Auditory, Visio
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Transcript of Auditory, Visio
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Vision , Auditory, SpeechEpilepsy, Mental Retardation
Learning DisabilitiesChildren
with
CerebralPalsy
Movement
PosturePoor Sensorimotor Experiences
Poor Perceptual motor ProcessingVision, Auditory, Hand,
Oromotor, Breathing, Speech
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MOVEMENT
AROUSAL
ATTENTION
AWAKENESS
MOTIVATION SAFETY
SENSORY
=INFORMATION
=VISION, AUDITORY
TACTILE, CUTANEOUS
PROPRIOCEPTIVE
PERCEPTUAL
COGNITIVE PROCESS
FEEDBACKFEEDFORWARD
BIOMECHANICALIGNMENT/MIDLINEBODY SCHEME
MUSCLE PROPERTIES
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PERCEPTUAL - MOTOR INTEGRATIONMODEL
INPUT PROCESSINGORGANISATION
MEMORY
EXPERIENCES (past / present)
INTERPRETATION
OUTPUT
Cognitive
processing
Taking in
information
from senses :
- internal
- external
Planning &
executing a
response :
- motor
- behaviour
FEEDBACK / FEEDFORWARDcritical to learning & adaption of new experiences
reinforces observable behaviour
provides new input
internal / external
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MEMORIES OF MOVEMENT
PERCEPTUAL
COGNITIVE PROCESS
SENSORIMOTOR EXPERIENCES
FEEDBACK-FEEDFORWARD CHANNEL
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PERCEPTUAL PROCESS
BODY AWARENESS
IMAGE, CONCEPT,SCHEME
ALIGNMENT, MIDLINE, LATERALITY
WEIGHT BEARING, SHIFTINGMOBILE WEIGHT BEARING, GRADING
BASE OF SUPPORT
PERCEIVE OURSELVES AS THREEDIMENSIONAL INDIVIDUALS
ALLOWS US TO DEVELOP SENSE OFMIDDLE/MIDLINE AND AWARENESS OF TOP-
BOTTOM-FRONT-BACK-SIDES
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Fig. 2. 4 Cartoon summary highlighting the motivationalfunction of the limbic system in motor control. Direct
and indirect connections indicated as heavyand lightarrows. Feedforward connections (A) and feedbackbetween equivalent system in (B).
EMOTIVE COGNITIVE
A
B
LIMBIC
SYSTEM
ASSOCIATION
SYSTEM
PROJECTION
SYSTEM
SPINAL
SYSTEM
SKELETAL MUSCULAR
SYSTEM
DEMANDS
(FILL
MY NEEDS!)
SELECTS
(TAKE
THISRECUTE!)
GUIDES
(DO IT THIS
WAY.NOW!)
EXECUTES
(DO IT!)
MOVES
(DOING IT!)
HIGHEST
LEVEL
MIDDLE
LEVEL
LOWEST
LEVEL
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* The Materialization of genetic information
= Feedforward
* Changing (learning) = Feedback
Functional property of Brain
Adaptation to the Environment
Functional Plasticity of the Brain
ex) # Movement of NeonatesAdaptation to environmental changes
antigravity
Righting, Equilibrium
learning of Body image
* Developmental process of the Brain
Hereditary factor
Environmental factor
Reciprocal exchange
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TONE INFLENCE PATTERN
NEURAL FACTOR
AROUSAL , PROPRIOCEPTIVE REFLEX,CUTANEOUS REFLEX,
FEEDBACK, FEEDFORWARD
PERCEPTION, COGNITION
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TONE INFLUENCE PATTERN
NONE NEURAL FACTORS
BIOMECHANICS
MUSCLE PROPERTIES
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Level of Arousal
Proprioceptive reflex &
cutaneous reflexFeedforward
Cognition
& PerceptionNormal Tone
Stability & Mobility
Muscle PropertiesFeedbackward
Biomechanics
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Abnormal tone
Abnormal pattern of movement/posture
TIPs
Tone(non neural)Tone(neural)
Biomechanical alignmentProprioceptive reflexes Cutaneous reflexes
More efficient
Force production
Feedback/feedforward mechanism
More normal postural tone
More efficient and effective control of posture and
movement for function
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NONE NEURAL FACTORS
1. VISCO-ELASTIC PROPERTIES1)Elasticity: the lengthHow extensible are the muscle fibers ?
2) Viscosity: the VelosityHow quickly can the length of the musclebe extended ?
3) Plasticity : the Time
How long does it take to return ?4) Contracture: shrtenning, reduced number ofsarcomeres in reduced for force output
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NONE NEURAL FACTORS
2. Muscle fiber properties
Type I slowType II fast
Most of muscles have a mixture of flbertypes ; slow, fast, intermediate
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MORPHOMETRIC ANALYSIS OFNORMAL SKELETAL MUSCLE
INFANCY, CHILDHOOD,ADLOLSCENE AUTOPSY STUDY DELTOID AND LATERAL VASTUS 113 BABY AFTER BIRTH 40% TYPE 1 FIBER
2 POSTNATAL YEARS 60%* MEAN DIAMETER OF MUSCLE FIBER
BIRTH : 10-12 MICRON15-20 YRS : 40-60 MICRON
TYPE 2 FIBER /MALE : 15-20YRS; THICKER THAN TYPE 1 FIBER TYPE 2 FIBER /FEMALE: SMALLER THAN TYPE 1 FIBER
BEFORE 15YRS: NO DIFFERENCES : MALE AND FEMALETYPE 1 FIBER WERE USUALLY THICKER THAN TYPE 2 FIBER
JOURNAL NEUROLOGY SCI 1988 DEC.
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GROWTH AND DEVELOPMENT OFHUMAN MUSCLES
VASTUS LATERALIS
PROPORTION OF TYPE 2 FIBERS INCREASESSIGNIFICANTLY 5 T0 20 YEARS OLD
5 YRS( 35%), 20YRS(50%) TOTAL NUMBER OF FIBER
MOST LIKELY CAUSED BYTRANSFORMATION OF TYPE 1 TO TYPE 2
FIBERS
MUSCLE NERVE 1992 MAR.
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NONE NEURAL FACTORS
Classic length- tension curve
Maximum tension around its mid-length
- shortened, lengthened muscle- Hypertonia, Hypotonia
- cant produce adequate tension
and force to produce an efficientmovement
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BASED ON CLINICAL PRACTICE AND EMERGING THEORIES
Normal postural control mechanism
1. Normal postural tone
2. All degree of reciprocal innervation
3. All patterns of movement
THEORY
1. Tone = neural and nonneural
2. Dynamic interacting systems
3. Motor control theories :
feedback and feedforward
4. Central and peripheral mechanism
5. Changed clinical picture
P
RE
P
A
R
A
T
I
O
N
FOR
FUNCTION
Sensation
Perception
Cognition
Aims of management
1. Increase skill repertoire
2. Maintain functional level
3. General management
TEAMWORKT.I.P.S
Tone reduction : neural and non-neuralfactors
Inhibition-Facilitation-stimulation
Balance reaction as part of task goal
Essential elements for function
: problem solving
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* Artificial intervention =
We should realize system of the Brain
(Inhibitory Mechanism)
* Change Intentional signal of CNS
Environment / Adaptation
Biological property of neuron network
Activated by specific input
Preparation of building up the new
neuron synapsis as a human being