Maturation of the CNS, particularly the motor cortex.
Movement that occurs in the absence of sensory input
Voluntary movement
Fast movement
Ability to over-ride the reflex response
<p><u>Maturation</u> of the CNS, particularly the motor cortex.</p>
<ul class="tight" data-tight="true"><li><p>Movement that occurs in the absence of sensory input</p></li><li><p>Voluntary movement</p></li><li><p>Fast movement </p></li><li><p>Ability to over-ride the reflex response</p></li></ul><p></p>
<p>A 'phase shift' occurs and a new movement emerges.</p>
<ol class="tight" data-tight="true"><li><p>Cortex </p></li><li><p>Subcortical </p></li><li><p>Brainstem </p></li><li><p>Spinal cord</p></li></ol><p></p>
<ul class="tight" data-tight="true"><li><p> <strong>internal:</strong></p><ul class="tight" data-tight="true"><li><p>musculoskeletal, cardiovascular, pulmonary, nervous systems </p></li></ul></li><li><p><strong>external:</strong></p><ul class="tight" data-tight="true"><li><p>environment or task</p></li></ul></li></ul><p></p>
<p>To accommodate in the womb (~full-term baby length: 50 cm).</p>
<p>weight of limb → cessation of stepping reflex → voluntary walking starts</p>
<ul class="tight" data-tight="true"><li><p>Inherent in developing subsystems </p></li><li><p>Applicable to both typically and atypically developed populations</p></li></ul><p></p>
<ul class="tight" data-tight="true"><li><p>Division: higher, middle, and lower centres </p></li><li><p>Top-down system </p><ul class="tight" data-tight="true"><li><p>Highest-level reflexive responses exert dominance over lower-level reflexive responses</p></li></ul></li></ul><p></p>
<p>log rolling → segmental rolling</p>
<p>Selective joint movements. </p>
<ul class="tight" data-tight="true"><li><p>Some abnormal movement patterns are due to secondary problems (contractures) or behavioral issues (compensation)</p></li><li><p>Cannot explain the dominance of reflex behaviour in certain situations in normal adults. </p></li></ul><p></p>
<p>It suggests that factors other than neural maturation (eg: biomechanical & environmental factors) play a role in motor development.</p>
<ul class="tight" data-tight="true"><li><p>Development of rotational component</p></li><li><p>Development of intralimb dissociation</p></li><li><p>Development of interlimb dissociation</p></li></ul><p></p>
<p>They guide how therapists treat patients with <u>neurological disorders</u>.</p>
<ol class="tight" data-tight="true"><li><p>Disappearance of stepping reflex by the end of 3 months normally.</p></li><li><p>Disappearance of stepping if the limb is weighted. </p></li><li><p>Stepping response re-appears when the body is submerged into water at an older age. </p></li></ol><p></p>
<ol class="tight" data-tight="true"><li><p><strong>Initial Stage:</strong> sitting</p></li><li><p><strong>Intermediate Stage:</strong> Weight-shift in the frontal/sagittal plane</p></li><li><p><strong>Final Stage:</strong> Rotation of the trunk</p><p></p></li></ol><p></p>
<p><em>Neuromaturational theory (aspect 1):</em></p><ul class="tight" data-tight="true"><li><p>sequence of (voluntary) motor development = sequence of CNS maturation process</p><ul class="tight" data-tight="true"><li><p>cephalocaudal progression</p></li><li><p>same among infants</p></li></ul></li><li><p>CNS maturation is the PRIMARY agent for change in development</p></li></ul><p></p>
It allows a child to develop his/her potential.
<ul class="tight" data-tight="true"><li><p>Reflex theory</p></li><li><p>(Reflex/) Hierarchical theory</p></li><li><p>Dynamic systems theory</p></li></ul><p></p>
Because movements occur too rapidly to allow for sensory feedback from the preceding movement to trigger the next.
<ul class="tight" data-tight="true"><li><p>Balance control</p></li><li><p>Moving the body</p></li></ul><p></p>
<p><em>Improve/ Stimulate:</em></p><ul class="tight" data-tight="true"><li><p>Help the brain better (re)organize</p></li><li><p>Facilitate normal movement patterns</p></li></ul><p><em>Reduce/ Inhibit:</em></p><ul class="tight" data-tight="true"><li><p> Reduce/inhibit abnormal patterns, primitive reflexes, or spasticity </p></li></ul><p></p>
<ul class="tight" data-tight="true"><li><p>Reflexes are the building blocks of complex behaviors.</p></li><li><p>Reflexes work together/ in sequence <u>[reflex chaining]</u> to achieve a common purpose.</p></li></ul><p></p>
<h3>Goal Setting</h3><ul class="tight" data-tight="true"><li><p>set a functional goal</p></li><li><p>work on identifiable functional tasks, NOT movement patterns alone</p></li></ul><h3>Adaptation and Practice</h3><ul class="tight" data-tight="true"><li><p>adaptation to changes in environment: practice in a variety of contexts (e.g., walking)</p></li><li><p>practice→experience→environment</p></li></ul><p></p>
<ul class="tight" data-tight="true"><li><p>At birth, higher levels are not functioning and reflexive movements are mediated by lower centers of the CNS. </p></li><li><p>Primitive reflexes from the lower levels are inhibited by the higher levels before voluntary movements are developed. </p></li></ul><p></p>
Each level of the brain is correlated to a specific anatomic region.
<ol class="tight" data-tight="true"><li><p>Movement is the result of interactions among many subsystems of an individual for a task under an environmental context. </p></li><li><p>Movements emerged as a result of the ability of different subsystems to interact and self-organise.</p><ul class="tight" data-tight="true"><li><p>No need for CNS</p></li></ul></li><li><p>Motor skills develop in an asynchronous & nonlinear manner. </p></li><li><p>Changes in motor behaviour are discontinuous and being attributed to “control parameters”. </p></li></ol><p></p>
Spinal cord injury: The brain may be well-developed, but movement of limbs is hindered, showing the primary role of CNS maturation.
<ul class="tight" data-tight="true"><li><p>Patients tend to play a more passive role </p></li><li><p>Limited carryover effect into functional activities</p></li></ul><p></p>
<p>rate & no. of motor skills acquired: 1st year > 2nd year</p>
<p><strong>Developmental Principles:</strong></p><ul class="tight" data-tight="true"><li><p>Cephalo-caudal</p></li><li><p>Proximal-distal</p></li><li><p>General-specific</p></li><li><p>Maturation and learning</p></li></ul><p><strong>Movement Patterns:</strong></p><ul class="tight" data-tight="true"><li><p>Extension-flexion</p></li><li><p>Stability-mobility</p></li></ul><p><strong>Individual Differences:</strong></p><ul class="tight" data-tight="true"><li><p>Individual variations</p></li></ul><p></p>
<ul class="tight" data-tight="true"><li><p>First 12 months: Gross motor</p></li><li><p>Second 12 months: Fine motor</p></li><li><p>Third 12 months: Language</p></li></ul><p></p>
<ol class="tight" data-tight="true"><li><p><strong>Cortex:</strong> </p><ul class="tight" data-tight="true"><li><p>Voluntary movement</p></li><li><p>Equilibrium reactions</p></li><li><p>Protective reactions</p></li></ul></li><li><p><strong>Mid-brain: </strong></p><ul class="tight" data-tight="true"><li><p>Righting reactions </p></li></ul></li><li><p><strong>Pons/medulla:</strong> </p><ul class="tight" data-tight="true"><li><p>Primitive reflexes</p></li></ul></li><li><p><strong>Spinal cord</strong>: </p><ul class="tight" data-tight="true"><li><p>Primitive reflexes</p></li></ul><p></p></li></ol><p></p>
<ul class="tight" data-tight="true"><li><p>biomechanics</p></li><li><p>MSK</p></li></ul><p></p>
<ul class="tight" data-tight="true"><li><p>No one subsystem has privileged status over the other subsystems</p></li><li><p>Each <u>internal subsystem</u> has its own sequence and development rate. </p></li></ul><p></p>
<p>[senior’s notes p.15]</p>
