Auditory, Visio

8/2/2019 Auditory, Visio

1/20

Vision , Auditory, SpeechEpilepsy, Mental Retardation

Learning DisabilitiesChildren

with

CerebralPalsy

Movement

PosturePoor Sensorimotor Experiences

Poor Perceptual motor ProcessingVision, Auditory, Hand,

Oromotor, Breathing, Speech


2/20


3/20


4/20

MOVEMENT

AROUSAL

ATTENTION

AWAKENESS

MOTIVATION SAFETY

SENSORY

=INFORMATION

=VISION, AUDITORY

TACTILE, CUTANEOUS

PROPRIOCEPTIVE

PERCEPTUAL

COGNITIVE PROCESS

FEEDBACKFEEDFORWARD

BIOMECHANICALIGNMENT/MIDLINEBODY SCHEME

MUSCLE PROPERTIES


5/20

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


6/20

MEMORIES OF MOVEMENT

PERCEPTUAL

COGNITIVE PROCESS

SENSORIMOTOR EXPERIENCES

FEEDBACK-FEEDFORWARD CHANNEL


7/20

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


8/20

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


9/20

* 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


10/20

TONE INFLENCE PATTERN

NEURAL FACTOR

AROUSAL , PROPRIOCEPTIVE REFLEX,CUTANEOUS REFLEX,

FEEDBACK, FEEDFORWARD

PERCEPTION, COGNITION


11/20

TONE INFLUENCE PATTERN

NONE NEURAL FACTORS

BIOMECHANICS

MUSCLE PROPERTIES


12/20

Level of Arousal

Proprioceptive reflex &

cutaneous reflexFeedforward

Cognition

& PerceptionNormal Tone

Stability & Mobility

Muscle PropertiesFeedbackward

Biomechanics


13/20

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


14/20

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


15/20

NONE NEURAL FACTORS

2. Muscle fiber properties

Type I slowType II fast

Most of muscles have a mixture of flbertypes ; slow, fast, intermediate


16/20

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.


17/20

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.


18/20

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


19/20

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


20/20

* 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

Auditory, Visio

Documents