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Motor Control


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What is motor control?
The unconsious ability to make continuous postural changes, and to regulate trunk and extremity movements
What performance components are necessary for motor control?
-postural tone
-postural mechanism
-normal MS tone
-Selective movement (normal movement)
-normal coordination
How can an OTR and COTA determine how impaired motor control interferes w/ function?
By observing during functional tasks (this gives a baseline)
-Motor control performance component-
Define postural tone:
-Refers to tonus (MS tension) in the neck, trunk, and limb girdles
Postural tone must be high enough for what? and low enough for what?
hi enough to resist gravity and be able to be upright (stability)
low enough for mobility
What interferes w/Postural Tone?
Hi or Lo tone interferes w/normal selective movement
-Motor control performance component-
Define Normal MS tone:
Continuous state of mild contraction, or a state of readiness of specific MS.
What does normal MS tone depend on
the integrity of the PNS and CNS and properties of MS's
What are the 7 characteristics of a Normal MS tone
1 Stabilization of neck and trunk (axial) and limb girdle joints
2 Ability of limb to move against gravity and resistance
3 Ability to keep limb in position once placed
4 Equal amt of resistance to passive stretch between the agonist and antagonis MS.
5 Ability to shift from stability to mobility and visa versa
6 Ability to use MS groups or a particular MS
7 slight resistance to passive movement
How is MS tone evaluated?
-Observation with ADL, while upright (sitting or standing)
Why does Gravity affect tone?
When gravity is present the tone is higher and when it's eliminated (supine) tone lower
What is abnormal MS tone?
-Hypotonicity (flaccid)
-Hypertonicity (spastic)
What is hypotonicity?
-It is when MS feels soft, offers no resistance (or very little)
-excessive ROM
-Feels heavy
-Unable to hold position once placed
What is hypertonicity?
-Increase resistance to passive stretch
-Hyperactive deep tendon reflexes and Clonus
-Occurs in patterns: UE usually flexor hypertonicity
LE usually extensor hypertonicity
What is rigidity?
Increased MS tone in the agonist and atagonist MS SIMULTANEOUSLY
What are 2 types of rigidity?
1 Lead Pipe: CONSTANT resistance throughout the ROM (flex or ext)
2 Cogwheel: Rhythmic give in the resistance
How do you measure the degree of hypertonicity
Mild-little resistance, but can move through ROM, and pt can perform ADLs
Moderate-Constant tone through ROM, but attainable, and pt has very difficult time performing ADLs
Severe-Strong resistance, can't move joint through ROM and pt cannot perform ADLs
What are the occurances that lead to hypotonicity?
-Peripheral nerve damage
-cerebellar disease
-frontal lobe damage
-this is usually the 1st stage for CVA & SCI, but may not last long.
What are the occurances that lead to hypertonicity (Usually in upper motor neuron disorders)
-brain tumor
-CVA and SCI after hypotonicity
What are the occurances that lead to Rigidity
(Usually due to lesions of the extrapyramidal system)
-Parkinson's Disease
-Degenerative diseases
What is the difference between rigid decerebrate and rigid decorticate?
Decerebrate is the EXTENSION of the full body, where Decorticate is the FLEXION of the full body
Define Reflex
the innate motor responses elicited by specific sensory stimuli
Are reflexes in adults good?
No, they interfere w/recovery of the automatic protective extension, righting and equilibrium REACTIONS.
Name 4 reflexes (the ones we need to learn)
-Asymmetical Tone Neck Reflex (ATNR)
-Symmetrical Tone Neck Reflex (STNR)
-Tonic Labyrinthine Reflex(TLR)
-Palmer Grasp Reflex
What is the stimulus and reflex for ATNR?
Stimuli: turning the head over the shoulder
Reflex: Extension of arm and leg on the face side
and flexion of the arm and leg on occipital bone side
What are the stimuli and reflexes for STNR?
1) Stimuli: Neck flexsion
Reflex: Arms flex and legs extend
2) Stimuli: Neck extension
Reflex Arms extend and legs flex
What are the stimuli and reflexes for TLR?
1) Stimuli: Supine (touch back)
Reflex: Full body extension
2) Stimuli: Pronate (touch stomach)
Reflex: Full body flexion
What is the stimulus and reflex for Palmer Grasp Reflex?
Stimulus: place something (pressure) in palm of hand
Reflex: flexion of fingers into palmer (close the hand) tightly around object
What are the influencing factors related to MS tone
-Environment: positioning of pt; too cold, too loud, stress in room
-Internal Infection (cold, flu, UTI)
-Feelings toward therapist

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