothalamic tract

Steps in information processing

stimulus identification, response selection, response programming

Attention - ability to maintain a consistent behavioral response during continuous and repetitive activity

sustained attention

Integrated system theory has what three things affecting movement

task, individual, environment

What does MiniBEST test? What ICF level? Higher or lower score better?

tests LE function and balance; tests body structure and activity, higher better

box and block tests what? What part of ICF? HIgher or lower score better

tests manual dexterity, activity, higher better

Spinothalamic tract travels to what part of thalamus? Gets ipsilateral or contralateral information?

to VPL; contralateral information (crosses immediately)

Retention or transfer a stronger test of motor learning

transfer

plasticity in response to one training experience can enhance the acquisition of similar behaviors

transference

Cut off score for 10MWT for Parkinson's/older adult/brain injury

under .4 m/s

What is the HOAC?

using information from interview and history for inform examination

Perception stream or the what stream

ventral

Verbal prep is for explicit or implicit knowledge? What about modeling?

verbal - explicit modeling - implicit

Does spatial orientation and self-motion perception

vestibulocortex

input for feedforward balance primarily mediated by

vision

input for feedback reactive balance mediated by

vision, vestibular, somatosensory

practice that is appropriate for all types of tasks

whole