Motor Control Motor Learning

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Application of Motor Control/

Motor Learning to Practice


Children with motor control deficits have difficulty in
performing childhood occupations and may not have the
same opportunities to explore their surroundings; they may
take longer and often do not master movements.

Because motor control is central to participation, occupational


therapists are concerned with how to help children control
movements so that they may engage in their occupations.
Motor Control
• The “ability to regulate or direct the mechanisms
essential to movement”

• refers to how the central nervous system organizes


movement, how we quantify movement, and the nature
of movement.
Dynamical Systems Theory
Dynamical systems theory suggests that
movement is dependent on task
characteristics and an interaction among
cognitive, neuromusculoskeletal, sensory,
perceptual, socio-emotional, and
environmental systems

Dysfunction occurs when there is a lack of


flexibility or adaptability of movements to
accommodate task demands and
environmental constraints.
Dynamical Systems Theory
PRINCIPLES:

 Whole-Learning
 Variability
 Problem-Solving
 Meaning
Synthesis
• Individual, 1 whole paper

• Develop a matrix of the 4 principles, and rationalize how can


it be applicable to the case.

Principle Discussion OT Role Case Application


CASE
Jensen is a 7-year-old boy who manifests a mixed presentation
of cerebral palsy. He is ambulatory with an ataxic gait. He also
has mild spasticity on bilateral UEs. Child presents with
difficulties in self-feeding, dressing, and playing his favorite play
activities such as basketball, building Lego towers, and
pretending to be Ryder from the show Paw Patrol.
Principle 1: Whole-Learning

Learning the whole motor task is more effective


and motivating than learning only a part of the
movement.

More areas of the brain are activated.


Principle 2: Variability

Movement occurs in a variety of settings and requires that


children adapt to environmental changes or internal
changes.

Functional movement, the goal of motor control intervention,


requires that children possess a variety of motor skills.
Principle 3: Problem-Solving

Children learn and retain motor skills more from intrinsically


problem-solving a motor action than from receiving external
feedback during an action.

Self-correcting enables children to rely on internal cues that


indicate the effectiveness of movement and thereby help
them adapt and modify movements in a variety of contexts
Principle 4: Meaning

A child’s participation in motor tasks is influenced by


the extent to which he can identify his own interests and
goals and believes he will be effective in those motor
tasks.

Participate for longer periods of time and perform more


repetitions when activities are meaningful.
DEVELOPMENT OF MOTOR CONTROL

COGNITIVE
Cognition

ASSOCIATIVE
Perception

AUTONOMOUS
Action
COGNITIVE

• Skill acquisition stage


• The learner practices new
movements
• Errors are common, and
movements are inefficient
and inconsistent.
• Learners need frequent
repetition and feedback.
ASSOCIATIVE

• Skill refinement
• Increased performance,
decreased errors
• Increased consistency and
efficiency.
• Learner relates past
experiences to the present,
thereby “associating”
movements
AUTONOMOUS

• Learner retains the skills


• Learner can perform the
movement functionally
• Skills are transferred easily to
different settings and refined
FACTORS AFFECTING MOTOR PERFORMANCE
Social-Emotional Factors Physical Factors
• Range of motion

• Muscle tone
– Hypertonicity
– Hypotonicity

• Strength
DEVELOPMENT OF MOTOR CONTROL
Refers to intent or the child’s
motivation to move, and also
to the ability to plan the
movement

Refers to how the individual


receives and makes sense of a
stimulus

Includes muscle contractions,


patterns, and precision and
nature of the movement
BALANCE
BALANCE
• For children to carry out skillful, coordinated, and effective
movements, whether they are fine motor or gross motor actions, they
must have an adequate foundation of balance and postural control.

• Posture is defined as the alignment of body parts and involves the


relationships among various segments of the body.

• Balance has to do with overall body equilibrium or stability.


Biomechanically, it is described as the maintenance of the center of
mass over the base of support.
The postural control system maintains the body’s stability by maintaining:

(1) the body in a stationary position when necessary

(2) balance when changing from one discrete position to another

(3) equilibrium while the body is in continuous motion


Sensory Organization
Vestibular System
Provides critical input regarding head position,
body orientation, balance, and equilibrium

- Is the head in upright, midline alignment?


- If not, is it forward, backward, to the side?
- Is the head moving?
- How fast is the head moving and in what
direction?
Proprioceptive/Somatosensory Systems
Children use proprioceptive information to
detect body position, determine stability, and
maintain posture and balance

– What is the position of the body?


– How are body parts aligned?
– Which joints are stationary/which are moving?
– If joint positions are changing, how fast and in what
direction (e.g., flexion, extension, rotation) are they
moving?
Visual System
Monitoring system that tracks a variety of aspects of information integral to
maintaining balance and postural control
- What are the primary features of the environment?
- What is present in the environment (objects, people)?
- Are these objects/people moving or stationary?
- Where are the objects/people in the environment in relation to
each other?
- Where are the objects in relation to the child?
- Self-motion: is the body stationary or moving?
- Speed and direction of body movement
- Verticality of the body: where is the head/body in relation to
gravity?
- Is this changing or constant?
Intersensory Function
• It is well known that the sensory systems do not work in isolation of each
other; rather they work in tandem and share information that is needed to
detect instability and help correct that instability
• Three conditions reveal how intersensory functions contribute to balance
control:
(1) Redundancy of information
(2) Removal or substitution of sensory information, a condition in which one or
more of the three inputs is missing or degraded;
(3) Sensory conflict, a condition in which input from any one of the three sensory
systems is in conflict with other inputs
Motor Coordination Aspects of
Posture/Balance Control

Postural Reflexes

Postural Synergies

Integrative Responses
Group Task Time! 

Form a small groups discuss with each other


the 3 postural strategies
Balance Control Issues in Children with
Developmental Coordination Disorder
Evidence suggests that many children,
including those with DCD, have deficits
not in any one sensory system but in
sensory organization (i.e., integration of
visual, proprioceptive and/or vestibular
inputs).

For that reason, many young children, in


particular children with DCD, tend to rely
more on vision than proprioception for
balance control.
Improving Balance: Intervention

Occupational therapy practitioners


help children perform a variety of
daily living activities, play, and
academic activities, all of which
require balance
Improving Balance: Intervention
PRIMARY COMPONENTS SECONDARY COMPONENTS

Body Movement Position of the Body

Use of Vision Internal Base of Support

External Base of Support Elevation


Body Movement

It is important to provide opportunities to develop control under


conditions where the body remains stationary and where the body
is moving or changing positions.
Use of Vision

It is important to provide opportunities to


practice balance under a variety of visual
conditions.
External Base of Support

• Wide to narrow
• Rigid to compliant
• Stable to unstable
• Flat to tilted or inclined
Position of the Body

OT practitioners modify the position in which the child balances to


challenge stability and improve balance control whether the child is
stationary or moving through space.
Internal Base of Support

Involves varying the


nature and number of
body parts used to
maintain balance.
Elevation

Structuring the environment so that the element of height is added.

Children tend to perceive a greater risk or challenge to balance with elevation


than when they balance on the ground.
Assessment of Balance
Non-standing balance
Assessment of Balance
Stationary and Moving Upright balance
Body Schema
• The neural substrate for body awareness
• The child’s own body representations
• Becomes defined through sensory input from receptors in
the skin, muscles, tendons, joints, and the vestibular system,
which act to define the boundaries of the limb(s) in the body
schema
• Children develop body schema through active use of the
body. Adequate planning of action is based, in part, on the
fullness of the body schema
Body Image

Refers to the image one has of


oneself as a physical entity

It includes the perception that one


has of the body’s physical or
structural and physical performance
abilities.
Body Awareness
It involves the conscious awareness
of the location, position, and
movement of the body and its parts,
as well as the relationship between
the body and the external
environment.
MOTOR LEARNING
Motor learning refers to the acquisition or modification of motor skills.
– Transfer of learning
– Sequencing tasks
– Adapting tasks
– Type and amount of practice
– Error-based learning
– Timing
– Feedback
– Mental rehearsal
Transfer of Learning
• Generalization
• Refers to applying learning to new
situations
• The goal of occupational therapy
intervention is that the child transfer
learning performed in the clinic or
intervention setting to the natural
context.
Sequencing and Adapting Tasks
Practice Levels and Types
Massed (blocked) practice – the
period performing the movement is
greater than the rest period.

Distributed practice – rest


between trials is greater than the
time of the trial
Practice Levels and Types
Variable (random) practice
- requires that learners repeat the same patterns but make
small changes as necessary
- this type of practice increases the ability to adapt and
generalize learning.
Practice Levels and Types
Mental Practice
- includes performing the skill in the
imagination, without any action
involved
- role playing, watching a video, or
imagining.
- effective in teaching motor skills and
re-training the timing and
coordination of muscle group activity
Error-Based Learning
Children learn movement by making
errors or mistakes and self-correcting.

Clinicians must sometimes allow the


challenge to exceed the capacity of the
child so that he or she is given the
opportunity to make errors, correct them,
and learn from the experience.
Feedback
• Intrinsic feedback
• Extrinsic feedback
• Demonstrative feedback
• Knowledge of performance (KP)
• Knowledge of results (KR)
• Verbal feedback
End!

Chapter exam next week.

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