Motor Development Test 1
Parietal lobe = "______"
"Where is it and how do I interact with it?"
Long-loop reflex
"functional stretch reflex"
Movement Time
initiation of response to the end of the movement
Information processing model
input [signals] → processing → output [motor response]
Response- programming would ______ with more complex movements
increase
Process of vision
Light is focused by the cornea and lens → travels to the retina where rods/cones are located
Preparatory phase = Compensatory phase =
Preparatory phase = feedforward Compensatory phase = feedback
type 1a sensory afferent is most sensitive to: type 1b sensory afferent is most sensitive to:
1a: dynamic stretch 1b: static stretch
motor skills that develop in the _______of life & form basis for attainment of functional motor skills
1st year
foreperiod of ____ seconds is best to decrease but anything greater _____ will increase
2-3 seconds 12 seconds
Clinical implications to motor programming theory
abnormal movement is not just reflexive, re-train movement is important to task
Hypertonia
abnormally high muscle tone
hypotonia
abnormally low muscle tone
Fixed base of support strategies for perturbed stance [2]
ankle and hip
Lobes of cerebellum
anterior, posterior, Flocculonodular [nodulus and flocculus]
Feedforward main concepts
anticipation, old movements (seen/done before)
face validity
appear to measure what it is set out to measure at face-value
Action system = areas of ________ that perform processing essential to _________ of movement
areas of nervous system that perform processing essential to control of movement
causes of apraxia:
brain injury or neurodegenerative illness or congenital
Normal to have ______ at rest but with postural control deficits it increases
small amounts of postural sway
Central Set
state of the nervous system that is influenced or determined by the context of a task
Motor cortex deficits is presented as _______
weakness [paresis]
______ have the highest number of cutaneous receptors for safety and dexterity
Fingers
Sensory organization test [SOT]:
Firm w/ vision, firm w/ no vision, firm w/ inaccurate vision, foam w/ vision, foam w/ no vision, foam w/ inaccurate vision
Steady state postural control ["static"]:
ability to control COM relative to BOS in predictable conditions
Dysdiadochokinesia:
inability to perform rapid alternating muscle movements
Primary descending pathways split into __________
lateral and medial motor systems
Example of cross-extensor reflex:
o Ex: step on something sharp - 1 flex and 1 extends to protect
Locations of greatest # of muscle spindles
neck, extraocular m., hand
Clinical implications of dynamic systems theory
need to understand physical properties of the body, other properties such as velocity can be used to facilitate movement
Muscle tone = normal ______ resistance to ______
normal passive resistance to stretch
Advantage of feedforward
not replying on sensory feedback - good for fast movements
Reactive postural control - multi-directional stability states not _____
not simple reflexes or fixed muscle synergies
2 things monosynaptic stretch reflex loop utilizes
o Activation of agonist o Reciprocal inhibition
Feedback is used for ______ movements
slower
constant validity
instrument measure all the dimensions of the function
more senses involved =
more information
Motor unit size relates to _______
dexterity and power needed
temporal lobe= "______"
"what is this?"
Parietal lobe/ dorsal stream = "_______"
"where is it and how do I interact with it?"
Factors of response-programming [3]
# of moving parts, accuracy of movement, and movement duration
- Center of mass: - Center of gravity: - Base of support: - Center of pressure:
- Center of mass: point at the center of total body mass - Center of gravity: vertical projection of center of mass - Base of support: area of the body in contact with support surface - Center of pressure: center of the distribution of total force applied to the supporting surface
Hypothetical model:
- Cerebral cortex → basal ganglia or spinal cord - From basal ganglia → inhibit thalamus or excite brain stem
according to cortical homunculus - Laterally = - Medially =
- Laterally = more trunk/thorax/face - Medially = more LE/legs
- Orientation (______): - Stability (________):
- Orientation (posture): able to maintain balance between body's segment, body, and environment for a task - Stability (balance): ability to control center of mass in relationship to the base of support
reflexes involved in locomotion - Reciprocal inhibition: - Cross-extensor reflex: - Reflex-reversal phenomenon
- Reciprocal inhibition: flexors are automatically inhibited when the extensors are activated and vice versa - Cross-extensor reflex: extensors of one knee are activated when the flexors of the opposite knee are activated - Reflex-reversal phenomenon [opposing responses as a function of gait cycle]
Functions of the following - prefrontal cortex: -premotor cortex: -supplementary motor cortex: -primary motor cortex: -primary somatosensory cortex: -posterior parietal cortex: -primary visual cortex: -cerebellum: -brainstem:
- prefrontal cortex: planning of movement, specifies goal of movement [not details] -premotor cortex: organizes sequences of movement -supplementary motor cortex: coordination of complex learned responses [throwing/typing], coordination of large muscles for posture -primary motor cortex: intentions produce output to spinal cord that yields motor outcomes -primary somatosensory cortex: touch input from entire body with some output to prefrontal and spinal cord -posterior parietal cortex: ingrates body position and location of external objects, output goes directly to prefrontal cortex -primary visual cortex: identifies colors, lines, edges, depth, etc. -cerebellum: - motor learning & fine correction of speed and distance of ongoing movements -brainstem: origin of motor neurons to spinal cord
Primary direct circuits -Cortex to striatum: -Striatum to globus pallidus: -GPi to thalamus (VA/VL):
-Cortex to striatum: glutamate (+) -Striatum to globus pallidus: GABA (-) -GPi to thalamus (VA/VL): GABA (-)
Types of apraxia -Apraxia of speech: -Constructional apraxia: -Ideational/conceptual apraxia: -Ideomotor apraxia:
-Apraxia of speech: difficulty planning and coordinating the movement needed to speech -Constructional apraxia: inability to draw, construct, or copy simply configurations/shapes -Ideational/conceptual apraxia: inability to understand concept/idea [ex: putting in shoes then socks] -Ideomotor apraxia: deficits in ability to plan or complete tasks that rely on sematic memory [can explain, but can't do it - ex: "show me how to brush your teeth"]
Structures involved with motor PLANNING: [7]
-Primary motor cortex: programming volitional movement -caudate: controls conscious contraction of certain skeletal muscles -putamen: movement control -glubus pallidus: regulate muscle tone for intentional movement -subthalamus: involved in ballistic movements -Substantia nigra: balance between dopinergic inhibition and cholinergic excitation of striatal output (GABA) -Thalamus: part of the motor planning & communicates with basal ganglia
Secondary circuits -Striatum to GPe: -GPe to subthalamic nucleus: -Subthalamic nucleus to Gpi: -Striatum to substantia nigra: -Substantia nigra to striatum:
-Striatum to GPe: GABA (-) -GPe to subthalamic nucleus: GABA (-) -Subthalamic nucleus to Gpi: glutamate (+) -Striatum to substantia nigra: GABA (-) -Substantia nigra to striatum: dopamine (-) or (+) - has the effect to either excite more or inhibit
Deficits of each structure -primary motor: -caudate: -putamen: -globus pallidus: -subthalamus: -substantia nigra:
-primary motor: inability to perform purposeful movement even though there is no paralysis -caudate: negative actions or positive actions -putamen: positive and negative signs -globus pallidus: positive and negative signs -subthalamus: hemiballismus -substantia nigra: muscle tremors and rigidity
Functional zones of cerebellum -spinocerebellar: -cerebrocerebellar: -vestibulocerebellar:
-spinocerebellar: somatosensory info from the extremities -cerebrocerebellar: motor planning -vestibulocerebellar: balance and eye movement
Task considerations [4]
1. body action - stability vs. mobility 2. UE manipulation 3. organization - discrete vs. continuous 4. open vs. closed
Motor strategies used to respond to a threat to balance [3]:
1. characteristics of perturbation (direction and magnitude] 2. biomechanical constraints 3. environmental conditions [space available, surface, etc.]
Ankle: vs. Hip:
Ankle: distal to proximal Hip: proximal to distal
hallmark of pathology within cerebellum [2 ish]
Ataxia or discoordination of voluntary movement direction and extent [dysmetria] including limb and gait
Body righting [part of righting reactions]
Body righting: movement around the body axis which are necessary for anti-gravity positions
stepping strategy is used when ______
COM is moved outside BOS
Basal ganglia 2 parallel loops:
Caudate and putamen
What are CPGs?
Central pattern generator - patterns that live withing spinal network for control of movement without conscious control [walking, running, skipping, swimming, breathing, wing flapping]
Main function of cerebellum
Coordination
Reflex theory identified these things (3)
Interaction of excitatory and inhibitory processes, sensory receptors (nociceptors and muscle spindles), proprioception
In the optic chiasm, axons from the nasal retina [L] ________, and axons on the R _____
L: Cross over R: Do not cross over
paresis is part of ______ syndrome
LMN syndrome
Motor unit =
Motor unit = alpha motor neuron + fibers it innervates
myotatic reflexes: Long-loop reflexes: Triggered reactions:
Myotatic: stretch reflex - spindles, gamma loop, and same muscle Long-loop reflexes: spindles, SC interneurons, cortex/cerebellum, same muscles Triggered reactions: various receptors, higher centers and associated musculature
function of caudate loop: process _____ motor tasks/circuits
NEW [modulates multiple sensory inputs from association cortex & Processes information through circuit → frontal lobe]
Open vs. closed skill
Open = changing environment, more variability Closed= less variability, controlled/constant
types of mechanoreceptors [4]
Pacinian corpuscle [deep pressure], Merkle's disks/Ruffini ending/ Meissner corpuscle [light touch]
Dorsal stream = ______ lobe
Parietal lobe
death of dopamine neurons in the substantia nigra-pars compacta = _______
Parkinson's
Primary versus secondary effects
Primary: primary impairment affecting motor, sensory/perceptual, and/or cognitive/ behavioral systems - CNS lesion Secondary: do not result from CNS lesion directly from as a result of original problem
Motor control theory refuted the idea that...
REFUTED THE IDEA THAT MOVEMENTS WERE CONDITIED REFLEXES
Hick's Law
RT increased by 150 ms for each doubling of S-R choice & training is possible to decrease RT (more options are available to a person, the longer it will take for him or her to make a decision about which option is best)
Response Time
Reaction time + Movement Time
Rods = Cones =
Rods = night vision Cones = daylight/color
Sign: Symptom:
Sign: objective finding from a physical examination Symptom: pt reported, subjective finding
Simple RT task: Choice RT task: Go/No Go RT task:
Simple RT task: 1 button, 1 light Choice RT task: 4 buttons, 4 corresponding lights Go/No Go RT task: 2 buttons, 1 corresponding light
Classes of motor units
Slow fatigue: small, sustained contraction for posture fast fatigue: somewhat fatigable, twice the power as slow fast fatigable: large burst of power
Posterior parietal function general terms:
Talk to prefrontal about planning
Movement is the interaction between (3)
Task, environment, individual
spasticity is part of _____ syndrome
UMN syndrome
Sensitivity
a test detecting dysfunction when it is present [true positive rate] - SNOut
Specificity
a testing detecting no dysfunction when not present [true negative rate] - SPIn
Anticipatory postural control [proactive]:
ability to activate muscles in legs/trunk for balance in advance of potentially destabilizing voluntary movements
Adaptive postural control: ability to modify ______ and ______ systems in response to changing task and environmental demands; maintain postural control while __________
ability to modify sensory and motor systems in response to changing task and environmental demands; maintain postural control while moving through space
Reactive postural control:
ability to recover a stable position following an unexpected perturbation
Individuation:
ability to selectively activate a muscle allowing isolated joint motion
impaired individuation leads to _________
abnormal coupling between related muscles
Construct validity
accurately measures a construct [abstract variable] (ex: QoL)
Positive signs:
actions that the pt does not want - over excitation Ex: hypertonicity, tremors, chorea (jerky), athetosis, ballismus and tics [Huntington's]
Negative signs:
actions that the pt wants to perform but can't - inhibition Ex: akinesia and abnormal postural adjustments [Parkinson's]
Response-programming
after selecting response, need to convert it to a coordinated action
Correlation of coefficient
amount of shared associated that exists between 2 data sets [no causation]
Equilibrium reactions:
balance when the center of gravity is disturbed o Counter rotations the head and trunk away from the direction of displacement and use of extremities
discrete: Serial: Continuous:
beginning and end discrete strung together no beginning and end
CPG: Circuits remain intact _______ level of lesion
below
Medial motor system is ______ or _______
bilateral or ipsilateral
Parts of basal ganglia [5]:
caudate nucleus, putamen, globus pallidus, subthalamic nucleus, and substantia nigra
caudate: _______ tasks vs. putamen: _______ tasks
caudate: new motor tasks putamen: previous motor tasks
Main idea of motor control theory
central motor program can be elicited wither with sensory stimulation or through central processes
______ and ______ act directly on LMN
cerebral cortex and brainstem
Muscle stiffness = ________ / _______
change on tension divided by change in length
Lateral motor system is located in ______ and _____ from site of orgin
contralateral spinal cord cross over from site of origin
Optic ataxia
correctly identify but do not know how to use it
Giving a constant foreperiod ______ RT
decreases
Function of secondary circuits:
decreases excitability of the thalamus to decrease excitability in motor cortex [opposite of direct loops]
Agnosia
deficit in ability to identify objects
Function of muscle spindles
detect absolute muscle length [static] and change in muscle length [dynamic]
Limitations to hierarchical theory
does not explain why adults have reflexive behavior in certain situations [such as flexor withdrawal] which is a result of bottom-up control
Motor performance
efficient control of motor processes, the execution of movement [skill]
Variable Error
error relative to performer's consistency
Constant Error
error relative to target
Anticipatory adjustments are influenced by [3]:
expectations, anticipation, and practice
Limitations of motor programming theory
fails to account for influence of MSK and environment for motor control
higher intensity stimulus = _______ processing
faster
Basal ganglia and cerebellum are part of __________ from the thalamus
feedback loops [do not act directly on LMN]
reactive postural control includes [2]:
fixed support strategies and change in support strategies
CPG do not change ______
force
Temporal anticipation uses a ______
foreperiod [1,2,3, GO!]
Location and function of joint receptors
found in joint receptors and fire at extreme ends of range
Saccadic eye movement helps keep _________
fovea on information
Limitations of reflex theory
goal directed movement is possible without somatic sensation even if vision is occluded
high variable error = low variable error =
high variable error = performance is inconsistent low variable error = scores are similar/ less variation
Precision/resolution
how much a measurement tool will pick up on subtle changes
Optic ataxia is an issue with the _______ lobe
issue with dorsal stream [parietal lobe]
agnosia is a problem with the ______ lobe
issue with ventral stream/temporal lobe
COP moves around constantly to _____
keep COM within BOS
Clinical implication of stimulus-response compatibility
keep it simple to have a better RT
high CE= low CE =
less accurate performance accurate performance
Neuroanatomy
levels of control, spinal bord, brainstem, etc.
Location of golgi tendon organ
located at muscle and tendon junction
Function of gamma motor neurons:
maintain tension
Number of muscle spindles depends on:
mass of muscle and muscle that require precise control
Vailidity
measuring what we think it is measuring
3 types of cutaneous receptors
mechanoreceptors, thermoreceptors, nociceptors
Ecological theory main idea
motor control evolved so we can cope with the environment & accomplish goal-oriented movement
Apraxia
motor disorder caused by damage to posterior parietal cortex or corpus collosum - difficulty motor planning when ASKED
Basal ganglia is involved in:
movement control [especially higher-level and internally generate movements], learning [reward-based], and cognition/memory/affect
Main idea of dynamic systems theory
movements are active a goal-oriented and not conditioned reflexes, CNS is not solely responsible for movement but biomechanical characteristics too
- Within synergies, _______ has a weighting factor
muscle
Type of receptors
muscle [muscle spindle & Golgi Tendon], joint, and cutaneous [mechano-, thermo-, and nociceptors]
Gamma motor neurons bring info from CNS to ______
muscle spindle [efferent]
Muscles spindle maintain
muscle stiffness
Synergies
muscles linked together to form movement [adaptive and dynamic]
3 neurological reflexes
myotatic, long-loop reflexes, and triggered reactions
Types of paresis:
o Hemiplegia: weakness of 1 side of body o Paraplegia: weakness of lower extremities o Tetraplegia: weakness of all 4 limbs
example of reflex-reversal phenomenon:
o Hitting your foot on unexpected object leads to tibialis posterior to cause DF o Placing your foot on ground, despite stimulus, does not cause tibialis anterior burst
Reactive postural control - medial-lateral strategies require [2]:
o Requires adduction of one leg and abduction of the other o Loading and unloading of limbs are mirror images
Objectivity
observers get the same result with evaluating the same thing [if not, then it is subjective]
Somatosensory
perception of sensory stimuli from skin and internal organs
Limitations to dynamic systems theory
place less importance on role of CNS, increased emphasis on body mechanics and mathematical concepts
Direct circuits utilize ______ feedback loops
positive
other sx of Parkinson's [2]
postural instability and gait disturbances
Protective reactions:
prevent injury if the equilibrium reactions are unable to restore balance [ex: putting arm out when falling]
function of putamen loop:
primarily concerned with movement o Input from sensory areas and motor/premotor areas of cortex
Postural control: process of the CNS controlling the body's _________ for purposes of ______ & _______
process of the CNS controlling the body's position in space for purposes of orientation and stability
According to motor control theory, 4 pieces of info that are stored in memory
proprioception, force & speed, feeling of movement, and outcome
Function of medial motor system:
proximal, axial, and girdle muscles in postural control
Lateral motor system is essential for:
rapid, dexterous movement and individual digit/joint movement
what 2 schemas is information abstracted in
recall [motor] & recognition [sensory]
3 types of anticipation in feedforward
receptor: detect using senses effector: anticipate how long the movement will take and body positions (ex: swinging a bat) perceptual: internal rhythm (ex: running)
Neurophysiology
receptors, synapses, reflexes, neural networks, brain & spinal physiology
Reflex theory main idea
reflexes are the basis for all movement & complex movement is the result of chained reflexes - sensory input is necessary for movement
environment regulatory features: environment non-regulatory features:
regulatory features: shape of movement itself [weight, size, shape of object, type of walking surface] non-regulatory features: affect performance [background noise, distractions]
Hallmark symptoms of Parkinson's [3]
resting tremor, bradykinesia, and rigidity
Treatment of Parkinson's
restore dopamine levels [L-Dopa] and balance overactive BG circuit
Motor skill
result of learning, producing a planned movement with certainty and maximum efficiency
Postural reactions include [3]:
righting reactions, equilibrium, and protective reactions
cerebellar dysfunction will appear on _______ side of cerebellar lesion
same
Stimulus-Response compatibility
same side as hand = high SR compatibility opposite side as hand = low SR compatibility
Function of golgi tendon organs
senses tension and inhibit agonist and excites antagonist so tension doesn't get too high [muscle protection] - role in fatigue
Coactivation
simultaneous activation of additional muscles during functional movements, present in neurologically intact individuals just learning a skill and individuals with neurological pathology
Location of muscle spindles
skeletal muscle
2 forms of hypertonia
spasticity: velocity dependent rigidity
Conditions that require anticipatory adjustments [3]:
speed, weight of load to be removed, and support
3 parts of Control of locomotion:
spinal preparation, decerebrate preparation, and decorticate preparations
CPGs require ______ to start movement but not to maintain movement
stimulus [electrical, pharm]
Monosynaptic stretch reflex loop
stretched muscle → excited 1a afferent → CNS
Caudate + putamen = ________
striatum
Righting reactions
supporting positioning of the head vertically in space
Ventral stream = _______ lobe
temporal lobe
Clinical implications for hierarchical theory
test reflexes, prevent primitive reflexes [grasping, rooting], normalize muscle tone/reduce hyperactive stretch, and facilitate normal patterns of movement
issue with direct circuit would result in inhibition of _______
thalamus
Skill
the ability to bring about some end result with maximum certainty and minimum outlay of energy, or of time and energy
Motor Control
the ability to regulate or direct the mechanisms essential to movement - result of complex interaction between individual, task, and the environment
Concurrent validity
the instrument agrees with other instruments - "gold standard"
Realibility
the measurement is able to be reproduced
Subtractive method key principle
the time is takes to perform a task depends on the number and types of mental stages involved
Reaction time
time from beginning of stimulus to beginning of response
Fitt's Law
time to complete a targeted movement depends on the distance to the target and the width of the target - as movement becomes more difficult the speed and accuracy are compromised
Hierarchical theory main idea
top-down CNS organization of motor control, sensory feedback needed to control movement, and reflexive movement is only seen after CNS damage
True or false: in hierarchical theory, higher levels control lower levels
true
example of impaired individuation
trying to isolate elbow flexion but get shoulder ABD/ flexion and wrist flexion - unable to isolate
Spatial anticipation uses _______
use spatial cutes to predict [ex: goalie looks at foot placement to predict]
Feedback concept
uses sensory information, more for first time movement
Sensory feedback (part of feedback system) uses (2)
vision and somatosensory
3 systems used for sensory-perceptual systems
vision, somatosensory, vestibular
Gamma motor neurons are activated at the same time as _________
voluntary contraction
Example of adaptive postural control
walking on grass -> walking on gravel
When fovea is straight ahead, and stimulus is on the L - projected on L _____ and R _____
when stimulus is on the L, NASAL L and TEMPORAL R