Motor Control

THEORIES OF MOTOR CONTROL
& CLINICAL IMPLICATIONS

BY : DR. HANZALA SHAIKH
INDEX :
■ INTRODUCTION
■ NATURE OF MOVEMENT
■ WHY SHOULD THERAPIST STUDY MOTOR CONTROL ?
■ VALUE OF THEORY TO PRACTICE
■ MOTOR CONTROL THEORIES – LIMITATIONS , CLINICAL
IMPLICATIONS
■ REFERENCES
INTRODUCTIO
N:
• DEFINITION:
Motor control is defined as the ABILITY TO REGULATE / DIRECT the
mechanisms essential to MOVEMENT.
Thus, the MAIN GOAL of motor control research is to create a formal description,
operating with exactly deﬁned variables, of the physical and physiological processes that
make such movements possible.
• THE FIELD OF MOTOR CONTROL IS DIRECTED AT:

1. Studying the nature of movement.
2. How movement is controlled ?
NATURE OF MOVEMENT :
TASK
Movement
ENVIRONME
INDIVIDUAL
NT
WHY SHOULD THERAPIST STUDY MOTOR
CONTROL?
• Directed at CHANGING MOVEMENT or INCREASING THE CAPACITY

TO MOVE.
• STRATEGIES - Designed to IMPROVE the QUALITY AND QUANTITY OF POSTURE

AND MOVEMENTS essential to FUNCTION.
THE CONTROL OF MOVEMENT:
THEORIES OF MOTOR CONTROL
• A theory of motor control is a GROUP OF IDEAS about the CONTROL OF
MOVEMENT.
•A theory is a SET
OF INTERCONNECTED STATEMENT that
DESCRIBES UNOBSERVABLE STRUCTURES or processes and
RELATES them to each other and to observable events.
VALUE OF THEORY TO
PRACTICE :
FRAME WORK FOR INTERPRETING
BEHAVIOUR
GUIDE FOR CLINICAL ACTION
THEORY
PROVID
ES NEW IDEAS: DYNAMIC & EVOLVING
WORKING HYPOTHESIS FOR

EXAMINATION & INTERVENTION
REFLEX THEORY :
■ Established by CHARLES SHERRINGTON, a
neurophysiologist.
■ His research on sensory receptors led to view that
MOVEMENT was a result of STIMULUS-RESPONSE
sequence of events or REFLEX BASED
■ STIMULUS RESPONSE
■ Sensation assumed a primary role in INITIATION AND
PRODUCTION of movement.
■ He believed, REFLEXES were the BUILDING
BLOCKS of complex behavior.
LIMITATIONS :
• Reflexes cannot be considered the basic unit of behavior if both SPONTANEOUS AND
VOLUNTARY MOVEMENTS are recognized as acceptable classes of behavior as it must be
activated by an outside agent.
• Does not adequately explain and predict movement that occurs in the ABSENCE OF SENSORY
STIMULUS.
• Does not adequately explain FAST MOVEMENTS. Eg typing
• Fails to explain the fact that a SINGLE STIMULUS can result in VARYING RESPONSES
depending on context and descending commands.
• Does not explain the ability to produce NOVEL MOVEMENTS. Eg violinist
CLINICAL
IMPLICATIONS
• Clinical strategies designed to test reflexes :
should allow therapists to PREDICT
FUNCTION.
• Patient’s movement behavior would be interpreted in terms of PRESENCE OR

ABSENCE of CONTROLLING REFLEXES.
• Retraining motor control for functional skills would focus on ENHANCING OR

REDUCING the effect of various reflexes during motor tasks. Eg. Facilitation /
inhibition
HIERARCHIAL
THERAPY :
•Many researchers have contributed to the view that the nervous system is
organized as HIERARCHY.
• Among them, HUGHLINGS JACKSON, an English physician

argued that the brain has :
HIGHER LEVEL HIGHER ASSOCIATION AREAS
MIDDLE LEVEL MOTOR CORTEX
LOWER LEVEL THE SPINAL LEVELS OF MOTOR
FUNCTION.
• The hierarchical control model is characterized by a

TOP-DOWN STRUCTURE, in which
HIGHER CENTRES are always in charge LOWER CENTERS.
CURRENT CONCEPTS RELATED
TO HIERARCHICAL CONTROL :
• The concept of a strict hierarchy has been modified.
• Within this modification, THE ASSOCIATION CORTEX operates as the HIGHEST LEVEL
(Elaborating perception and planning strategies)
• While SENSORY-MOTOR CORTEX in association with the PORTIONS OF THE BASAL
GANGLIA, BRAIN STEM AND CEREBELLUM functions as the MIDDLE LEVEL(Converting
strategies into motor programs and commands).
• The SPINAL CORD functions as the LOWEST LEVEL, translating commands into muscle
actions resulting in the execution of movement.
• Modern hierarchical theory proposes that the three levels do not operate in a RIGID, TOP-DOWN
ORDER but rather as a FLEXIBLE SYSTEM in which each level can exert effect on each other.
• Shifts in control are dependent on the DEMANDS AND COMPLEXITY OF THE TASK
WITH THE HIGHER CENTERS ALWAYS ASSUMING CONTROL.
LIMITATIO
NS explain
• Cannot : the DOMINANCE OF REFLEX BEHAVIOUR in certain
situations in normal adults. E.G.. Stepping on a pin results in an immediate
withdrawal of leg. This is an example of a reflex within the lowest level of
hierarchy dominating motor function.
• Limitation of hierarchical theory reflex within the lowest level of the

hierarchy dominating motor function. (BOTTOM UP CONTROL)
• All low-level behaviours are primitive, immature and non-adaptive, while
all higher level (cortical) behaviours are mature, adaptive and appropriate
CLINICAL IMPLICATIONS :
• Signe Brunnstrom, used a reflex hierarchical theory to describe disordered movement

following a motor cortex lesion.
• She stated “when the influence of higher centers is temporarily or permanently

interfered with the normal reflexes become exaggerated and so called pathological
reflexes appear”.
• “The release of motor responses integrated at lower levels from restraining influences of
higher centers, especially that of the cortex leads to abnormal postural reflex
activity”(Bobath,1965; Mayston,1922).
MOTOR PROGRAMMING
THEORY :
• Reflex theories have been useful in explaining certain STEREOTYPED PATTERNS of
movement.
• One can remove the stimulus, or the afferent input and still have a patterned motor
response.(Van sant,1987).
• E.G grasshopper – flight depended on rhythmic pattern generator. Even when sensory
nerves were cut, the nervous system could generate the output with no sensory input – but
wing beat was slow
• Concept of central motor pattern, is more flexible than the concept of a reflex because it
can be EITHER ACTIVATED BY SENSORY STIMULI OR BY CENTRAL
PROCESSES. The term motor program may be used to identify a central pattern
generator(CPG).
• Central pattern generator (CPG) - specific neural circuit in spinal cord –neural
networks that can endogenously (i.E. Without rhythmic sensory or central input) produce
rhythmic patterned outputs or as neural circuits that generate periodic motor commands for
rhythmic movements such as locomotion.
LIMITATIONS :
• Central motor program CANNOT be considered as sole Determinant of action.
•Motor program concept does not take into account Musculoskeletal system and
Environmental variables
• In patients whose higher levels of motor programming are affected, motor program
theory helps patients relearn correct rules for action.
• Intervention should focus on retraining movements important to a functional task, not

just on re-educating specific muscles in isolation.
SYSTEMS THEORY :
• Bernstein,1967 looked at the whole body as a mechanical system, with mass and
subject to both external forces such as gravity and internal forces including both inertial
and movement dependent forces.
• He also noted that we have many degrees of freedom.

• Higher levels of the nervous system activate lower levels, while lower levels activate
synergies or group of muscles that are constrained to act together as a UNIT.
LIMITATION :
• Systems theory does not focus heavily on the interaction of the organism
with the environment.
• Examine the contribution of impairments in the musculoskeletal as well as neural

system.
• Intervention must focus not only on the impairments within the individual system, but
among the multiple systems
DYNAMIC ACTION THEORY :
• The dynamic action theory approach to motor control has begun to look at the moving
person from a new perspective.
(Kamm 1991, kelso and tuller ,1984;kugler and turvey1987)
• The perspective comes from the broader study of dynamics and synergetic.
• “Fundamental dynamic systems principle.” It says that when a system of
individual parts come together , it’s elements behave collectively in an ordered way.
• This principle applied to motor control predicts that movement could emerge as a
result of interacting elements without the need for specific commands or motor
programs within the nervous system.
• E.G – thousand muscle cells of heart work together as a single unit – heart beat
• Dynamic theory states that the new movement emerges due to a critical change in in
one of the systems called “controlled parameter”.- A variable that regulates change in
behaviour of the entire system.
• Dynamic action theory has been modified to incorporate many of Bernstein's concepts
‘”dynamic system model” suggests that movement underlying action results from
interaction of both and neural components.
LIMITATION :
• A limitation of this model can be the presumption that the nervous system has fairly
unimportant role and that the relationship between the physical system of the animal and
the environment in which it operates primarily determines the animal’s behaviour.
• One of the major implication of the dynamic action theory is movement is an

emergent property.
• It emerges from the interaction of multiple elements that self organize

based on certain dynamic properties of the elements themselves.
• Movement behavior can often be explained in terms of physical principles rather

than in terms of neural structures.
• Can make use in helping patients to regain motor control.

ECOLOGICAL THEORY :
• In 1960s, James Gibson explores the way in which our motor systems allow us to
interact most effectively with the environment to perform goal-oriented behavior.
• Actions require perceptual information that is specific to a desired goal-

directed action performed within a specific environment.
• Perception focuses on detecting information in the environment that will support

the actions necessary to achieve the goal.
• Ecological perspective has broadened our understanding of nervous system

function from that of sensory/motor system , reaction to environmental variables
to that of perception /action system that actively explores the environment to satisfy
its own goal.
LIMITATIONS :
• Give less emphasis to the organization and function of the nervous system that has led to
this interaction, more on organism/environment interface.
• A major contribution of this view is in describing the individual as an active explorer to

the environment.
• An important part of intervention is helping the patient explore the possibilities for
achieving a functional task in multiple ways.
• The ability to develop multiple adaptive solutions to accomplish a task and discover the
best solution for them, given the patients set of limitations.
WHICH IS THE BEST THEORY OF
MOTOR CONTROL ?
• The best and most complete theory of motor control, the one that really predicts the
nature and cause of movement and is consistent with our current knowledge of brain
anatomy and physiology?
• There is no one theory that has it all best theory is that combines
elements from all the theories presented.
NEUROLOGIC REHABILITATION: REFLEX
BASED NEUROFACILITATION APPROACHES :
• Neuro - facilitation approaches include Bobath ( Karl and Berta Bobath,1965), the
Rood approach ( Margaret Rood,1967), Brunnstrom approach ( Signe
Brunnstrom,1966) PNF (Voss,1985) , Sensory integration therapy ( Jean Ayres,1972).
• These were based on assumptions drawn from both the reflex and hierarchical theories of
motor control.
• They focus on retraining motor control through techniques designed to facilitate

and/or to inhibit different motor patterns
• Examination of motor control should focus on identifying the presence or absence of

normal and abnormal reflexes controlling movement.
• Interventions should be directed at modifying the refexes that control movement.

• The importance for sensory input for stimulating normal motor output suggests an
intervention focus of modifying the CNS through sensory stimulation
TASK ORIENTED APPROACH :
• Based on newer theories of motor control

• It is assumed that the normal movement emerges as an interaction among many
systems.
• Movement is organized around a behavioral goal and is constrained by the

environment.
• CLINICAL IMPLICATION - task oriented approach to intervention assumes that patients

learn by actively attempting to solve the problems inherent in a functional
task rather than repetitively practicing normal patterns of movement
REFERENCES:
■ Motor control – shumway cook (4th edition )

■ Functional neurorehabilitation – dolores b. Bertoti (1st indian edition)
■ Motor control theories and their applications. (Mark L. Latash1, mindy F. Levin2, john
P. Scholz3, gregor schöner4) – 2010
■ Clinical applications for motor control – patricia C. Montgomery
THANK YOU .

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THEORIES OF MOTOR CONTROL

& CLINICAL IMPLICATIONS

• THE FIELD OF MOTOR CONTROL IS DIRECTED AT:

• Directed at CHANGING MOVEMENT or INCREASING THE CAPACITY

• STRATEGIES - Designed to IMPROVE the QUALITY AND QUANTITY OF POSTURE

GUIDE FOR CLINICAL ACTION

WORKING HYPOTHESIS FOR

• Patient’s movement behavior would be interpreted in terms of PRESENCE OR

• Retraining motor control for functional skills would focus on ENHANCING OR

• Among them, HUGHLINGS JACKSON, an English physician

• The hierarchical control model is characterized by a

• Limitation of hierarchical theory reflex within the lowest level of the

• Signe Brunnstrom, used a reflex hierarchical theory to describe disordered movement

• She stated “when the influence of higher centers is temporarily or permanently

• Intervention should focus on retraining movements important to a functional task, not

• He also noted that we have many degrees of freedom.

• Examine the contribution of impairments in the musculoskeletal as well as neural

• One of the major implication of the dynamic action theory is movement is an

• It emerges from the interaction of multiple elements that self organize

• Movement behavior can often be explained in terms of physical principles rather

• Can make use in helping patients to regain motor control.

• Actions require perceptual information that is specific to a desired goal-

• Perception focuses on detecting information in the environment that will support

• Ecological perspective has broadened our understanding of nervous system

• A major contribution of this view is in describing the individual as an active explorer to

• They focus on retraining motor control through techniques designed to facilitate

• Examination of motor control should focus on identifying the presence or absence of

• Interventions should be directed at modifying the refexes that control movement.

• Based on newer theories of motor control

• Movement is organized around a behavioral goal and is constrained by the

• CLINICAL IMPLICATION - task oriented approach to intervention assumes that patients

■ Motor control – shumway cook (4th edition )

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