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Translation of motor control concepts to clinical applications: knowledge to implementation cycle (2025)| shared_uid | 3704 |
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| title | Translation of motor control concepts to clinical applications: knowledge to implementation cycle |
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| type | Conférence |
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| year | 2025 |
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| start_date | 2025/03/31 |
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| stop_date | 2025/03/31 |
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| schedule | 11h |
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| active | yes |
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| summary | Understanding how to improve functional motor recovery remains a major scientific, clinical and patient priority in rehabilitation efforts. Yet, despite numerous studies attempting to identify the most effective rehabilitation interventions, sensorimotor recovery in people with central nervous lesions (CNS) such as stroke remains incomplete. The threshold control theory of motor control provides a means by which rehabilitation approaches can be designed to improve functional motor recovery. The threshold control theory describes how central regulation of reflexes, including the stretch reflex, results in different motor actions, in particular, muscle relaxation, motion, and isometric torque production in single- and multi- joint systems. Control is exerted via descending systems mediating both direct and indirect influences on motoneurons. This control is manifested as the specification and regulation of Tonic Stretch Reflex Thresholds (TSRTs) in specific muscles. Injury in the CNS results in deficits in dynamic stretch reflex threshold (DSRT) and TSRT regulation leading to limitations in kinematic redundancy, the appearance of abnormal muscle activation in specific joint ranges, identified as ‘spasticity zones’, and the adoption of compensatory movements during task performance. These problems lead to decreased functional ability and decreased ability to adapt movements to task requirements. For example, people with mild stroke using excessive shoulder-elbow (e.g., arm-plane) motion can still adapt motion to compensate for deficits in reaching, while those with more severe stroke may be unable to adapt such movements to improve reaching accuracy. The relationship between disordered threshold control leading to limitations in reflex modulation and the development of motor impairments of the upper limb will be discussed. The process by which these concepts have been implemented in clinical rehabilitation approaches will be illustrated through the Knowledge Translation and Implementation model. |
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| responsibles | NC |
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