Download - PNF and Motor control/Motor learning Theory
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How to apply Motor control/ learning theory in daily practice with PNF concept.
PNF andMotor control/Motor learning Theory
Beata Wnuk; Poland
Shingo Toda; Japan
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Goal of this presentation
- PNF is not just facilitation method (changes in the concept)
- Motor control/Motor learning is one of the science area, it is not treatment approach
- How to apply science into clinical practice?(Theoretical basis for PNF approach)
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What is the motor control
The term motor control refers to the study of posture and movement as well as the functions of the mind and body, which directs the posture and movement.
(Shumway – Cook, 1995)
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What is the motor control
In studies on the nature and causes of movement we are talking about two problems - first, to stabilize the body in space, motor control of posture and balance, second -movement of the body in space-motor control on the movement
(Shumway – Cook, 1995)
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Models of motor control
etc.
Reflex
Hierarchical
Motor programming(CPG)
Systems
Ekological
Dynamical action
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●Muscle reeducation
●Facilitation (reflex, hierarchical)
●Goal oriented (reflex, hierarchical, systems)
Different terapeutical approaches based on different models of motor control:
Models of motor control
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Systems approach
Movement is not the result of muscle – specific
motor programs, or stereotyped reflexes, but result
from dynamic interplay between perception,
cognition, and action systems
(Shumway-cook,
Woollacott)
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Goal oriented model
Control of the movement is organized around goal oriented functional behaviors, not just muscles and movement patterns. F. Horak 1991
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Nature of movement
Task
EnvironmentIndividual
Movement
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Factors affecting the organization of movement
T
EI
Mobility
Stability manipulationCognition
(ex:positiveapproach)
Perception
(ex: sumation
of stimuli)
Action(ex: mat activities)
Regulatory
(ex: size,
shape of the cup)
Nonregulatory
(ex: noise)
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Movement? Postual control?
We need to work with patients to improve
the movement for daily activities.
Patients need postural control for movement.
We can work acording to the stages of motor control
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The stage of motor control
Mobility
Stability
Controlled mobility/Mobility on Stability
Skill
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Mobility
Global, uncoordinated, aimless movements, poor antigravity work -newborn
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Stability
In between 8 and 10 month the child is able to sit independently, on the beginning upper limbs have a support function (stabilization) but when the trunk postural control became better they are free for movement
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Mobility on stability
Stable sitting allows to free upper limbs for movement and development of manual skills.
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Skill
Total automatisation of sitting and multitasking.
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The stage of motor control
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How to apply?
Mobility
Stability
Controlled mobility/Mobility on Stability
Skill
Basic principlesBasic proceduresTechniques
+
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Basic principles and procedures Techniques
MobilityTactile/Auditory-Verbal/Visual StimuliResistance ,Traction , Irradiation,Elongation , pattern…
Contract/Hold-relaxRe-stretch through range,Dynamic revesals…
StabilityTactile/Auditory-Verbal/Visual StimuliResistance, Approximation ,Bodymechanics , reinforcement…
Combination of IsotonicsStabilizing reversalsRhythmic reversals …
Controlled mobility
/Mobility on Stability
Tactile/Auditory-Verbal/Visual StimuliResistance, Approximation,Timing ….
Combination of IsotonicsDynamic revesals …
SkillTactile/Auditory-Verbal/Visual StimuliResistance ,Timing for emphasis
Re-stretch through rangeCombination of IsotonicsReplication…
Basic principles and procedures Techniques
MobilityTraction Irradiation
Contract/Hold-relax
StabilityResistanceApproximation
Stabilizing reversalsRhythmic reversals …
Controlled mobility
/Mobility on Stability
ApproximationNormal timing
Combination of Isotonics
Skill Timing for emphasisRe-stretch through rangeRhythmic Initiation
Stage of motor control with PNF concept
This ideas are so useful to find the problem or make a hypothesis!
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limitation of the active ROM of shoulderless coordination with scapula and upper extremityless external rotation of Glenohumeral jointtoo much side bending of trunk…
Example: Shoulder problem
How to treat this case in each stage of motor control?
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Mobility
Hook lying/Bridging Lower trunk rotationWithdrawal from radial thrust
Indirect treatment
direct treatment
U/E pattern Hold-relax, contract-relax , Dynamic reversals
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Stability
sittingquadraped
standing
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Controlled mobility /Mobility on Stability
quadraped standing
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Skill
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Which phase of motor control ?
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Which phase of motor control ?
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Stages of motor learning (Fitts&Posner,1967)
CognitiveWhat to do in the task/understanding the task
AssociativeMore “how to do” the task then “what to do” / searching for performance
Autonomousmotor skill mostly automatic, perform the skill in any environment with very little cognitive involvement
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Stages of motor learning
Video
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Principles of motor learning for PT
Fundumental to motor learning is practice.
Motor learning is not a passive imprinting process; it requires active participation.
The Law of effect is based on meaningful goals.
• Winstein, CJ 1999
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Elements of Motor learning
Practice
Active participation
Meaningful goals
Feedback
Activity/tasks
Environment
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What is good?・More meaningful・Motivation・Goal
Task is able to change the pattern of movement.
Task oriented treatment!
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Patients need ability of postural control
Control is over tasks, goals or behavior rather than muscles or movement patterns.
The tasks mobilize patient’s reserves!
The task is able to …
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Task for motor learning!
Age:90 female Stroke :Right hemi on set: March 2014
Goal: live in home by herself independently
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Task oriented treatmentwith PNF concept
Exercise Task Task + PNF
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Task oriented treatmentwith PNF concept
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Task oriented treatmentwith PNF concept
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Task oriented treatmentwith PNF concept
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Summary
・ With PNF we can influence all component
of movement control
・ In PNF approach we use the principles of
motor control and motor learning
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THANK YOU FOR YOUR ATTENTION!