PTA 208 Motor Control and Motor Learning

- The ability to maintain and change posture and movement- Is the result of a complex set of mechanical and neurological processes- Resulting from motor, cognitive, and perceptual development

Cortex (protective & equlibrium reactions)Midbrain (quadruped activities & righting reactions)Brain stem (Postural tonic reflexes)Spinal cord (Phasic primitive reflexes)

- Initiation of movement, random movements within available ROM for the 1st 3 months of development - movement at this stage are erratic, lack purpose and are often reflex based.-

- Ability to maintain a steady antigravity posture also static postural control- Tonic hold, prone extension - (swimmers pose)- co-contraction, postural holding of the head progression

- Wgt shifting within a posture, righting reactions- Proximal stability is combined with distal mobility-the limbs are wgt bearing and the body move such as wgt shifting on all fours or in standing

Ability to manipulate the environment- Locomotion, creeping & walking reciprocally is a skilled movement- Selective voluntary movement

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-LOS - limits of stability are the boundaries of the BOS of any given posture.-Environmental adaption - our posture adapts to the environment in which the movement takes place in.-Musculoskeletal system provides the mechanical structure for any postural response, Neurologic system processes vital sensory info to choose the correct postural and motor response.

-Predictive central set - Postural readiness-Motor coordination - ability to sequence muscle responses in a timely fashion to respond to displacements of COG & BOS-Eye-head stabilization - visual & vestibular systems work together for accurate info of the environment-Sensory organization - visual, vestibular & somatosensory

- Cognitive phase: New to learner, understanding task - What to do- Associative: PhasePractice movement, errors decre spatial/temoral, more proprioceptive- Autonomous: Refined movement, requires little thought "How sweet to succeed"

this phase is associated with the close loop model of control because sensory input is used by the nervous system to learn about moving and about desired movement. The learner must understand "what to do".

Success comes with practice and the ability of the person to detect errors and to correct them. Focus of the learner is on "How to do" the task. Very dependent on the closed loop model.

Once the task is mastered it can be carried out with little attention to the details. This is an example of open feedback model...in which once the action is started it is completed w/o conscious feedback.

- Task oriented - componet- Augmented feedback- Facilitation - demonstration, muscle facilitation- Encouragement and motiviation- Manual guidance...active movement- Low effort- Part to whole task

- Frequent practice- ID only consistent error- Fade demonstration, less and less as practice improves- Major task elements, more whole task less partial task- Proprioceptive feedback - "feel"-Fade feedback, self correction

- Vary the environmental context- Use distractorsextraneous conversationsimultaneous activities

- Varying the practice setting and environment to facilitate earning of the motor skill- Practice the tasks randomly- Provide feedback on the desires outcome of the task after the pt has completed the task, incorporation biofeedback- Practice the whole task and incorporate part-task activities as needed

4 months

6 to 8 months

8 months

9 months

10 months

12 months

Birth

5 months

6 months

7 months

9 months

9 - 12 months

12 months

12 months

- Makes jerky, quivering arm thrust- Brings hands within range of eyes and mouth- Moves head from side to side while lying on stomach- Head flops backward if unsupported- Keeps hands in tight fists- Strong reflex movements

- Raises head and chest when lying on stomach- Supports upper body with arms when lying on the stomach- Stretches legs out and kicks when lying on stomach or back- Opens and shuts hands- Pushes down on his legs when his feet are placed on a firm surface- Brings hand to mouth- Takes swipes at dangling objects with hands- Grasps and shakes hand toys

- hold head steady when sitting with your help- reach for and grasp objects- play with his toes- help hold the bottle during feeding- explore by mouthing and banging objects- move toys from one hand to another- shake a rattle- pull up to a sitting position on her own if you grasp her hands- sit with only a little support- sit in a high chair- roll over

- Rolls both ways (frt to bk, bk to frt)- Sits with, and then w/o, support of her hands- Supports her whole wgt on her legs- Reaches with one hand- Transfers object from hand to hand- Uses raking grasp (not pincer)

- Sitting- Can move from side lying to siting- May begin to belly crawl

- Reaches sitting position w/o assistance- Crawls fwd on belly

- Walks alone- Pulls toys behind her whiile walking- Carries large toy or several toys while walking- Begins to run- Stands on tiptoe- Kicks a ball- Climbs onto and down from furniture unassisted- Walks up and down stairs holding on to support

- Scribbles spontaneously- Turns over container to pour out contents- Builds tower of four blocks or more- Might use one hand more frequently than the other

- Climbs well- Walks up and down stairs, alternating feet- Kicks ball- Runs easily- Pedals tricycle- Bends over easily w/o falling- Climbs ladders; uses slide independently

- Makes vertical, horizontal and circular strokes with pencil or crayon- Turns book pages one at a time- Builds a tower of more than six blocks- Holds a pencil in writing position- Screws and unscrews jar lids, nuts and bolts- turns rotating handles- assembles simple puzzles- Manipulates clay; finger points

- Hops and stands on one foot up to five seconds- Goes upstairs and downstairs w/o support- Kicks ball fwd- Throws ball overhand- Catches bounced ball most of the time- Moves fwd and backward with agility- Turns somersaults; gallops- Can easily catch, throw, and bounce a ball- Can brush teeth, comb hair, wash, and dress with little assistance

- Copies square shapes- Draws a person with two to four body parts- Uses scissors, cuts on a line- Draws circles and squares- Begins to copy some capital letters

- Stands on one foot for 10 or longer- Hops, somersaults- Swings, climbs- May be able to skip- Walks on balance beam- Skates, jumps rope

- Hand preference established- Copies triangle and other geometric patterns- Draws person with body- Prints some letters- Dresses and undresses w/o assistance- Uses fork, spoon and somtimes a table knife- Usually cares for own toilet needs