Motor Neglect - ️️- impaired initiation or execution of movement into contralateral
hemispace by either limb
- often difficult to distinguish between sensory or motor neglect
◦Limb akinesia: failure to move limb
◦Hypokinesia: limb moves only after long delay and much encouragement
◦h...
OCCTH 1 PART 2 (WEEK 3 - neuromotor
impairments)
Motor Neglect - ✔️✔️- impaired initiation or execution of movement into contralateral
hemispace by either limb
- often difficult to distinguish between sensory or motor neglect
◦Limb akinesia: failure to move limb
◦Hypokinesia: limb moves only after long delay and much encouragement
◦hypometria: movements are of decreased amplitude
◦impersistence: inability to maintain a movement or posture
◦motor perseveration: inability to disengage from a motor activity
◦motor extinction: delay or failure to move contralateral limb when also required to move
ipsilateral limb
LESIONS IN CORTEX// APRAXIA - ✔️✔️inability to perform goal-directed motor
activity; omissions, disturbed sequence, clumsiness, perseveration, inability to gesture
or use common objects
4 types:
IDEOMOTOR: Errors made with goal-directed movements; improves with use of actual
movements (Awkward or clumsy use of tools to complete tasks; may not be able to
complete movement pattern for brushing teeth, but able to complete task in context with
real objects)
IDEATIONAL(CONCEPTUAL): Error in use of common object use and sequencing of
multistep tasks (may attempt to use toothbrush to brush hair)
CONSTRUCTIONAL: Difficulty with copying, drawing, and constructing 2D and 3D
designs (setting table, making sandwich, etc.)
DRESSING: inability to dress oneself
Neuromaturational Theory of motor development - ✔️✔️Changes in neural structures is
directly related to changes in motor function
- Changes in neural structures --> Changes in motor function
- Changes are due to interaction of multiple systems & contexts
- CNS damage can lead to regression to lower levels and stereotypical behaviors
Assumptions of Therapeutic Approaches - ✔️✔️- CNS is hierarchically organized
, - Motor control is heterarchical system (smaller subsystems have effect on overall motor
function)
- Environment, Activity demands, and client factors all relate to performance
- Behavioral changes reflect attempts to compensate and achieve task performance
◦use remaining capacities in addition to new strategies to continue functional
performance
(ex: learned non-use)
site, extent - ✔️✔️______ and _________ of CNS damage will determine the type of
motor dysfunction
** damage in specific locations will correlate to damage/deficits
PATHWAY of MOTOR messages (start in neuro system and move to skeletal) -
✔️✔️Precentral Gyrus: primary motor cortex (combines with sensory info here) ---->
internal capsule ----> thalamus ----> brainstem -----> spinal cord (ventral horn to ventral
root to PNS) ----> skeletal muscle
LESIONS IN CORTEX// PRECENTRAL GYRUS - ✔️✔️loss of voluntary muscle
movement on contralateral side
◦spasticity, hyperreflexia
LESION IN CORTEX// HYPOTONIA, HYPERTONIA, SPASTICITY - ✔️✔️Hypotonia:
decreased muscle tone or flaccidity; less than normal resistance to passive elongation
Hypertonia: increased muscle tone; more than normal resistance to passive elongation
Spasticity: *velocity-dependent* increase in tonic stretch reflexes and exaggerated
tendon reflexes
◦component of hypertonicity
***Change in tone can be caused by both mechanical or neurological factors of the
muscle
Mechanical factors: changes in the elastic part of the muscle
Neurological factors: spasticity in muscle because of damage to the brain
LESIONS IN CORTEX// CLONUS - ✔️✔️oscillating contraction and relaxation of a limb
caused by alternating stretch reflex and inverse stretch reflex of spastic muscle
- Caused by hyperreflexia of muscle
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