Coordination functional training.
Coordination, also known as ataxic coordination function is an ability of the body to self-regulate and complete smooth, accurate and controlled random movements.
Coordination includes.
aspects such as following a certain direction and rhythm, using the appropriate force and speed, and achieving an accurate goal. Coordinated function requires appropriate speed, distance, direction, rhythm, and muscle strength. Uncoordination is a general term to describe movement disorders that are usually awkward, unbalanced and inaccurate. Motor and coordination dysfunction is also known as ataxia.
I. Neurophysiological basis of motor control.
1, reflexes, the central part of the reflex arc excitability transmission characteristics are as follows.
(1) one-way transmission: when the impulse passes through the synapse, it can only be transmitted from the axon terminal of one neuron to the cytosol or protrusion of another neuron, and cannot be transmitted in the reverse direction.
(2) Central delay: The slow passage of an impulse through the central part, with a long delay, is called central delay.
(3) Summation: The transmission of an impulse to the same neuron through several fibers at the same time or a fiber with several impulses in succession can cause reflex activity, and this phenomenon is called summation.
(4) Post-release: In reflex activity, after the stimulus stops, the efferent nerve can continue to be activated for a certain period of time, and this phenomenon is called post-release.
(5) Diffusion: If the stimulation site remains unchanged and only the intensity of the stimulus is increased, causing a wider range of activity, this is called diffusion of the reflex.
(6) Easy fatigue, susceptible to the internal environment and certain drugs.
2. Regulation of the superior center.
The pyramidal system affects a person’s muscle strength, sensation of the limbs, and the ability to speak. The extrapyramidal system coordinates the stability, accuracy and coordination of human limb activities.
3. Basal ganglia of the brain.
(motor program generator) is associated with the production of balanced movements that can be controlled at random speed. It has an important role in the movement of the limbs, trunk and head.
4.Modulation of movement by the cerebellum
5.The role of the cerebral cortex in motor control
6.The feedback role of sensory afferents on motor control
Second, the motor nervous system and the central nervous system training effects.
Action learning and improved reaction time synapses
Third, the performance of coordination disorders.
1, coordination deficits caused by cerebellar insufficiency.
Lack of fine coordination and judgment of distance, this defect can affect gait, posture and movement patterns. The gait is characterized by wide separation of the feet, irregularity, instability and waddling.
The following different manifestations are common.
(1) Poor distance discrimination: poor judgment of distance.
(2) Intentional tremor: tremor occurs during casual movements.
(3) Postural tremor: the body sways back and forth when standing.
(4) Rotational dyskinesia: also known as fast repetitive dyskinesia, difficulty in completing fast alternating movements.
(5) Motor fractional rhythm: the activity accomplished is not a smooth one, but a series of motor components.
2. Coordination deficits due to basal ganglia insufficiency.
As a result of basal ganglia lesions, the clinical focus is on abnormal movements and alterations in muscle tone. In one category: the main manifestations are tremor, hypertonia, reduced random movements, slow movements, and dull facial expressions, such as Parkinson’s syndrome; the other category manifests involuntary and purposeless movements of the upper limbs and head and face, which resemble a fragment of random movements, but with low muscle tone, such as chorea.
The specific manifestations are as follows.
(1) Resting tremor: sometimes called “pill-rubbing”, characterized by a reduction or disappearance with purposeful movement.
(2) Motor inability: Inability to initiate a movement.
(3) Tardive dyskinesia: slow, involuntary twisting movements of parts of the body other than the limbs, trunk, and face.
(4) Eccentric chorea: sudden, spastic, forceful, purposeless whiplash-like movements on one side of the body.
(5) Dystonia: unpredictable change in muscle tone from high to low.
3.Coordination disorder due to posterior spinal cord (cord) insufficiency (sensory)
Due to posterior cord lesions, proprioceptive and discriminative tactile information cannot be transmitted to the cerebral cortex, and the patient cannot determine the position of each joint when the eyes are closed.
This is manifested by.
(1) When the eyes are closed or the room is too dark, the weakened visual feedback increases balance disturbance, which is seen as the patient’s body swaying and tilting when standing and prone to fall.
(2) Abnormal gait: wide separation of the feet, swaying, unequal gait distance, high lifted feet, landing with a sound, and walking looking at the feet.
(3) Poor distance discrimination: inability to accurately position the limbs or to reach a specific object; the patient cannot say the words written on his skin by the examiner without using his eyes.