front.qxd 4/10/2006 2:23 PM Page i Clinical Applications for Motor Control front.qxd 4/10/2006 2:23 PM Page ii front.qxd 4/10/2006 2:23 PM Page iii Clinical Applications for Motor Control Edited by Patricia C. Montgomery, PhD, PT Therapeutic Intervention Programs, Inc. Hopkins, Minnesota Barbara H. Connolly, EdD, PT, FAPTA University of Tennessee Health Science Center Memphis, Tennessee An innovative information, education, and management company 6900 Grove Road • Thorofare, NJ 08086 front.qxd 4/10/2006 2:23 PM Page iv Copyright © 2003 by SLACK Incorporated All rights reserved. No part of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher, except for brief quotations embodied in critical articles and reviews. The procedures and practices described in this book should be implemented in a manner con- sistent with the professional standards set for the circumstances that apply in each specific situa- tion. Every effort has been made to confirm the accuracy of the information presented and to cor- rectly relate generally accepted practices. The author, editor, and publisher cannot accept respon- sibility for errors or exclusions or for the outcome of the application of the material presented herein. There is no expressed or implied warranty of this book or information imparted by it. The work SLACK Incorporated publishes is peer reviewed. Prior to publication, recognized leaders in the field, educators, and clinicians provide important feedback on the concepts and con- tent that we publish. We welcome feedback on this work. Clinical applications for motor control/(edited by) Patricia Montgomery, Barbara Connolly. p,; cm. Includes bibliographical references and index. ISBN 1-55642-545-7 (alk. paper) 1. Physical therapy--Case studies. 2. Neuromuscular diseases--Pathophysiology. 3. Movement disorders--Pathophysiology. 4. Motor ability. 5. Motor learning. [DNLM: 1. Movement Disorders--rehabilitation--Case Report. 2. Motor Skills-- physiology--Case Report. 3. Physical Therapy Techniques--Case Report. 4. Psychomotor Performance--Case Report. WL 390 C641 2002] I. Montgomery, Patricia. II. Connolly, Barbara H. RM701 .C58 2002 615.8’2--dc21 2002010007 Printed in the United States of America. Published by: SLACK Incorporated 6900 Grove Road Thorofare, NJ 08086 USA Telephone: 856-848-1000 Fax: 856-853-5991 www.slackbooks.com Contact SLACK Incorporated for more information about other books in this field or about the availability of our books from distributors outside the United States. For permission to reprint material in another publication, contact SLACK Incorporated. Authorization to photocopy items for internal, personal, or academic use is granted by SLACK Incorporated provided that the appropriate fee is paid directly to Copyright Clearance Center. Prior to photocopying items, please contact the Copyright Clearance Center at 222 Rosewood Drive, Danvers, MA 01923 USA; phone: 978-750-8400; website: www.copyright.com; email: [email protected]. Last digit is print number: 10 9 8 7 6 5 4 3 2 1 front.qxd 4/10/2006 2:23 PM Page v CONTENTS Acknowledgments........................vii About the Editors ........................ix Contributing Authors ................xi Introduction ..................xv Chapter 1 A Framework for Examination, Evaluation, and Intervention ..1 Barbara H. Connolly, EdD, PT, FAPTA Patricia C. Montgomery, PhD, PT Chapter 2 Motor Control, Motor Learning, and Motor Development ..25 Ann F. VanSant, PhD, PT Chapter 3 Neural Systems Underlying Motor Control ..........................53 Roberta A. Newton, PhD, PT Chapter 4 Neuroplasticity: Applications to Motor Control ....................79 Nancy N. Byl, PhD, PT, FAPTA Chapter 5 Musculoskeletal Considerations ..........................................109 in Production and Control of Movement Mary M. Rodgers, PhD, PT Chapter 6 Case Studies ........................................................................135 Patricia C. Montgomery, PhD, PT Barbara H. Connolly, EdD, PT, FAPTA Chapter 7 Applying the Guide to Physical Therapist Practice ....................147 Joanell A. Bohmert, PT, MS Marilyn Woods, PT Chapter 8 Examination and Evaluation of Motor Control....................175 Mitzi B. Zeno, PT, MS, NCS Patricia Leahy, PT, MS, NCS Chapter 9 Sensory and Perceptual Issues Related to Motor Control ....207 Audrey Zucker-Levin, PT, MS, GCS Chapter 10 Issues of Cognition for Motor Control................................245 Kathye E. Light, PhD, PT front.qxd 4/10/2006 2:23 PM Page vi vi Contents Chapter 11 Balance Deficits: Examination, Evaluation, ........................271 and Intervention Mary Ann Seeger, PT, MS Chapter 12 Spasticity and Motor Control ..............................................309 Carol A. Giuliani, PhD, PT Chapter 13 Perspectives on Examination, Evaluation, ..........................335 and Intervention for Disorders of Gait Carol A. Oatis, PhD, PT Lisa M. Cipriany-Dacko, PT, MA Chapter 14 The Patients: Intervention and Discharge Planning..............365 Patricia C. Montgomery, PhD, PT Barbara H. Connolly, EdD, PT, FAPTA Index ............................................................................................................................381 front.qxd 4/10/2006 2:23 PM Page vii ACKNOWLEDGMENTS We would like to acknowledge the artwork of Sandy Lowrance that was initially pre- pared for the first edition of this text (Motor Control and Physical Therapy: Theoretical Framework and Practical Application) and has been reprinted in this revision titled Clinical Applications for Motor Control. Our appreciation also goes to the authors of the individual chapters for being so responsible and efficient, and to our families for their support during the process of writing and editing. front.qxd 4/10/2006 2:23 PM Page viii front.qxd 4/10/2006 2:23 PM Page ix ABOUT THE EDITORS Patricia C. Montgomery, PhD, PT received her BS degree in physical therapy from the University of Oklahoma, Norman, Okla, her MA degree in educational psychology, and her PhD in child psychology from the University of Minnesota, Minneapolis. Dr. Montgomery has a private practice in pediatrics in the Minneapolis-St. Paul area and has taught in physical therapy programs at several academic institutions. She is currently an associate professor at the University of Tennessee Health Science Center and also pro- vides continuing education courses for physical therapy clinicians. Barbara H. Connolly, EdD, PT, FAPTA received her BS degree in physical therapy from the University of Florida, Gainesville. She received an MEd in special education and an EdD in curriculum and instruction from Memphis State University, Tenn. She is professor and chairman of the department of physical therapy at the University of Tennessee Health Science Center. She holds an academic appointment in physical ther- apy at the University of Indianapolis and serves as a guest lecturer at numerous other programs in physical therapy. Additionally, Dr. Connolly remains active in the clinic through the University of Tennessee faculty practice. front.qxd 4/10/2006 2:23 PM Page x front.qxd 4/10/2006 2:23 PM Page xi CONTRIBUTING AUTHORS Joanell A. Bohmert, PT, MS, received her BS degree and advanced MS degree in physical therapy from the University of Minnesota, Minneapolis. She is a full-time cli- nician with the Anoka-Hennepin school district with a focus on pediatrics and neurolo- gy. Ms. Bohmert was actively involved in the development and revision of the Guide to Physical Therapist Practice as a member of the project advisory group and liaison to the musculoskeletal panel for Part Two; member of the task force on development of Part Three; a project editor for the second edition, Parts One and Two; and is currently a member of the American Physical Therapy Association board of directors oversight committee for the second edition. She has lectured extensively on the Guide and is an APTA Trainer for the Guide. Nancy N. Byl, PhD, PT, FAPTA, is currently professor and chair of the department of physical therapy and rehabilitation science at the University of California, San Francisco. Dr. Byl received her BS degree in physical therapy and an MPH in public health from the University of California, San Francisco. She received her PhD in special education from the University of California, Berkeley and San Francisco State University. In 2000, she was awarded a Catherine Worthingham Fellowship from the American Physical Therapy Association. Dr. Byl has engaged in research and published extensively in the areas of motor control and neuroplasticity. Lisa M. Cipriany-Dacko, PT, MA, received BS and MA degrees in physical therapy from Boston University, Mass. She also received an MA degree in motor learning from Columbia University, NY. She is currently an assistant professor and academic coordi- nator of clinical education at Arcadia University (formerly Beaver College) in Glenside, Pa. She has published numerous articles on physical therapy and elder individuals. Carol A. Giuliani, PhD, PT, received a BS degree in physical therapy from California State University at Long Beach, and MS and PhD degrees in kinesiology, with an emphasis in the neural control of movement, from the University of California at Los Angeles. Dr. Giuliani currently is a professor in the division of physical therapy at the University of North Carolina at Chapel Hill. Patricia Leahy, PT, MS,