CONTROL OF MOVEMENT

THEORIES OF MOTOR
CONTROL

ZAHID MEHMOOD BHATTI

Assistant Professor
LAHORE COLLEGE OF PHYSICAL THERAPY
(LM&DC)
Objectives:
After this session the student should be able to:
Identify the different theories.
Able to interpret these theories.
Discuss the relationship between theories and motor control.
Limitation and clinical implications of different theories.
 Compare and contrast the neurofacilitation approaches to the task-
oriented approach.
 Introduction
 Theories of Motor Control describe the viewpoints regarding how
movement is controlled.

 A theory of motor control is a group of abstract ideas about the

control of movement.

 A theory is a set of interconnected statements that describes

unobservable structure or processes and relate them to each other
and to observable events.
 Theory and Practice

 Do theories really influence what therapist do with their patients?

 Yes; rehabilitation practice reflects the theories or basic ideas we

have about the cause and nature of function and dysfunction.
 Theory and Practice

 Theory provides;
 A framework for interpreting behavior.
 A guide for clinical action
 New Ideas; dynamic and evolving
 Working Hypothesis for examination and intervention
 Theories of Motor Control

 Reflex Theory
 Hierarchical Theory

 Motor Programing Theory

 Systems Theory

 Ecological Theory
 REFLEX THEORY

 Sir Charles Sherrington (1906) neurophysiologist wrote

a book “integrative action of Nervous System”
 3 parts: receptor, pathway, effector
 Reflexes were the building blocks of complex behavior
 Reflexes worked together or in sequence to achieve a goal
 Limitations
 Thereare number of limitations of a reflex theory of Motor
Control (Rosenbaum, 1991):
1. Reflexes can not be considered as the Basic unit of behavior. Because:
a. Reflex must be activated by an outside agent.
b. Unable to explain spontaneous and voluntary movements
2. It does not explain and predict movement that occurs in the Absence of sensory
stimulus as animal move in a relatively coordinated fashion in the absence of
sensory input.
3. It does not explain Fast movements
4. The concept that a chain of reflexes can creating complex behavior fails to explain
the fact that a single stimulus can result in varying responses depends upon context
and descending commands.
5. Finally reflex chaining does not explain the ability to produce novel movements.
 Definitions

 Noval Movement: A movements that exits outside of a

stereotypical pattern with limited set of solutions to movement
related problems.
 Spontaneous/Involuntary movement: Amovement that

results from an impulse that occurs without thought.

 Fast Movement: A movement said to be fast regarding:

- duration of movement (e.g., seconds)

- speed of movement (e.g., meters per second)
 Clinical Implication
 How might a reflex theory of motor control be used to interpret a
patient’s behavior and serve as a guide for the therapist’s action?
1. First, If chained or compounded reflexes are the bases of functional
movement, then testing strategies of reflexes will produce the
functional movement instead of single response.
2. Secondly, presence and absence of reflex will determine movement
task
3. Finally, retraining of motor control for functional skills would focus
on enhancing or reducing the effect of various reflexes during motor
tasks.
HEIRARCHICAL THEORY

CORTEX

MIDBRAIN
 Hughling Jackson
BRAINSTEM  There are Higher, Middle, and Lower levels of motor
& SPINAL control, equated with higher association areas: the
CORD
motor cortex and spinal level of motor function
(forester 1977)
 Top down organizational control, strictly vertical
 Never bottom up control
 THEORY Development
 Rudolf Magnus 1920 found that:
 Reflexes controlled by lower levels are present only when cortical centers are
damaged.
 Georg Schealtenberg 1928 explain:
 The development of mobility in children and adults.
 He describes the development of human mobility in terms of presence and
disappearance of primitive reflexes.
 He proposed that Pathology of brain may result in the persistence of primitive lower level
of reflexes.
 Stephen Weisz 1930 reported:
 Equilibrium reflexes in normally developing child.
 He proposed a relationship between the maturation of these reflexes and the child’s
capacity to sit, stand and walk.
Similar/Related concept Theories

 Reflex /Herarchical Theory

 Neuro-maturation Theory
 Reflex /Herararchical Theory.

 This theory suggest that motor control emerges

from reflexes that are nested within hierarchically
organized level of CNS.
 It minimizes the importance of other factors such as

musculoskeletal changes during development.

 Neuro-maturation Theory
 Arnold Gesell 1940, 1954, Gasel & Armatruda 1947 and Myrtle
McGraw 1945 explain that:
 Motor development was attributed to increase carticalization of CNS,
resulting in the emergence of higher level of control over lower level of
reflexes. This is referred to as Neuromaturation Theory.
Neuroanatomical Postural Reflex Motor Development
Structures Development
Cortex Equilibrium Bipedal Function
Reaction
Midbrain Righting Quadrupedal Function
Reactions
Brainstem/Spinal Primitive A pedal Function
Cord reflexes
 Limitations and Clinical implications

Limitations
 Can’t explain dominant reflex behavior in certain stimulus in normal
adult
 Bottom up control………pin prick
Clinical implication
 Brunnstrom, Said “when the influence of high center is temporarily or
permanently interfered with normal, reflexes exaggerated and so called
pathological reflexes appear”.
 According to Berta Bobath “The release of motor response integrated at

lower levels from restraining influence of higher center .especially that of

cortex, leads to abnormal postural reflex activity”
 Current Concept Related to Hierarchical Conrol

 Modern Scientist Confirmed the importance of elements of

Hierarchical organization of motor Control.
 According to the Current Concept of Hierarchical Control each
level of nervous system has an impact on other level of nervous
system (Higher and lower) depending upon the task
 In addition the role of reflexes in movement has been modified
 Reflexes are not considered the sole determinant of motor control,
but only as one of many processes important for the generation and
control of movement.
Current Concept
 Motor Programming Theory
 Instead of the CNS being just and always “reactive”, this theory states
that CNS can act on its own as a result of prepared motor programs
 There is an abstract motor program stored on the higher levels and sent
down to be interpreted and carried out depending on the situation and
context.
 The term motor program may be used to identify a central pattern
generator (CPG) that is a specific neural circuit represents neural
connections that are stereotyped and hardwired.
 Individual can still act in the absence of a stimulus
 Higher level stores the rules for generating movements patterns so that
we can perform the tasks with a variety of effector systems
 Motor Programming Theory
Limitations
 It simply enhance our understanding of creating movement in

isolation from feedback but it never replace the concept of

importance of sensory input in controlling movement
 Motor program or CPG is not considered as sole determinant of

action.
 It can also not explain how a single command produce different

movements.
 It also unable to explain the role of Gravity, fatigue and other

environmental constraints.
 Motor Programming Theory

 Clinical implication
 Clinicians move beyond reflex explanation for motor control

disorders.
 It explain abnormal movements are the result of the problems or

abnormalities in central pattern generator (CPG).

 In patients with Higher level damage this theory demonstrate at least

the correct rules for relearning action.

 Interventions focus on retraining movements important to functional

task not just on re-educating specific muscles in isolation.

 Lab Activity
 Objective:
 Apply the Concept of Motor Program to functional movement.
 Procedure:
 Signature on a paper, make it larger and larger.
 Try with your left hand.
 Assignment:
 Examine these signatures carefully and write down common elements you
found.
 What do you think are the cause of both , the common elements and the
difference.
 How your result support or contradict, the theory of motor programming.
 System Theory

 Nicolai Bernstein ( 1896-1966)

 States that “ the body is a mechanical system with mass, subject to external and
internal forces”
 Control of integrated movement was probably distributed throughout many
interacting systems working cooperatively to achieve movement.
 Coordination of movement is the process of mastering the redundant degrees of
freedom of the moving organism.”
 Synergies play an important role in solving degrees of freedom
 On the basis of these assumptions it can be called as Distributed Model of Motor
Control.
 Latish et al 2007, Latish and Anson 2006 describe new definition of Synergy:
“Synergies are not used by the nervous system to eliminate degrees of freedom,
but instead of ensuring flexible and stable performance of motor tasks”.
 System Theory
LIMITATION
 It does not focus as heavily on the interaction of the organism
with the environment.
Clinical implication
 Body as mechanical device

 Movement are not only the result of nervous system activation and control

but both nervous and other body systems

 In CVA…flexor contracture…decrease range of motion….muscle limitation

 Treatment focus not only damage system but multiple system

 Dynamical Action Theory

 Principle of self-organization – when a system of

individual parts comes together, its elements behave
collectively in an ordered way
 Movement underlying action results from the

interaction of both physical and neural components

 No need for higher center to issue instruction or give

command because coordinated movement will be

achieved no matter what
 Dynamical Action Theory
 Limitation :
 It altogether removes emphasis on the CNS

 Not allow the prediction of movement

Clinical implication
 Inter-action of multiple elements that self organize

according to certain dynamic properties.

 Ecological Theory
 Motor control evolved so that animals could cope with the
environment around them.
 It is not sensation but perception that was important to the individual

LIMITATION:
Emphasis has shifted from the nervous system to the organism-
environment interface
 ENVIRON
MENT

INDUVIDUAL

ENVIRON ENVIRON
MENT MENT
Which Theory of Motor Control is
Best ?????????????????????????
Parallel Development of clinical Practice and Scientific Theory

 A Theory is not right or wrong in an absolute sense, but must be

judged to be more or less useful in solving problems presented by
patients with movement dysfunction.
MOTOR CONTROL MODEL

Refex Theory Hierarchical System

Contemporar
Muscle Neurotherapeuti
y Task
Reeducation c Fascilitation
Oriented

Neorological Rehabilitation Model

THANKS