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Principles ofPrinciples ofHuman MovementHuman Movement
Therapist’sInvolvement
Gentile’sModel
Map of EssentialMap of EssentialConceptsConcepts
Conclusion
DM McKeoughDM McKeough© 2009© 2009
Goal Directed MovementGoal Directed Movement
Gentile’s Model Therapist involvement Conclusion
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Goal Directed MovementGoal Directed Movement
Goal Strategy SelectiveAttention
MotorPlan
Decision
RegulatoryStimuli
R2
R1
KRKP
Where can a therapist impact goal directed movement?
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Therapists Impact onTherapists Impact onGoal Directed Movement Goal Directed Movement
1/131/13
Goal Strategy SelectiveAttention
MotorPlan
Decision
RegulatoryStimuli
R2
R1
KRKP
High Impact
Low Impact
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Therapists Impact onTherapists Impact onGoal Directed Movement Goal Directed Movement
2/132/13 Goal selectionGoal selection
In the end, the only goal that matters, is the one the In the end, the only goal that matters, is the one the performer is trying to attain. performer is trying to attain.
The therapist can only negotiate with the performer to The therapist can only negotiate with the performer to arrive at a mutually acceptable goal.arrive at a mutually acceptable goal.
Therapist’s decision in goal selection is two fold:Therapist’s decision in goal selection is two fold: Skill development: selecting progressively harder Skill development: selecting progressively harder
goals (taxonomy)goals (taxonomy) Motivation: performer satisfaction vs frustrationMotivation: performer satisfaction vs frustration
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3/133/13 StrategyStrategy
Based on knowledge of task requirements, Based on knowledge of task requirements, and how movement is controlled, the and how movement is controlled, the therapist plays a major role in helping the therapist plays a major role in helping the performer to select an effective strategy to performer to select an effective strategy to achieve the goal.achieve the goal.
During sit-to-stand transferDuring sit-to-stand transfer ““Lean forward until your nose is over your toes, Lean forward until your nose is over your toes,
then push up with your legs”then push up with your legs”
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Therapists Impact onTherapists Impact onGoal Directed Movement Goal Directed Movement
4/134/13 Regulatory stimuliRegulatory stimuli
Those aspects of the strategy that are Those aspects of the strategy that are essentialessential to goal to goal accomplishment. accomplishment.
Each strategy has a different set of regulatory stimuli. Each strategy has a different set of regulatory stimuli. The therapist plays a major role in informing the The therapist plays a major role in informing the
performer which stimuli are essential and must be performer which stimuli are essential and must be attended to selectively for incorporation into the attended to selectively for incorporation into the movement plan and which stimuli are nonessential and movement plan and which stimuli are nonessential and
may be ignored.may be ignored.
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Motor equivalence
MotorMotorEquivalenceEquivalence
5/135/13
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Therapists Impact onTherapists Impact onGoal Directed Movement Goal Directed Movement
6/136/13 Selective attentionSelective attention
Given a limited attention capacity, performers must Given a limited attention capacity, performers must attend selectively to the stimuli that are regulatory attend selectively to the stimuli that are regulatory given the strategy they have selected.given the strategy they have selected.
The therapist cannot assist the performer in selectively The therapist cannot assist the performer in selectively attending.attending.
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Motor planMotor plan The “program” of neuromotor instructions for producing The “program” of neuromotor instructions for producing
the movement pattern that implements the selected the movement pattern that implements the selected strategy. strategy.
The therapist cannot assist in formulating the motor The therapist cannot assist in formulating the motor plan.plan.
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Motor Plan 8/13Motor Plan 8/13 A motor plan is the motor equivalent of a symphonyA motor plan is the motor equivalent of a symphony A symphony is comprised of the score for every A symphony is comprised of the score for every
instrument in the orchestrainstrument in the orchestra The score is instructing each instrument what note to play, The score is instructing each instrument what note to play,
when and how stronglywhen and how strongly The symphony is performed when each instrument The symphony is performed when each instrument
contributes its notes at the appropriate time with the contributes its notes at the appropriate time with the appropriate intensityappropriate intensity
A motor plan is comprised of the neural activation A motor plan is comprised of the neural activation patter for every muscle involved in the movementpatter for every muscle involved in the movement The motor plan is instructing each muscle when to contract The motor plan is instructing each muscle when to contract
and with how much intensityand with how much intensity A movement is produced when each muscle contributes its A movement is produced when each muscle contributes its
force at the appropriate timeforce at the appropriate time Prime movers, secondary movers, stabilizers, neutralizes, Prime movers, secondary movers, stabilizers, neutralizes,
antagonistsantagonists
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9/139/13 Response 1Response 1
The initiation of a first attempt at implementing the The initiation of a first attempt at implementing the selected movement strategy.selected movement strategy.
If synchronized force production at initiation is a If synchronized force production at initiation is a regulatory stimulus, the PT could impose an external regulatory stimulus, the PT could impose an external temporal pacer (“ready, set, go”).temporal pacer (“ready, set, go”).
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10/1310/13 Knowledge of Results (KR)Knowledge of Results (KR)
Knowledge of results is terminal, extrinsic feedback Knowledge of results is terminal, extrinsic feedback about the about the outcomeoutcome of the movement, in terms of the of the movement, in terms of the movement goal. movement goal.
One of the most important roles of the therapist is to One of the most important roles of the therapist is to augment KRaugment KR
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11/1311/13 Knowledge of Performance (KP)Knowledge of Performance (KP)
Knowledge of performance is concurrent, intrinsic Knowledge of performance is concurrent, intrinsic feedback about the feedback about the movement pattern movement pattern used to used to achieve the goal.achieve the goal.
The therapist can do little to augment KP.The therapist can do little to augment KP.
Therapists can draw performer’s attention to KP to Therapists can draw performer’s attention to KP to assist achieving the goal (“begin pushing up when assist achieving the goal (“begin pushing up when you feel your weight in your toes”)you feel your weight in your toes”)
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12/1312/13
DecisionDecision The process of evaluating response effectiveness in The process of evaluating response effectiveness in
achieving the goal is an area where the therapist can achieving the goal is an area where the therapist can play a major role.play a major role.
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13/1313/13
Response 2 (R2)Response 2 (R2) Depending on the result of the evaluation and Depending on the result of the evaluation and
decision process, the performer may choose to decision process, the performer may choose to repeat R1 under similar circumstances or try a repeat R1 under similar circumstances or try a
different strategy for R2.different strategy for R2.
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ConclusionConclusion
In goal directed movement, the movement is a In goal directed movement, the movement is a means of solving the problem of how to attain the means of solving the problem of how to attain the goalgoal
There are 2 types of goalsThere are 2 types of goals Movement as a means to achieving the goalMovement as a means to achieving the goal The movement pattern is the goal itselfThe movement pattern is the goal itself
Movement is controlled by a logical and Movement is controlled by a logical and consistent problem solving processconsistent problem solving process
There are certain steps in the problem solving There are certain steps in the problem solving process where a therapist can effectively assist process where a therapist can effectively assist the performerthe performer
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The EndThe End
© DM McKeough 2009© DM McKeough 2009
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