Presentation on theme: "MOEIN KADKHODAPOUR,AMIRHOSEIN HASHEMIAN,ALI ABAEIYAN"— Presentation transcript:
1 Motor control and Physiotherapy and Sports in Neuromuscular disorder(NMD) MOEIN KADKHODAPOUR,AMIRHOSEIN HASHEMIAN,ALI ABAEIYANSupervisor: dr. arshiSpring 2013
2 Table of Content Introduction of Motor control Physiotherapy and neuromuscular disorderSport and neuromuscular disorder
3 Motor controlThe brain plays a major role in our body motoricity . Motor controls are the information processing activities carry out by our central nervous system that helps us organize , move and coordinate our movements and muscles.
4 I. What Controls Movement II. What the Motor System ControlsIII. Mechanisms of Motor ControlIV. Motor MemoryV. Flexibility in Motor ControlVI. Evolution of the Motor System
5 WHAT CONTROLS MOVEMENT The motor system consists of two interacting parts: peripheral and centralPeripheral Motor System- Muscles- Motor Neurons and Motor UnitsCentral Motor System- Spinal Cord- Brain stem- Diencephalon- Telencephalon
6 Physiotherapy Physiotherapy: Physiotherapy is a health care profession primarily concerned with the remediation of impairments and disabilities and the promotion of mobility, functional ability, quality of life and movement potential through examination, evaluation, diagnosis and physical intervention carried out by physiotherapists.Neurological physiotherapy is a field focused on working with individuals who have a neurological disorder or disease
7 Effects of NMD on muscles As motor neurons die, muscles become weaker and stiffer. They gradually cease to work and waste away.associated joints become stiff and may contract and This, makes everyday activities increasingly difficult, and sometimes painful.Once the supply of motor neurons that control a particular muscle has degenerated, it cannot be regenerated by exercise or anything else. Nevertheless, muscle elasticity, joint range of movement and prevention of muscle shortening can be helped by regular exercises.
8 Types of physiotherapy treatment If the assessment takes place in the early stages of the disease, patient might start with simple exercises which can do himself. as the disease progresses, he will probably need to move on to a different regime of less active exercisesTreatments include:Range of Movement (ROM) exercises: to maintain joint range and prevent joint deformity and soft tissue shorteningMassage and soft tissue mobilization: to increase circulation, reduce pain, aid relaxation, reduce spasticity.Breathing techniques: to facilitate respiratory effort and to aid clearance of secretions.
9 Exercises Exercises can be split into three categories: Active exercises: when your muscles can perform the full movement.Active-assisted exercises: when you can no longer move through a ROM exercise on your own, but a helper can assist the muscle through the movement.Passive exercises and stretches: when the muscles can no longer perform any of the movement and these are done completely by a helper.(Passive exercises work the joints but not the muscles.)Moderation in exercisingFatigue will only increase weakness and sap your energyexercise will not strengthen muscles that have been weakened by NMD. However, it is still invaluable, as by strengthening the healthy muscles, it enables them to help compensate for those muscles that are no longer working properly.
10 Objective Measures monitored in NMD clinic Range of Movement of joints and muscle lengthTimed Functional activitiesBalanceRespiratory function, along with Pulmonary function testing
11 Range of Movement of joints and muscle length For Muscular Dystrophies, muscles that are most often measured include:Hip flexorsHip abductorsHamstringsCalvesElbow flexorsWrist flexors
12 Timed Functional activities Assessment of tasks that are important for everyday life completed for those who are able:Timed 10 meter walk/runTimed supine to stand up from lying on the floorTimed climbing 4 stairs
13 Exercise training role in NMD IntroductionPatients- Progressive weakening and loss of functional skeletal musclesDisabilities- Depends on the specific type of disease, pathogenesis, extent of clinical involvement, and rate of progressionPrimary clinical goal- maintaining strength, function, independence, and quality of lifeMain tool- ExerciseExercise mechanism in maintaining strength- Stress causes microscopic damage to the myofibers which initiates gene transcriptional and splice mechanisms
14 Exercise training role in NMD treatment Exercise and neuromuscular diseaseMain question- Whether exercise training may be helpful in individuals with neuromuscular diseasesPostmortem muscle study of a patient with Duchenne muscular dystrophy (DMD)- the greatest muscle degeneration occurred in muscles used during sustained physical activityExercise studies in NMDsRarity of NMDsGrouping different subjects of NMDs
15 Exercise training role in NMD Motor neuron diseaseALS(Amyotrophic Lateral Sclerosis)Undelineated pathogenesis and Motor neuron deficiency in ALSStudies of effects of exercise on mice with ALSRandomized control trial among 25 individuals3 months improvement in patient condition6 months no difference
16 Conclusion Inadequate evidence from randomized controlled trials Potential to improve condition of individuals regarding to the type, stage, and severity of the diseaseAssessing effects of exercise