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Motor

MotorlearningAspectsofprac+calapplica+onAspectsofsorehaMotorMotorAspectsClinicalidealidealorienta+onto‘sneedsandsorehaMotorAspectsof

aproblem-‐solvingapproachtotheassessmentandtreatmentofindividualswithdisturbancesoffunc+on,movementandposturalcontrolduetoalesionof centralnervoussystem(IBITA1996) 的评估和治疗aclinicalreasoningprocess,ratherthanaseriestreatmentsorsorehaMotorAspectsNormalmovementisalways：coordinatedadaptedfluentsorehaMotor

Motorsolvinga(motor)taskinin c+onwithenvironment与外precondi+onsformotor(re)learning:awareness,AspectsofsorehaMotor

Motorneuro s-city;formf sfunc-thebrain‘sabilitytolearn,toadapt,tointenses+mula+onandadequatecontexts+mulatebraintoproducemoreneurotransmiSersinac+vatedareas 刺激和适当的的环境刺激大脑产生的神AspectsofsorehaMotorAspectsMotorchangesonmolecular,biochemical,electrophysiologicalandstructurallevels在分子学，生物化学，电生理学和结onalllevelsofCNSPNSandmuscularstructuresprecondi+onsimultaneousinputofsensoryinforma+on&modula+ngtransmiSers(informa+onaboutmo+va+on&awarenessatsynapse先决条件：感觉信息和调节递质在sorehaMotorAspectsMotorLearningrepe++on:notalwaysexactthesamebutvaria+on:totransfera(re)learnedac+vitytocomparablebutslightlydifferentsitua+ons→toregainfunc+onnotonlyinclinicaltrainingsitua+onbutalsoinpa+ent’severydaylifespecific:mustbetask-‐directed,notjusttrainingabodyfunc+onsorehaMotorAspects

MotorLearningprocesswithdifferentphases:repe++on&+mearera+otraining/rest+me:performancebenefitsfromearlylearningphase:quickimprovmentsverytask-‐specific,independentofperfomancelevel早期学习阶段：进步快，increasingnumberofrepe++onsleadstoslowerimprovments–consolida+onprocessescantake (furtherimprovementofataskwithoutfurthertraining)增加 的训练不加强但是会得到更好地效果sorehaMotorAspectsof

MotorLearningpassivemovementsarenotaseffec+veasini+atedbythe repe++onofataskasanen+ty让患者任务的重复次数实realis+candsuppor+veenvironment环境要现实和具有支sorehaMotorAspectsprac-calAspectsofprac-calapplica-TreatmentPrinciplesforNeurologicPa-sorehaMotorAspectsprac-cal原技soreha

Prac-calApplica-CmpCmptConceptMotor

c+onbetweenpa+entand24hmanagement24

Aspectsofprac-calsorehaCmptPrac-calApplica-onCmptMotorMotorAspectsprac- pa+ent’s(physicalandcogni+ve)combina+onofbothmethodsispossibletoachievedifferentpartsofagoalBUTconsidermotorlearning sorehaeduca+onCmptMotorAspectsofprac-cal

Prac-calApplica-on实际应Facilita-on/Modifica+onof易化/environment:heightoftreatmenttable,qualityofchair,basicposi+onofthepa+ent,hands-‐on/环境：治疗床高度，座椅质量，患 ，亲task:verbalinstruc+on,al+onofpunctum ,differentkindsofmuscleindividual:control,dual-‐task/max.sorehaCmptMotorAspectsofprac-cal

Prac-calApplica-on实际应ysisofmovementanddemandingac+vity:atleastmentalpar+cipa+on;mustbedemandingsorehaCmptMotorAspectsofprac-cal

Prac-calApplica-on实际应Principle watchoutforcompensatorystrategies!reflec+ve:evalua+on e/processbypa+ent/thenningofmovement:bythepa+ent;partoffeed-sorehaCmptMotor

Prac-calApplica-on实际应Principleintegra+onofpostural结 控eAspectsofprac-calsorehaCmptPrac-calApplica-CmptMotorAspectsprac-

repe++onandvaria+onac+veandself-‐determined:pa+entshoulddevelopstrategyforac+vity(needs+me,partoffeed-自身能动性：患者应当自身发展主动参与的方法（exercisingmotorfunc+onsatwhichmusculo-‐sceletalcondi+on(biomechanicalaspects)isconsideredandin socanbeop+mized把握运动功能 点（生物力学），达到治疗效

sorehaCmptPrac-calApplica-onCmptMotorMotorAspectsprac-（治疗师）亲手治疗vs言语指导（非亲手治疗sorehaCmptMotorAspectsofprac-cal

Prac-calApplica-on实际Techniquemobilisa+on,manualtherapy松解术， stretchingstrengtheningmentalrehearsaltransfer,beddingMTTsorehaMotor

Prac-calApplica-on实际应Treatmentposturalcontrol/trunk symmetrical/asymmetricalpaSerns对称/decreaseofmaincompensatorystrategiestrainingatupperperformanceAspectsofprac-calsorehaMotor

Berta„Ifthepa+entesbeSer-‐changethetreatment,ifthepa