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LEARNING OBJECTIVES
Identify the purposes and components of the examination of motor function: motor control and motor learning.
Describe the examination process and specific tests and measures of various components of motor function.
Discuss the implications of common deficits associated with disorders of motor function for examination and treatment planning.
Discuss factors that influence the complexity of the motor examination and evaluation process.
Describe the instrumentations systems and general methodology of electrodiagnosis in the performance of electromyography (EMG) and nerve conduction study (NCS) examinations.
Describe the characteristics of normal and abnormal EMG and NCS findings.
Discuss the implications of clinical EMG and NCS findings for goal setting and treatment planning.
Discuss factors that influence determination of the physical therapy diagnosis with disorders of motor function.
Analyze and interpret patient data, formulate realistic goals and expected outcomes, and identify appropriate interventions when presented with a clinical case study.
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OVERVIEW OF MOTOR FUNCTION
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Motor control evolves from a complex set of neural, physical, and behavioral processes that govern posture and movement. Some movements have a genetic basis and emerge through processes of normal growth and development. Examples of these include the largely reactive reflex patterns that predominate during much of early life and in some patients with brain damage. Other movements, termed motor skills, are learned through interaction and exploration of the environment. Practice and feedback are important variables in defining motor learning and motor skill development. Sensory information about movement is used to guide and shape the development of motor programs. A motor program is defined as “an abstract representation that, when initiated, results in the production of a coordinated movement sequence.”1, p. 497 Examples include the complex neural circuitry in the spinal cord known as central pattern generators that control locomotion and gait.
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Higher-level motor programs can be viewed as abstract rules or code for coordinated actions that are stored (generalized motor programs [GMPs]). GMPs contain information about the order of events, the timing of events (temporal structure), the overall force of contractions, and the muscle(s) or limb(s) used in the movements. Sensory feedback from the responding limbs, as well as from the environment, modifies the resulting movements. A motor plan (complex motor program) is an idea or plan for purposeful movement that is made up of several component motor programs. Motor memory (procedural memory) involves the recall of motor programs or subroutines and includes information on (1) initial movement conditions; (2) sensory parameters (how the movement felt, looked, and sounded); (3) specific movement performance parameters (knowledge of performance); and (4) outcome of the movement (knowledge of results).
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The cooperative actions of multiple systems allow for accommodation of movement to match the specific demands of the task and the environment. This is defined by systems theory, a distributed model of motor control. The central concept ...