Physiotherapeutic theory for neurological rehabili
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Summary physiotherapeutic theory: the cerebellum
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Physiotherapeutic theory for neurological rehabili
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Katholieke Universiteit Leuven (KU Leuven)
Summary of the cerebellum lesson given by prof. L. Moumdjian from the subject of physiotherapeutic theory. It is a summary of the powerpoint slides and additional items noted during the lesson. The slides were in English and my own notes are always in Dutch as much as possible. It is therefore a mi...
Physiotherapeutic theory for neurological rehabili
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Phys.theory: the cerebellum
FUNCTIONAL ANATOMY AND NEUROPHYSIOLOGY
coordinatie
- Motor plan
- Position sense
- Feedback
- Balance
Bijdragen cerebellumaan een papier zien & vastnemen
- Visuele iinput (iets zine)= sens infonaar somatosens regio
- Integreren motor plan ik moet reiken
Naar motor cortexnaar RMnaar spieren
+ naar cerebellumefference copyFB tussen geplande & uitgevoerde bew
o Corrigeren indien nodig
o Cerebellum moet snel reageren
Probleem vermis cerebellum= ↑posturale controle prob
Lat.hemisferen aangedaan= ↑fine texture, dysartia
Vest. Cortical cerebellum aangedaan=↑vestibulo-ocular disf., oogbew
Pathways
- 1. UMN to LMN to SC to muscle = motor plan
- 2. Copy of motor plan will be send to the cerebellum -> information of the intention of the movement
- 3. Informaition from muscles back to cerebellum (position sense)
- 4. Then there is feedback from the cerebellum to the motor cortex
Any lesion/disruption of these pathways cause different problems
CEREBELLAR PEDUNCLES AND LOBES
3 pedicules
FUNCTIONAL NEUROPHYSIOLOGY
Nala Melis Pagina 1
, Phys.theory: the cerebellum
Nala Melis Pagina 2
, Phys.theory: the cerebellum
CEREBELLUM SYSTEM – IN-AND OUTPUTS
- Inputs:
Comparator
linking intention of movement with actual performance
- Outputs: Motor output via 3 deep cerebellar nuclei in white matter
Fastigial nuclei
Interposed nuclei
Dentate nuclei
Motor execution and motor planning: modulation of motor
output (UMN)
- One other output via vestibular nuclei
Balance and eye movements
multiple effectors
- If damage:
Incoordination
postural imbalance
eye movement deficits
but preserved muscle strength and sensation
o cerebellum hier niet verantwoordelijk voor
FUNCTIONAL ANATOMY OF THE CEREBELLUM
Spinocerebellum: vermis and intermediate hemispheres
- Sensory information
- Control actual movement execution (on-line control): gross limb movements & normal muscle tone
- Ruggenmergcerebellum
Cerebrocerebellum: lateral hemispheres
- Cortico-pontine-cerebellum-thalamus-cortex
- Fine, distal, voluntary movements
- Planning and preparation of the movement – timing
- Evalulatin of sensory outcome of movement – motor learning
Vestibulocerebellum: flocculondular lobe
- Vestibular & visual information
- Equilibrium (control of axial muscles) & VOR
Heterogenity in cerebellar patients
Bogaert, Romano, Cabaraux, Feys, Moumdjian, 2023, Disability & Rehabilitation
- 28 articles with a total of 38 different patients were included.
- Wie zijn P? Wat hebben P?
CEREBELLAR SYMPTOMS
CEREBELLAR ATAXIA
ATAXIA: Incoordination of limbs, posture, and gait.
- An umbrella term for the disorder of the control of force and timing of movements leading to
abnormalities of speed, range, rhythm, starting, and stopping.
- Slowed movement initiation
- Force regulation deficits
- Dysdiadochokinesis
Nala Melis Pagina 3
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