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• Cover
• Title Page
• Copyright
• Dedication
• Preface
• Content
• PART I: THEORETICAL FRAMEWORK
• 1 Motor Control: Issues and Theories
• Introduction
• What Is Motor Control?
• Why Should Therapists Study Motor Control?
• Understanding the Nature of Movement
• Individual Systems Underlying Motor Control
• Task Constraints on Movement Control
• Environmental Constraints on Movement Control
• The Control of Movement: Theories of Motor Control
• Value of Theory to Practice
• Reflex Theory
• Hierarchical Theory
• Motor Programming Theories
• Systems Theory
• Ecological Theory
• Which Theory of Motor Control Is Best?
• Parallel Development of Clinical Practice and Scientific Theory
• Neurologic Rehabilitation: Reflex-Based Neurofacilitation Approaches
• Task-Oriented Approach
• Case Studies
• Summary
• Answers to Lab Activity Assignments
• 2 Motor Learning and Recovery of Function
• Introduction to Motor Learning
• What Is Motor Learning?
• Nature of Motor Learning
• Early Definitions of Motor Learning
• Broadening the Definition of Motor Learning
• Relating Performance and Learning
• Attention and Motor Learning
• Forms of Learning
• Basic Forms of Long-Term Memory: Nondeclarative (Implicit) and Declarative (Explicit)
• Theories of Motor Learning
• Schmidt’s Schema Theory
• Ecological Theory
• Theories Related to Stages of Learning Motor Skills
• Fitts and Posner’s Three-Stage Model
• Bernstein’s Three-Stage Approach to Motor Learning: Mastering Degrees of Freedom
• Gentile’s Two-Stage Model
• Stages of Motor Program Formation
• Practical Applications of Motor Learning Research
• Practice Levels
• Feedback
• Practice Conditions
• Recovery of Function
• Concepts Related to Recovery of Function
• Factors Affecting Recovery of Function
• Preinjury Neuroprotective Factors
• Postinjury Factors
• Summary
• Answers to Lab Activity Assignments
• 3 Physiology of Motor Control
• Introduction and Overview
• Motor Control Theories and Physiology
• Overview of Brain Function
• Neuron: The Basic Unit of the CNS
• Sensory and Perceptual Systems
• Somatosensory System
• Visual System
• Vestibular System
• Action Systems
• Motor Cortex
• Higher-Level Association Areas
• Cerebellum
• Basal Ganglia
• Mesencephalon and Brainstem
• Summary
• 4 Physiological Basis of Motor Learning and Recovery of Function
• Introduction
• Defining Neural Plasticity
• Learning and Memory
• Localization of Learning and Memory
• Plasticity and Learning
• Plasticity and Nondeclarative (Implicit) Forms of Learning
• Procedural Learning (Skills and Habits)
• Plasticity and Declarative (Explicit) Forms of Learning
• The Shift from Implicit to Explicit Knowledge
• The Shift from Explicit to Implicit Memory
• Complex Forms of Motor Learning
• Acquisition of Skill: The Shift to Automaticity
• Summary of Forms of Learning
• Neural Plasticity and Recovery of Function
• Conceptualizing Recovery
• Axonal Damage: Effects on Neurons and Neighboring Cells
• Early Transient Events That Depress Brain Function
• Axonal Regeneration: Difference in the Peripheral versus Central Nervous Systems
• CNS Response to Injury
• Changes in Cortical Maps after Lesions and during Recovery of Function
• Strategies to Enhance Neural Plasticity and Cortical Reorganization
• Clinical Implications of Research on Neural Plasticity and Recovery of Function in Acquired Brain Injury
• Neural Plasticity and Neurodegenerative Disease
• Neural Plasticity and Parkinson’s Disease
• Clinical Implications of Research on Neural Plasticity and Recovery of Function in PD
• Summary
• 5 Constraints on Motor Control: An Overview of Neurologic Impairments
• Introduction: Signs and Symptoms of Pathophysiology of Motor Control
• Classifying Impairments Associated with Central Nervous System Lesions
• Signs versus Symptoms
• Positive versus Negative Signs and Symptoms
• Primary versus Secondary Effects
• Impairments in the Action Systems
• Motor Cortex Deficits
• Motor Impairments Associated with Subcortical Pathology
• Secondary Musculoskeletal Impairments
• Impairments in Sensory Systems
• Somatosensory Deficits
• Visual Deficits
• Vestibular Deficits
• Pathology of Higher-Order Association Cortices: Spatial and Nonspatial Impairments
• Right Hemisphere Spatial Deficits
• Right Hemisphere Nonspatial Deficits
• Clinical Management of Impairments in the Action (Motor) Systems
• Motor Cortex and Corticospinal Tract Impairments
• Clinical Management of Cerebellar and Basal Ganglia Impairments
• Clinical Management of Musculoskeletal Impairments
• Clinical Management of Impairments in the Sensory Systems
• Somatosensory Impairments
• Visual Impairments
• Vestibular Impairments
• Clinical Management of Impairments in the Perceptual and Cognitive Systems
• Spatial Deficits: Hemineglect
• Nonspatial Cognitive Deficits
• Summary
• 6 A Conceptual Framework for Clinical Practice
• Introduction
• Components of a Conceptual Framework for Clinical Practice
• Models of Practice
• Models of Functioning and Disability
• Hypothesis-Oriented Clinical Practice
• Theories of Motor Control and Learning
• Evidence-Based Clinical Practice
• Applying a Conceptual Framework to Clinical Practice
• Developing a Personal Conceptual Framework for Clinical Practice
• Task-Oriented Approach to Examination
• Examination of Functional Activities and Participation
• Examination at the Strategy Level
• Examining Impairments of Body Structure and Function
• Task-Oriented Approach to Intervention
• Recovery Versus Compensation
• Summary
• Answers to Lab Activity Assignments
• PART II: POSTURAL CONTROL
• 7 Normal Postural Control
• Introduction
• Defining Postural Control
• A Systems Framework for Postural Control
• Motor Systems in Postural Control
• Steady-State Balance
• Reactive Balance Control
• Proactive (Anticipatory) Balance Control
• Sensory and Perceptual Systems in Postural Control
• Sensory Inputs for Steady-State Balance
• Sensory Inputs for Reactive Balance
• Clinical Applications of Research on Sensory and Perceptual Aspects of Postural Control
• Cognitive Systems in Postural Control
• Clinical Applications of Research on Cognitive Aspects of Postural Control
• Neural Subsystems Controlling Postural Orientation and Stability
• Spinal Contributions
• Brainstem Contributions
• Basal Ganglia and Cerebellar Contributions
• Summary
• Answers to Lab Activity Assignments
• 8 Development of Postural Control
• Introduction
• Postural Control and Development
• Motor Milestones and Emerging Postural Control
• Theories of Developing Postural Control
• Reflex/Hierarchical Theory
• Systems Theory
• Development of Postural Control: A Systems Perspective
• General Movements in Infants
• Emerging Head Control
• Emergence of Independent Sitting
• Transition to Independent Stance
• Refinement of Postural Control
• Cognitive Systems in Postural Development
• Summary
• 9 Aging and Postural Control
• Introduction
• Factors Contributing to Aging
• Interactions between Primary and Secondary Factors
• Heterogeneity of Aging
• Behavioral Indicators of Instability
• Defining Falls
• Risk Factors for Falls
• Age-Related Changes in the Systems of Postural Control
• Motor Systems
• Changes to Steady-State Balance
• Changes in Reactive Balance Control
• Aging in the Sensory or Perceptual Systems
• Changes in Individual Sensory Systems
• Adapting Senses for Postural Control
• Cognitive Issues and Posture Control
• A Case Study Approach to Understanding Age-Related Postural Disorders
• Summary
• Answers to Lab Activity Assignments
• 10 Abnormal Postural Control
• Introduction
• Falls in Persons with Neurologic Pathology
• Problems in the Motor Systems
• Impaired Steady-State Balance
• Impaired Reactive Balance
• Impaired Anticipatory Postural Control
• Problems in the Sensory/Perceptual Systems
• Sensory Problems Affecting Steady-State Balance
• Sensory Problems Affecting Reactive Balance
• Sensory Problems Affecting Anticipatory Balance
• Perceptual Problems Affecting Postural Control
• Clinical Implications of Research on Impaired Sensation/Perceptions and Postural Control
• Problems in Cognitive Systems
• Balance and Falls Self-Efficacy
• Impaired Postural Stability and Dual-Task Interference
• A Case Study Approach to Understanding Postural Dyscontrol
• Jean J and Genise T: Postural Problems following Cerebral Vascular Accident
• Mike M: Postural Problems in Parkinson’s Disease
• John C: Postural Problems in Cerebellar Disorders
• Thomas L: Postural Problems in Spastic Diplegic CP
• Malachi: Postural Problems in Severe Athetoid/Spastic CP
• Sue: Postural Problems in Multiple Sclerosis
• Summary
• 11 Clinical Management of the Patient with a Postural Control Disorder
• Introduction
• Conceptual Framework for Balance Rehabilitation
• Examination
• Safety—The First Concern
• Examining the Effect of Balance on Participation
• Examining Balance in Functional Activities
• Assessing Strategies for Balance
• Examination of Underlying Impairments
• Evaluation: Interpreting the Results of the Examination
• Task-Oriented Balance Rehabilitation
• Motor System
• Sensory Systems
• Cognitive Systems
• Putting It All Together
• Research Evidence for a Task-Oriented Approach to Balance Rehabilitation
• Improving Participation—Evidence-Based Fall Prevention
• Summary
• Answers to Lab Activity Assignments
• PART III: MOBILITY FUNCTIONS
• 12 Control of Normal Mobility
• Introduction
• Mobility in the International Classification of Functioning, Disability and Health Framework
• Motor Systems and Gait
• Essential Requirements of Locomotion: Progression, Postural Control, and Adaptation
• Characterizing Steady-State Gait
• Adaptation of Gait: Contributions of Reactive and Proactive Balance Control in Gait
• Initiating Gait
• Control Mechanisms for Gait
• Pattern Generators for Gait
• Descending Influences
• Musculoskeletal Contributions to Gait
• Sensory Systems and the Control of Gait
• Somatosensory Systems
• Vision
• Vestibular System
• Cognitive Systems and Gait
• Dual-Task Performance during Steady-State Gait
• Dual-Task Performance during Obstacle Crossing
• Stair Walking
• Ascent
• Descent
• Adapting Stair-Walking Patterns to Changes in Sensory Cues
• Mobility Other Than Gait
• Transfers and Bed Mobility
• Summary
• Answers to Lab Activity Assignments
• 13 Development of Mobility
• Introduction
• Development of Motor Systems and Gait
• Development of Steady-State Gait
• Development of Adaptation
• Expanding the Repertoire of Steady-State Gait Patterns: Run, Skip, Hop, and Gallop
• Sensory Systems
• Cognitive Systems
• Development of Other Mobility Skills
• Development of Rolling
• Development of Supine to Stand
• Summary
• Answers to Lab Activity Assignments
• 14 Aging and Mobility
• Introduction
• Gait Dysfunction: Aging or Pathology?
• Motor Systems and Gait
• Age-Related Changes in Steady-State Gait
• Age-Related Changes in Adaptation of Gait: Reactive and Proactive Balance
• Role of Pathology in Gait Changes in Older Adults
• Age-Related Changes in Sensory Systems and Gait
• Somatosensation
• Vision
• Vestibular
• Age-Related Changes in Cognitive Systems and Gait
• Age-Related Changes in Dual-Task Performance during Steady-State Gait
• Age-Related Changes in Dual-Task Performance during Obstacle Crossing
• Cognitive Influences on Gait: Fear of Falling in Older Adults
• Age-Related Changes in Other Mobility Skills
• Gait Initiation and Backward Gait
• Stair Walking
• Sit-to-Stand
• Rising from a Bed
• Supine to Standing
• Comparing Gait Characteristics of Infants and Older Adults: Testing the Regression Hypothesis
• A Case Study Approach to Understanding Age-Related Changes in Mobility
• Summary
• Answers to Lab Activity Assignments
• 15 Abnormal Mobility
• Introduction
• Classification Systems
• Motor Systems and Abnormal Gait
• Paresis or Weakness
• Spasticity
• Loss of Selective Control and the Emergence of Abnormal Synergies
• Coordination Problems
• Musculoskeletal Impairments
• Impaired Adaptation of Gait: Contributions of Impaired Reactive and Proactive Balance Control
• Sensory Systems and Abnormal Gait
• Somatosensory Deficits
• Visual Deficits
• Vestibular Deficits
• Perceptual Problems Affecting Gait
• Cognitive Systems and Impaired Gait
• Impaired Dual-Task Walking
• What Factors Limit Participation in the Mobility Domain?
• Disorders of Mobility Other than Gait
• Gait Initiation
• Stair Walking
• Transfers and Bed Mobility
• A Case Study Approach to Understanding Mobility Disorders
• Jean J and Genise T: Stroke
• Mike M: Parkinson’s Disease
• John C: Degenerative Cerebellar Injury
• Sue: Multiple Sclerosis
• Thomas: Spastic Diplegic Cerebral Palsy
• Summary
• 16 Clinical Management of the Patient with a Mobility Disorder
• Introduction
• A Task-Oriented Approach to Examination
• Measuring Participation: Mobility Performance in the Home and Community Contexts
• Standardized Measures of Walking Capacity
• Examining the Gait Pattern
• Examination at the Impairment Level
• Measuring Mobility: Do We Really Need All These Tests and Measures?
• Transition to Treatment
• Setting Goals
• Task-Oriented Approach to Locomotor Training
• Interventions at the Impairment Level
• Intervention at the Strategy Level: Improving the Gait Pattern
• Training Adaptation: Complex Walking Tasks
• Research Supporting Locomotor Training in Specific Patient Populations
• Improving Participation and Reducing Mobility Disability
• Retraining Other Mobility Skills
• Stair Walking
• Sit-to-Stand
• Importance of Varying Task and Environmental Demands
• Summary
• Answers to Lab Activity Assignments
• PART IV: REACH, GRASP, AND MANIPULATION
• 17 Normal Reach, Grasp, and Manipulation
• Introduction
• Movement Control Principles
• Feedforward versus Feedback Control of Movement
• Locating a Target
• Eye–Head–Trunk Coordination
• Interactions between Eye Movements and Hand Movements
• Reach and Grasp
• Kinematics of Reach and Grasp
• Neural Control of Reach and Grasp
• Sensory Systems
• Motor Systems
• Grasping
• Classification of Grasping Patterns
• Anticipatory Control of Grasping Patterns: Precision Grip Formation
• Grasp and Lift Tasks
• Coordination of Reach and Grasp
• General Principles of Neural Control of Reach and Grasp
• Invariant Features of Movement: Motor Programs
• Reaction Times for Reach and Grasp
• Fitts’s Law
• How Does the Nervous System Plan Movements? Muscle Coordinate, Joint Angle Coordinate, and End Point Coordinate Strategies
• Distance versus Location Programming Theories
• Interference between Reaching and the Performance of Secondary Cognitive Tasks
• Summary
• Answers to Lab Activity Assignments
• 18 Reach, Grasp, and Manipulation: Changes across the Life Span
• Introduction
• Principles Underlying the Development of Reaching Behaviors
• Role of Reflexes in the Development of Reaching Behaviors
• Reaching Behaviors: Innate or Learned?
• Locating a Target: Eye–Head Coordination
• Shifting Gaze
• Tracking Object Movements
• Development of Visual Pathways for Reaching
• Eye–Head–Hand Coordination Development
• Reach and Grasp
• Motor Components
• Sensory Components
• Grasp Development
• When Do Children Start Using Anticipatory Control in Grasping and Lifting Objects?
• Adaptation of Grip Forces
• Learning to Reach for and Grasp Moving Objects (Catching)
• Cognitive Components
• The Role of Experience in the Development of Eye–Hand Coordination
• Reaction Time Reaching Tasks
• Fitts’ Law
• Changes in Older Adults
• Reaching: Changes with Age
• Grasping: Changes with Age
• Reach–Grasp Adaptation: Changes with Age
• Compensation and Reversibility of Decrements in Reaching Performance
• A Case Study Approach to Understanding Age-Related Changes in Reach, Grasp, and Manipulation
• Summary
• Answers to Lab Activity Assignments
• 19 Abnormal Reach, Grasp, and Manipulation
• Introduction
• Target Location Problems
• Visual Deficits and Object Localization
• Problems with Eye−Head−Hand Coordination
• Problems with Reach and Grasp
• Impairments of Reach
• Problems with Grasp
• Problems with In-Hand Manipulation
• Problems with Release
• Interlimb Coupling and Bimanual Tasks
• Reach and Grasp in the Ipsilesional Nonhemiparetic Limb
• Apraxia
• A Case Study Approach to Understanding Upper-Extremity Disorders
• Jean J and Genise T: Reach-and-Grasp Problems Following Cerebrovascular Accident
• Mike M: Reach-and-Grasp Problems in Parkinson’s Disease
• John C: Reach-and-Grasp Problems Following Cerebellar Pathology
• Thomas: Reach-and-Grasp Problems in Cerebral Palsy
• Malachi: Reach-and-Grasp Problems in Severe Dystonic/Spastic Cerebral Palsy
• Sue: Reach-and-Grasp Problems in Multiple Sclerosis
• Summary
• 20 Clinical Management of the Patient with Reach, Grasp, and Manipulation Disorders
• Introduction
• Examination
• Examining the Effect of Prehension on Participation
• Examining Prehension in Functional Activities
• Examination of Underlying Impairments
• Evaluation: Interpreting the Results of the Examination
• Long-Term Goals
• Short-Term Goals
• Client-Identified Goals
• Intervention for Sensorimotor Strategies
• Interventions at the Functional Level
• Improving Participation
• Summary
• Answers to Lab Activity Assignments
• References
• Index