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