THE CONTEMPORARY MOTOR CONTROL MODEL

                        THE CONTEMPORARY MOTOR CONTROL MODEL

1.      THEORY

·         Motor control is viewed as emerging from the interaction of the human (including motivational, cognitive, CNS, and musculoskeletal components) with environmental and task variables

·          In this approach, movement is understood not to depend solely on the CNS

·          The CNS is viewed as a heterarchically organized system with higher and lower centers interacting cooperatively with each other and with the musculoskeletal system 

·         Movement patterns are understood not as invariant sequences “pre-wired” into the CNS but as stable ways to accomplish occupational performance, given the unique characteristics of the human being and certain environmental conditions 

·         Motor control is learned through a process in which the person seeks optimal solutions for accomplishing an occupation 

·         When patterns of movement are practiced, they become attractor states 

·         Changes in the environmental conditions, the task, or the person can result in a disintegration or a qualitative shift in the preferred pattern of movement 

·         The contemporary model of motor control in occupational therapy emphasizes the role of the occupation being performed and the occupational context in which it is performed  Within this model, motor control is viewed as behavior that self-organizes specifically in the context of performing a given task 

·         The sequence of motor change or learning depends both on the unique characteristics of the individual and on variations in the environment in which motor control is learned

2.      UNDERSTANDING MOTOR PROBLEMS 

·         When persons have CNS damage, problems of motor behavior result from the attempt to compensate for the damage while performing a specific occupational form in a given context

·         Movement patterns are a consequence of the dynamics that occur between a person with specific abilities and limitations, the task being performed, and the environmental conditions in which performance takes place

3.      THERAPEUTIC INTERVENTION 

·         Therapy begins by identifying those tasks that are difficult to perform and by noting the preferred movement patterns the person uses for those tasks 

·         The therapist then determines the personal and environmental systems that either support optimal performance or contribute to ineffective performance 

·         The therapist also seeks to determine the stability or instability of motor behaviors across occupational and environmental conditions 

·         This reveals how strong an attractor state a particular movement pattern is and, therefore, how easily it can be disturbed or shifted to another pattern 

·         The contemporary motor control approach stresses learning the entire task rather than discrete parts 

·         This approach also emphasizes allowing persons to find their own optimal solutions to motor problems rather than relying on instructions and constant feedback 

·         The goals of treatment in this approach focus on:

ü  Accomplishing necessary and desired tasks in the most efficient way, given the client’s characteristics

ü   Allowing the person to practice in varying and natural contexts so the learned motor behaviors are more stable

ü  Maximizing personal and environmental characteristics that enhance performance

ü   Enhancing problem-solving abilities of clients so they will more readily find solutions to challenges encountered in new environments beyond the treatment setting

4.      PRACTICE RESOURCES 

·         The approach to evaluation is client-centered and task-oriented, emphasizing the observation of a person’s attempts to perform meaningful tasks in context 

·         Evaluation methods incorporate both quantitative and qualitative data-gathering 

·         Evaluation begins with observation of occupational performance and proceeds to examine underlying systems only when further understanding of how those systems are constraining performance is needed 

·         The therapist begins by learning what tasks are necessary for the role performance of the client

·          There are not yet validated standard methods of evaluation. However, principles of assessment and ways of incorporating existing assessments into the approach have been identified 

·         Because this model emphasizes the use of client-centered occupational forms, natural environments, and a process of active experimentation for optimal motor solutions, its techniques cannot be as readily specified as those of the neurodevelopmental approaches 

·         The contemporary approach identifies multiple factors that influence motor control and argues that their relative importance and influence on a client’s performance are situationally dependent 

·         The actual techniques used in therapy require an individualized understanding of the client’s situation across many dimensions. It has been suggested that therapists should:

Ø  Use functional tasks as the focus in treatment

Ø   Select tasks that are meaningful and important in the client’s roles

Ø   Analyze the characteristics of the tasks selected for treatment

Ø   Describe the movements used for the task performance

Ø   Determine whether the movement patterns are stable or in transition

Ø  Analyze the movement patterns and functional outcomes of task performance