MOTOR CONTROL THEORIES

Presented by : PETETI SAIRAM

MPT 2nd year.

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 INTRODUCTION
 Motor control is defined as the ability to regulate or
direct the mechanisms essential to movement.
 Therapeutic intervention is often directed at changing
movement or increasing the capacity to move.
 Therapeutic strategies are designed to improve quality
and quantity of posture and movements essential to
function.

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 NATURE OF MOVEMENT

TASK
MOVEMENT

ENVIRONMENT

INDIVIDUAL

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 FACTORS THAT CONSTRAIN MOVEMENT.
 Cognition
 Perception
 Action

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 TASK CONSTRAINTS ON MOVEMENT.
 Mobility
 Stability
 Manipulation

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 REFLEX THEORY
 The reflex can not be considered the basic unit of behavior.
 The reflex theory does not adequately explain and predict
movement that occurs in the absence of a sensory stimulus.
 The theory does not explain fast movements.
 The concept that a chain of reflexes can create complex
behaviors fails to explain the fact that a single stimulus can
result in varying responses depending on context and
descending commands.
 It does not explain the ability to produce novel movements.

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 CLINICAL IMPLICATION
 If chained or compounded reflexes are the basis for
functional movement, clinical strategies designed to test
reflexes should allow therapist to predict function.
 A patient’s movement behavior would be interpreted in
terms of presence or absence of controlling reflexes.
 Retraining motor control for functional skills would focus on
enhancing or reducing the effect of various reflexes during
motor tasks.

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 HIERARCHICAL TEORY
 The nervous system is organized as an hierarchy.
 Hierarchical control is defined as organizational control that
is top down.
 The current concept describing hierarchical control within
the nervous system recognize the fact that each level of
nervous system can act on other level depending on the task.

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 LIMITATIONS
 It can not explain the dominance of reflex behavior in certain
situations in normal adults.
 E.g. stepping on a pin.

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 CLINICAL IMPLICATION
 Abnormalities of reflex organization have been used
by many clinicians to explain disordered motor
control in the patient with a neurologic disorder.
 The reflex hierarchical theory was used to describe
disordered movement following a motor cortex
lession.
 Bobath sated that “ the release of motor responses
integrated at lower levels of from restraining
influences of higher centers, especially that of the
cortex, leads to abnormal postural reflex activity. ”

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 MOTOR PROGRAMING THEORY
 The concept of a central motor pattern, or motor
program, is more flexible than the concept of a reflex.
 As it can either be activated by sensory stimuli or by
central processes.
 The term motor program may be used to identify a
central pattern generator, that is a specific neural
circuit.

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 LIMITATIONS
 The motor program cannot be considered to be the sole
determinant of action.
 Thus the motor program concept does not take into
account the fact that the nervous system must deal with
both musculoskeletal and environmental variables in
achieving movement control.

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 CLINICAL IMPLICATION
 Explanations for abnormal movement have been
expanded to include problems resulting from
abnormalities in central pattern generators or in higher
levels of motor programs.
 In patients whose higher level of motor programming
are affected, motor program theory suggest the
importance of helping patients relearn the correct rule
for action.

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 SYSTEM THEORY
 Berstein , a Russian scientist, was looking at the
nervous system and body in a whole new way.
 He suggested that one can not understand neural
control of movement without an understanding of the
characteristics of the system you are moving and the
external and internal forces acting on the body.
 In describing the body as a mechanical system,
berstein noted that we had many degrees of freedom
that need to be controlled.

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  As a solution to the degree of freedom problem, he
hypothesized that hierarchical control exists to
simplify the control of the bodies multiply degrees of
freedom.
 He believed that synergies play an important role in
solving the degree of freedom problem.

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 LIMITATIONS
 It does not focus heavily on the interaction of the
organism with the environment, as do some other
theories of motor control.

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 CLINICAL IMPLICATIONS
 It stresses the importance of understanding the body as
a mechanical system.
 When working with a patient who has CNS deficit, the
therapist must be careful to examine the contribution
of impairments in the musculoskeletal system, as well
as the neural system, to overall loss of motor control.

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 DYNAMIC ACTION THEORY
 Self organization is a fundamental dynamic systems
principle.
 It says that when a system of individual parts come
together, its elements behave collectively in an ordered
way. There is no need for a higher center issuing
commands in order to achieve coordinated action.
 This principle applied to motor control predicts that
movement could emerge as a result of interacting
elements, without the need for specific command or
motor programs within the nervous system.

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  This theory suggests that the new movement emerges
due to a critical change in one of the systems called a
control parameter.
 A control parameter is a variable that regulates change
in the behavior of the entire system.
 An important concept in describing movement from a
dynamic action theory perspective is that of attractor
state.
 Attractor states may be considered preferred patterns
of movement used to accomplish common activities of
daily life.

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 LIMITATIONS
 The presumption that the nervous system has a fairly
unimportant role and that the relationship between the
physical system of the animal and the environment in
which it operates primarily determines the animal’s
behavior.

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 CLINICAL IMPLICATIONS
 Movement is an emergent property.
 i.e it emerges from the interaction of multiple elements
that self organize based on certain dynamic properties
of the elements themselves.
 It means that alterations in the movement behavior can
be explained in terms of physical principles rather than
necessarily in terms of neural structures.

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 ECOLOGICAL THEORY
 The ability to use perceptions to guide action emerges
early in life.
 Gibson, stated that perception focuses on detecting in
the information in the environment that will support
the action necessary to achieve the goal.
 The ecological perspective has broadened our
understanding of nervous system function from that of
a sensory/motor system, reacting to environmental
variables, to that of perception/action system that
actively explores the environment to satisfy its own
goals.

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 LIMITATIONS
 It has tended to give less emphasis to the organization
and function of the nervous system that led to this
interaction.

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 CLINICAL IMPLICATIONS
 A major contribution of this view is in describing the
individual as an active explorer of the environment.
 An important part of intervention is helping the patient
explore the possibilities for achieving a functional task
in multiple ways.
 The ability to develop multiple adaptive solutions to
accomplish a task and discover the best solution for
them, given the patients set of limitations.

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  Neurofacilitation approach including bobath, roods
approach, brunnstrom’s approach, proprioceptive
neuromuscluar facilitation (PNF) and the sensory
integration therapy, were based largely on assumptions
drawn from both the reflex and hierarchical theories of
motor control.
 Neurofacilitation techniques focused on retraining
motor control through techniques designed to facilitate
and /or inhibit different movement patterns.

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 CLINICAL IMPLICATION
 Examination of motor control should focus on
identifying the presence or absence of normal and
abnormal reflexes controlling movement.
 Intervention should be directed at modifing the
reflexes that control movement.
 The importance for sensory input for stimulating
normal motor output suggests an intervention focus of
modifying the CNS through sensory stimulation.
 A hierarchical theory suggests that one goal of therapy
is to regain independent control of movement by
higher centers of CNS.

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 TASK ORIENTED APPROACH
 These newer methods of are based on concepts
emerging from research in the field of motor control,
motor learning and rehabilitation science.
 Clinical implication: a task oriented approach to
intervention assumes that patients learn by actively
attempting to solve the problems inherent in the
functional task rather than respectively practising
normal patterns of movement.

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