Download to read offline
More Related Content
Similar to motor control theoriess.pptx
![Harsha JC[1].pptx](https://cdn.slidesharecdn.com/ss_thumbnails/harshajc1-230612082941-d5b94cc8-thumbnail.jpg?width=640&height=640&fit=bounds)
motor control theoriess.pptx
- 1. Motor Control Theories Dr.Khushbu Naik MPT (NEURO)
- 2. LEARNING OBJECTIVES STUDENTS WILLBE ABLE TO – DEFINE MOTOR CONTROL, AND DISCUSSITSRELEVANCE TO THE CLINICAL T/T OF PATIENTS WITH MOVEMENT PATHOLOGY . DISCUSSHOW FACTORS RELATED TO THE INDIVIDUAL, THE TASK,AND THE ENVIRONMENT AFFECT THE ORGANIZATION AND CONTROL OFMOVEMENT. ENUMERATE THE THEORIES OF MOTOR CONTROL AND ITSVALUETO CLINICAL PRACTICE COMPARE AND CONTRAST THE NEUROFACILITATION APPROACHES TOTHE TASKORIENTED APPROACH.
- 3. INTRODUCTION •DEFINITION: MOTOR CONTROL ISDEFINEDAS THE ABILITY TO REGULATE OR DIRECT THE MECHANISMS ESSENTIAL TO MOVEMENT. •THE FIELD OF MOTOR CONTROL ISDIRECTEDAT : STUDYING THE NATURE OF MOVEMENT HOW MOVEMENT ISCONTROLLED.
- 4. WHY SHOULD THERAPISTSTUDY MOTOR CONTROL? •DIRECTED AT CHANGING MOVEMENT OR INCREASING THE CAPACITY TO MOVE. •STRATEGIES- DESIGNED TO IMPROVE THE QUALITY AND QUANTITY OF POSTURE AND MOVEMENTS ESSENTIAL TO FUNCTION.
- 5. NATURE OF MOVEMENT •MOVEMENTEMERGES FROM INTERACTION OF THREEFACTORS: “THE INDIVIDUAL, THE TASKAND THE ENVIRONMENT”. TASK M ENVIRONMENT INDIVIDUAL
- 6. FACTORS WITHIN THEINDIVIDUAL THAT CONSTRAINT MOVEMENT
- 7. TASK CONSTRAINTS ONMOVEMENT MOVEMENT STABILITY MOBILTY MANIPULATION
- 8. • BUT WHATTASKSSHOULD BE TAUGHT? • IN WHAT ORDER? • WHAT TIME? • THUS UNDERSTANDING OF TASKATTRIBUTES CAN PROVIDE A FRAMEWORK FOR STRUCTURINGTASKS. • TASKSCAN BE SEQUENCED FROM LEAST TO MOST DIFFICULT BASED ON THEIR RELATIONSHIP TOA SHARED ATTRIBUTE.. • CONCEPT OF GROUPING AND CLASSIFYINGTASKS FUNCTIONAL TASKGROUPINGS. ACCORDING TO CRITICAL ATTRIBUTES. MOBILITY TASKS MANIPULATION COMPONENT MOVEMENT VARIABILITY
- 9.
- 10.
- 12. MANIPULATION COMPONENT Standing andlifting a heavy load Standing and lifting a light load standing
- 13. MOVEMENT VARIABILITY STABILITY QUASIMOBILEMOBILITY Closed predictable environment sit/stand/non- moving surface Sit to stand/ kitchen chair/arms Walk/non-moving surface Open unpredictable environment Stand/rocker board Sit to stand/rocking chair Walk on uneven or moving surface
- 14. ENVIRONMENTAL CONSTRAINTS ONMOVEMENT MOVEMENT REGULATORY NON REGULATORY
- 15. THE CONTROL OFMOVEMENT: THEORIES OF MOTOR CONTROL •A THEORY OF MOTOR CONTROL ISA GROUP OFIDEAS ABOUT THE CONTROL OF MOVEMENT. •A THEORY ISA SET OF INTERCONNECTED STATEMENT THAT DESCRIBES UNOBSERVABLE STRUCTURES OR PROCESSES AND RELATE THEM TO EACH OTHER AND TO OBSERVABLEEVENTS.
- 16. VALUE OF THEORYTO PRACTICE FRAME WORK FOR INTERPRETING BEHAVIOUR GUIDE FOR CLINICAL ACTION THEORY PROVIDES - NEW IDEAS:DYNAMIC & EVOLVING WORKING HYPOTHESIS FOR EXAMINATION & INTERVENTION
- 17. THEORIES REFLEX HIERACHICAL MOTOR PROGRAMMINGSYSTEMS DYNAMIC ACTION ECOLOGICAL
- 18. REFLEX THEORY • ESTABLISHEDBYCHARLES SHERRINGTON, A NEUROPHYSIOLOGIST . • HISRESEARCH ON SENSORY RECEPTORS LEAD TO VIEW THAT MOVEMENT WASRESULT OF STIMULUS-RESPONSE SEQUENCE OF EVENTS OR REFLEXBASED • STIMULUS RESPONSE • SENSATION ASSUMED A PRIMARY ROLE IN INITIATION AND PRODUCTIONOF MOVEMENT. • HE BELIEVED ,REFLEXESWERE THE BUILDING BLOCKS OF COMPLEX BEHAVIOR.
- 19. LIMITATIONS • THE REFLEXCANNOT BE CONSIDERED THE BASIC UNIT OF BEHAVIOUR IFBOTH SPONTANEOUS AND VOLUNTARY MOVEMENTS ARE RECOGNISED AS ACCEPTABLE CLASSES OF BEHAVIOUR AS ITMUST BE ACTIVATED BY AN OUTSIDEAGENT . • DOES NOT ADEQUATELY EXPLAIN AND PREDICT MOVEMENT THAT OCCURS IN THE ABSENCE OF SENSORY STIMULUS. E.G ANIMALS MOVE – ABSENCE OF SENSORYSTIMULUS • DOES NOT ADEQUATELY EXPLAIN FAST MOVEMENTS.SEQUENCE OF MOVEMENTS THAT OCCUR TOO RAPIDLY TO ALLOW SENSORY FEEDBACK FROM PRECEDING MOVEMENT TO TRIGGER THE NEXT E.G TYPING • FAILSTO EXPLAIN THE FACT THAT A SINGLE STIMULUS CAN RESULT IN VARYING RESPONSES DEPENDINGON CONTEXT AND DESCENDING COMMANDS. E.G OVERRIDE REFLEXES TO ACHIVEGOAL. • DOES NOT EXPLAIN THE ABILITY TO PRODUCE NOVELMOVEMENTS. E.G VIOLINIST
- 20. CLINICAL IMPLICATIONS •CLINICAL STRATEGIESDESIGNEDTO TEST REFLEXES SHOULD ALLOW THERAPISTS TO PREDICT FUNCTION. •PATIENT’S MOVEMENT BEHAVIORS WOULD BE INTERPRETED IN TERMS OF THE PRESENCE OR ABSENCE OF CONTROLLINGREFLEXES. •RETRAINING MOTOR CONTROL FOR FUNCTIONAL SKILLSWOULD FOCUS ON ENHANCING OR REDUCING THE EFFECT OF VARIOUS REFLEXES DURING MOTOR TASKS.E.G FACILITATION / INHIBITION.
- 21. HIERARCHICAL THEORY •MANY RESEARCHERSHAVE CONTRIBUTED TO THE VIEW THATNERVOUS SYSTEM ISORGANIZED AS A HIERARCHY . •AMONG THEM, HUGHLINGS JACKSON, AN ENGLISH PHYSICIAN ARGUEDTHAT THE BRAIN HAS HIGHER, MIDDLE AND LOWER LEVELS OF CONTROL, EQUATED WITH HIGHER ASSOCIATION AREAS, THE MOTOR CORTEX AND THE SPINAL LEVELS OF MOTOR FUNCTION. •THE HIERARCHICAL CONTROL MODEL ISCHARACTERIZED BY ATOP-DOWN STRUCTURE, IN WHICH HIGHER CENTERS ARE ALWAYS IN CHARGE OF LOWER CENTERS.
- 22. CURRENT CONCEPTS RELATEDTO HIERARCHICAL CONTROL • THE CONCEPT OF STRICT HIERARCHY HAS BEENMODIFIED. • WITHIN THISMODIFICATION, THE ASSOCIATION CORTEX OPERATES AS THE HIGHEST LEVEL(ELABORATING PERCEPTION AND PLANNING STRATEGIES) • WHILE SENSORY-MOTOR CORTEX IN ASSOCIATION WITH THE PORTIONS OF THE BASAL GANGLIA, BRAIN STEM AND CEREBELLUM FUNCTION AS THE MIDDLE LEVEL(CONVERTING STRATEGIESINTO MOTOR PROGRAMS ANDCOMMANDS). THE SPINAL CORD FUNCTIONS AT THE LOWEST LEVEL, TRANSLATING COMMANDS INTO MUSCLE ACTIONS RESULTING IN THE EXECUTION OF MOVEMENT. • MODERN HIERARCHICAL THEORY PROPOSES THAT THE THREE LEVELS DONOT OPERATE IN A RIGID,TOP-DOWN ORDER BUT RATHER AS A FLEXIBLESYSTEM IN WHICH EACH LEVEL CAN EXERT CONTROL ON THEOTHERS. • SHIFTS IN CONTROL ARE DEPENDENT ON THE DEMANDS AND COMPLEXITY OF THE TASK WITH THE HIGHER CENTERS ALWAYS ASSUMING CONTROL.
- 23. LIMITATIONS • CANNOT EXPLAINTHE DOMINANCE OF REFLEX BEHAVIOUR IN CERTAIN SITUATIONS IN NORMAL ADULTS. E.G..STEPPING ON A PIN RESULTSIN AN IMMEDIATE WITHDRAWAL OF LEG. THISISAN EXAMPLE OF A REFLEX WITHIN THE LOWEST LEVEL OF HIERARCHY DOMINATING MOTOR FUNCTION. • LIMITATION OF HIERARCHICAL THEORY REFLEX WITHIN THE LOWEST LEVEL OF THE HIERARCHY DOMINATING MOTOR FUNCTION. (BOTTOM UP CONTROL) • ALL LOW-LEVEL BEHAVIOURS ARE PRIMITIVE, IMMATURE AND NON-ADAPTIVE, WHILE ALL HIGHER LEVEL (CORTICAL) BEHAVIOURS ARE MATURE, ADAPTIVE AND APPROPRIATE.
- 24. CLINICAL IMPLICATIONS • SIGNEBRUNNSTROM, USED A REFLEX HIERARCHICAL THEORY TO DESCRIBEDISORDERED MOVEMENT FOLLOWING A MOTORCORTEX LESION. • SHE STATED“WHEN THE INFLUENCE OF HIGHER CENTERS ISTEMPORARILY OR PERMANENTLY INTERFERED WITH THE NORMAL REFLEXESBECOME EXAGGERATED ANDSO CALLED PATHOLOGICAL REFLEXESAPPEAR”. • “THE RELEASE OF MOTOR RESPONSES INTEGRATED AT LOWER LEVELS FROM RESTRAINING INFLUENCES OF HIGHER CENTERS, ESPECIALLY THAT OF THE CORTEX LEADS TOABNORMAL POSTURAL REFLEX ACTIVITY”(BOBATH,1965;MAYSTON,1922).
- 25. MOTOR PROGRAMMING THEORIES •REFLEX THEORIES HAVE BEEN USEFUL IN EXPLAINING CERTAIN STEREOTYPED PATTERNSOF MOVEMENT. • ONE CAN REMOVE THE STIMULUS, OR THE AFFERENT INPUT AND STILL HAVE A PATTERNED MOTOR RESPONSE.(VAN SANT ,1987). • E.G GRASSHOPPER – FLIGHT DEPENDED ON RHYTHMIC PATTERN GENERATOR. EVEN WHEN SENSORY NERVES WERE CUT , THE NERVOUS SYSTEM COULD GENERATE THE OUTPUT WITH NO SENSORY INPUT – BUT WING BEAT WASSLOW
- 26. MOTOR PROGRAMMING THEORIES •CONCEPT OF CENTRAL MOTORPATTERN, IS MORE FLEXIBLETHAN THE CONCEPT OF A REFLEX BECAUSE ITCAN BE EITHERACTIVATED BY SENSORY STIMULI OR BY CENTRAL PROCESSES.THE TERM MOTOR PROGRAM MAY BE USED TO IDENTIFY ACENTRAL PATTERN GENERATOR(CPG). • CENTRAL PATTERN GENERATOR (CPG)- SPECIFICNEURAL CIRCUIT IN SPINAL CORD –NEURAL NETWORKS THAT CAN ENDOGENOUSLY (I.E.WITHOUT RHYTHMIC SENSORY OR CENTRAL INPUT) PRODUCE RHYTHMIC PATTERNED OUTPUTS OR AS NEURAL CIRCUITSTHAT GENERATE PERIODIC MOTOR COMMANDS FOR RHYTHMIC MOVEMENTS SUCH AS LOCOMOTION.
- 27. LIMITATIONS •CENTRAL MOTOR PROGRAMCANNOT BE CONSIDERED ASSOLE DETERMINANT OF ACTION. •MOTOR PROGRAM CONCEPT DOES NOT TAKEINTOACCOUNT MUSCULOSKELETAL SYSTEM AND ENVIRONMENTAL VARIABLES
- 28. CLINICAL IMPLICATIONS •IN PATIENTSWHOSE HIGHER LEVELS OF MOTOR PROGRAMMING ARE AFFECTED, MOTOR PROGRAM THEORY HELPS PATIENTS RELEARN CORRECT RULES FOR ACTION. •INTERVENTION SHOULD FOCUS ON RETRAINING MOVEMENTS IMPORTANT TO A FUNCTIONAL TASK, NOT JUST ON RE-EDUCATING SPECIFIC MUSCLES IN ISOLATION.
- 29. SYSTEMS THEORY •BERNSTEIN,1967 LOOKEDAT THE WHOLE BODY AS A MECHANICAL SYSTEM, WITH MASS AND SUBJECT TO BOTH EXTERNAL FORCES SUCH ASGRAVITY AND INTERNAL FORCES INCLUDING BOTH INERTIAL AND MOVEMENT DEPENDENT FORCES. •HE ALSO NOTED THAT WE HAVE MANY DEGREES OF FREEDOM. •HIGHER LEVELS OF THE NERVOUS SYSTEM ACTIVATE LOWER LEVELS, WHILE LOWER LEVELS ACTIVATE SYNERGIES OR GROUP OF MUSCLES THATARE CONSTRAINED TO ACT TOGETHER AS A UNIT
- 30. LIMITATIONS •SYSTEMS THEORY DOESNOT FOCUS HEAVILY ON THE INTERACTIONOF THE ORGANISM WITH THE ENVIRONMENT .
- 31. CLINICAL IMPLICATIONS •EXAMINE THECONTRIBUTION OF IMPAIRMENTS IN THE MUSCULOSKELETALAS WELL AS NEURAL SYSTEM. •INTERVENTION MUST FOCUS NOT ONLY ON THE IMPAIRMENTS WITHINTHE INDIVIDUAL SYSTEM, BUT AMONG THE MULTIPLE SYSTEMS
- 32. DYNAMIC ACTION THEORY •THE DYNAMIC ACTION THEORY APPROACH TO MOTOR CONTROL HAS BEGUN TO LOOK AT THE MOVING PERSON FROM A NEW PERSPECTIVE.(KAMM 1991,KELSO AND TULLER ,1984;KUGLERAND TURVEY1987) • THE PERSPECTIVE COMES FROM THE BROADER STUDY OF DYNAMICS AND SYNERGETIC. • “FUNDAMENTAL DYNAMIC SYSTEMSPRINCIPLE.” ITSAYSTHAT WHEN A SYSTEM OF INDIVIDUAL PARTS COME TOGETHER ,IT’S ELEMENTS BEHAVE COLLECTIVELY IN AN ORDEREDWAY . • THIS PRINCIPLE APPLIED TO MOTOR CONTROL PREDICTS THAT MOVEMENT COULD EMERGE AS ARESULT OF INTERACTING ELEMENTS WITHOUT THE NEED FOR SPECIFIC COMMANDS OR MOTOR PROGRAMS WITHIN THE NERVOUS SYSTEM. • E.G – THOUSAND MUSCLE CELLS OF HEART WORK TOGETHER AS A SINGLE UNIT – HEART BEAT
- 33. DYNAMIC ACTION THEORY •DYNAMICTHEORY STATESTHAT THE NEW MOVEMENT EMERGES DUE TO A CRITICAL CHANGE IN IN ONE OF THE SYSTEMS CALLED “CONTROLLED PARAMETER”.- A VARIABLE THAT REGULATES CHANGE IN BEHAVIOUR OF THE ENTIRE SYSTEM. •DYNAMIC ACTION THEORY HAS BEEN MODIFIED TO INCORPORATE MANY OF BERNSTEIN'S CONCEPTS ‘”DYNAMIC SYSTEM MODEL” SUGGESTS THAT MOVEMENT UNDERLYING ACTION RESULTS FROM INTERACTION OF BOTH PHYSICAL AND NEURAL COMPONENTS.
- 34. LIMITATIONS •A LIMITATION OFTHIS MODEL CAN BE THE PRESUMPTION THAT THENERVOUS SYSTEM HAS FAIRLY UNIMPORTANT ROLE AND THAT THE RELATIONSHIP BETWEEN THE PHYSICAL SYSTEM OF THE ANIMAL AND THE ENVIRONMENTIN WHICH ITOPERATES PRIMARILY DETERMINES THE ANIMAL’S BEHAVIOUR.
- 35. CLINICAL IMPLICATIONS • ONEOF THE MAJOR IMPLICATION OF THE DYNAMIC ACTION THEORYISMOVEMENT ISAN EMERGENTPROPERTY . • ITEMERGES FROM THE INTERACTION MULTIPLE ELEMENTS THAT SELF ORGANIZE BASED ON CERTAIN DYNAMIC PROPERTIES OF THE ELEMENTSTHEMSELVES. • MOVEMENT BEHAVIOUR CAN OFTEN BE EXPLAINED IN TERMS OF PHYSICAL PRINCIPLES RATHER THAN IN TERMS OF NEURAL STRUCTURES • CAN MAKE USE IN HELPING PATIENTSTO REGAIN MOTOR CONTROL
- 36. ECOLOGICAL THEORY • IN1960S,JAMESGIBSON EXPLORES THE WAY IN WHICH OUR MOTOR SYSTEMS ALLOW US TO INTERACT MOST EFFECTIVELY WITH THE ENVIRONMENT TO PERFORM GOAL-ORIENTEDBEHAVIOR. • ACTIONS REQUIRE PERCEPTUAL INFORMATION THAT ISSPECIFIC TO A DESIRED GOAL-DIRECTED ACTION PERFORMED WITHIN A SPECIFICENVIRONMENT . • PERCEPTION FOCUSES ON DETECTING INFORMATION IN THE ENVIRONMENT THAT WILL SUPPORTTHE ACTIONS NECESSARY TO ACHIEVE THE GOAL. • ECOLOGICAL PERSPECTIVE HAS BROADENED OUR UNDERSTANDING OF NERVOUS SYSTEMFUNCTION FROM THAT OF SENSORY/MOTOR SYSTEM ,REACTION TO ENVIRONMENTAL VARIABLES TO THAT OF PERCEPTION /ACTION SYSTEM THAT ACTIVELY EXPLORES THE ENVIRONMENT TO SATISFYITSOWN GOAL.
- 37. LIMITATIONS •GIVE LESSEMPHASIS TOTHE ORGANIZATION AND FUNCTION OF THE NERVOUS SYSTEM THAT HAS LED TO THISINTERACTION, MORE ON ORGANISM/ENVIRONMENT INTERFACE
- 38. CLINICAL IMPLICATIONS • AMAJOR CONTRIBUTION OF THISVIEW ISIN DESCRIBING THE INDIVIDUAL AS AN ACTIVE EXPLORER TO THE ENVIRONMENT . • AN IMPORTANT PART OF INTERVENTION ISHELPING THE PATIENT EXPOLRE THE POSSIBILITIES FOR ACHIEVING A FUNCTIONAL TASKIN MULTIPLEWAYS • THE ABILITY TO DEVELOP MULTIPLE ADAPTIVE SOLUTIONS TO ACCOMPLISH A TASKAND DISCOVER THE BEST SOLUTION FOR THEM, GIVEN THE PATIENTS SETOF LIMITATIONS.
- 39. WHICH IS THEBEST THEORY OF MOTOR CONTROL •THE BEST AND MOST COMPLETE THEORY OFMOTOR CONTROL, THE ONE THAT REALLY PREDICTS THE NATURE AND CAUSE OF MOVEMENT ANDIS CONSISTENT WITH OUR CURRENT KNOWLEDGE OF BRAIN ANATOMY AND PHYSIOLOGY? •THERE ISNO ONE THEORY THAT HAS ITALL •BEST THEORY-THAT COMBINES ELEMENTS FROM ALL THE THEORIES PRESENTED
- 40. NEUROLOGIC REHABILITATION: REFLEXBASED NEUROFACILITATION APPROACHES • NEUROFACILITATION APPROACHES INCLUDE BOBATH(KARL AND BERTA BOBATH,1965),THE ROOD APPROACH(MARGARET ROOD,1967),BRUNNSTROM APPROACH(SIGNE BRUNNSTROM,1966) ,PNF(VOSS,1985),SENSORY INTEGRATION THERAPY(JEAN AYRES,1972). • THESE WERE BASED ON ASSUMPTIONS DRAWN FROM BOTH THE REFLEX ANDHIERARCHICAL THEORIES OF MOTOR CONTROL. • THEY FOCUS ON RETRAINING MOTOR CONTROL THROUGH TECHNIQUES DESIGNED TO FACILITATEAND/OR TO INHIBIT DIFFERENT MOTOR PATTERNS
- 41. CLINICAL IMPLICATIONS • EXAMINATIONOF MOTOR CONTROL SHOULD FOCUS ON IDENTIFYING THE PRESENCE OR ABSENCE OF NORMAL AND ABNORMAL REFLEXES CONTROLLING MOVEMENT. • INTERVENTIONS SHOULD BE DIRECTED AT MODIFYING THE REFEXESTHAT CONTROL MOVEMENT • THE IMPORTANCE FOR SENSORY INPUT FOR STIMULATING NORMAL MOTOROUTPUT SUGGESTSAN INTERVENTION FOCUS OF MODIFYING THE CNS THROUGH SENSORY STIMULATION
- 42. TASK-ORIENTED APPROACH • BASEDON NEWER THEORIES OF MOTORCONTROL • ITISASSUMED THAT THE NORMAL MOVEMENT EMERGES AS AN INTERACTIONAMONG MANY SYSTEMS. • MOVEMENT ISORGANIZED AROUND A BEHAVIORAL GOAL AND ISCONSTRAINED BYTHE ENVIRONMENT . • CLINICAL IMPLICATION - TASKORIENTED APPROACH TO INTERVENTION ASSUMESTHAT PATIENTSLEARN BY ACTIVELY ATTEMPTING TO SOLVE THE PROBLEMS INHERENT IN A FUNCTIONAL TASKRATHER THAN REPETITIVELYPRACTICING NORMAL PATTERNS OF MOVEMENT