theories of motor development

[linbin]

hi all
i urgently needed materials related to theories of motor development.so if anyone knows about books,articles related to it ,please let me know.thanks in advance

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[Bobby Nabeyama]

Please take a look at Motor Control: Translating Research into Clinical Practice by Anne Shumway-Cook and Marjorie Hines Woollacott. It's great.

[estherderu]

dear linbin,
I agree with bobby on the subject of the book motor control.

The 2 "new" theories motor development are wel documented. Attached a document I wrote about all the theories of motor development including some liturature. If you need more, try googling all the names and you will find a lot of information gratis.

A book about posture control ( written by authors like Mijna Hadders-Algra, Eva Bower + others) is in press at the moment. Should make very interesting reading.

good luck, hope this helps

In Holland, we are trying to understand and implement both "theories". Keeping in mind that they are hypothesis and they can be "used" together.

esther de ru

[Bobby Nabeyama]

Esther De Ru,

Do you have a preference on which theory or conceptual framework? So many to choose from right. Though many clinicians do combine theories- in fact they aren't very combinable at times. E.g., referencing neurodevelomental/hiearchal models and modern motor control theories such as systems. Or sensory integration and empirically validated "theories" such as learning processes/behavior analysis. Some clinicians may not even deal with theories.

Regards,
Bobby Nabeyama

[estherderu]

dear bobby,

I must say, my first personal feeling is to follow the theories based on neurological knowledge.
I am very much a practical person. The theoretical background to explaining motor behaviour in infants by mrs Mijna hadders-Algra in her Dutch book on infant motor development was an eye opener for me at the time. She was explaining the theory to what I had expierenced so often without knowing exactly why. Making me very curious to know more. At the same time the DST was being introduced.

By nature I am also a person who is willing to work without a theoretical background, using an open mind and common sense. Variability in motor behaviour motor performance, the sensory information capacity, the hyper-hypomobility, brain plasticity......there are so many interesting variables.... and I am comfortable with that. Not one child is the same, so why should their treatment be?

Am very happy if I find a hypothesis to explain why something works, but am especially busy trying to make "something work".
I have been in the health "business" (in various professions) long enough to be sceptical of "evidence based" and statistics.

Am looking forward to the book about posture.

kind regards

Esther de Ru

[Bobby Nabeyama]

Esther de Ru,

Postural Control: a key issue developmental disorders by Hadders-Algra should be released any day now. The release supposed to be Oct 08. I'm excited to get to read it as well.
So you're skeptical of evidence-based practice and statistics as you should. But, do you practice evidence-based?

Regards,
Bobby Nabeyama

[estherderu]

dear Bobby,

as much as possible.... and
as far as real evidence based theories can tell me what to do...

In Holland we have been very lucky to have people like the Bobaths across the Channel and Vojta around the corner ( long ago). In the last 15 years people like dr Prechtl, dr Mijna Hadders Algra and mrs Marjolein Ketelaar ( functional physiotherapy in CP), colleagues Eva Bower, Ann-Christin Eliasson (MACS) Olaf Verschuren ( physical fitness in CP) Raoul Engelbert (connective tissue- JRC) around the corner, and the European Academy of Childhood Disability,EACD -an active organisation promoting research. European Academy of Childhood Disability
Our NVFK ( pediatric group of our National Society) has strict rules about the education of paediatric physios... for more information look at our site NVFK; Nederlandse Vereniging voor Fysiotherapie in de Kinder- en jeugdgezondheidszorg (sorry most is in Dutch- a factsheet is in English). A 4 yrs part time education (used to be 3) covering all aspects of all childhood disabilities. Protocols and guidelines for various childhood diseases are used and being created.
The www.cebp.nl is "made in Holland"!
Look up... NetChild | homepage
Gait labs are working with video analysis, I can send my video to various Gait Labs and have colleagues + rehab specialists "look at my childs problems"

We are lucky....

We are probably one of the only countries with an electronic patient file system specifically for PPTers.

So being an older bird, I can say I was trained in many "old methods" , had to comply to the new regulations and recieved extra education in order to obtain knowledge of current evidence based work. To be registered and to stay in our paediatric physiotherapy register, ongoing postgraduate education was and is mandatory.

Being the clinician, it was nice to finally know the evidence behind the practice.
This sometimes meant changing things and like always.... everytime you hear something new ( in course- book- conference) you always know a patient you definitely want to "try this" with.


and... how about you?

Esther

[Bobby Nabeyama]

Esther,

Yes it can be very difficult to discriminate the mass information across multiple theories. You demonstrated the complexities with your attached summary. Seems your document was greatly influenced by Hadders-Algra (2000) in Developmental Medicine & Child Neurology.

Anyway, it seems as you have “come along with the times” well. It’s always interesting to find how different clinicians change or don’t change with the paradigm shifts of motor control models and neurologic rehabilitation models. As many clinicians still proclaim the efficacy of Bobath/NDT and Vojta. When in fact they should not, relative to the evidence.

Also, we should tread lightly in accepting many of the current motor control models since they better explain typical/normal development and not otherwise. You might find interesting that Neuronal Group Selection Theory (NGST) is not spoke of much in the States. We appear to reference Dynamic Action Theory or Systems Theory much more. The geographical science preference is pretty overt. I would like to hear more of NGST since it appears to function closely with Evolutionary Theory and Behavioral Learning Theory (which are empirically validated “theories”).

So again, do you have a strong preference towards a specific model?

Oh and I only practice evidence-based.

I would love to hear others speak of theories and the applicability. Guess clinicians avoid the chatter.

Thank you Esther.

Bobby Nabeyama

[estherderu]

dear Bobby,

Sorry for not answering this post earlier. I have been busy translating and correcting a manual for a colleague.

The answer to your last question So again, do you have a strong preference towards a specific model? has to be....

I do not really know enough about the "models"
I suppose that is probably the reason why so many "older experienced physio´s" will not, or cannot go into discussion with the young thoeretically "better" educated colleagues.

Last year, at the AECD conference in Groningen Holland, one of the keyspeakers Diana Damiana, reflected on the differences in the way PTers work and she told us that in the USA there are currently "two camps" These colleagues are in discussion, but both groups are still persuing their own way.

I would very much like to try understand and fill this "gap- communication problem?" and try reach consenses on what "the best" treatment is today and why!
Lets try!
Tell me....
what theories are currently "in" at the moment?

Does the fact that the Dutch have tried to integrate the ICF into their daily practice count for something?

Does the fact that I read a lot and still go to- and have always been- to numerous postgraduate courses ( problem being, they have always been in Europe)make me a "good candidate" for such a discussion?

Is it possible that I might not "remember" the theoretical explanations given, but concentrate on what is being said and seeing the practical implications??

Is it possible, that - being an old bird- I have heard so many explanations, hypothesis, so many people telling me this was "it", "the best therapy for..." that I have become a little sceptical???

Is it possible that some young colleagues have problems believing what older coleagues say because they percieve to have all the wisdom?

Should we not always try to stay open-minded and not just believe what some guru is telling us, even if it is so-called EBM?

Help me understand please!

Hope others join this discussion!

What is your opinion.... do we need to duplicate this discussion on more forums, such as the wcpt forum and the myphysicalspace forum?????


Esther

[linbin]

hi esther
most of the theories mentioned are discussed under the title of"theories of motor control". i agree that they will definitely be overlapping.in the book "reflex and vestibular aspects of motor control,motor development and motor learning" by marylou r barnes,carolyn a crutchfield etal they discussed 3 theories of motor development

[Bobby Nabeyama]

Hello Esther,

Sorry for such a delay. You bring up some good points regarding communication challenges between therapists. As far as age as being a constraining variable- it does seem so at times. However, in my experience both “younger” and “older” therapists may or may not know much about motor control or development. To be quite honest, I do at times jokingly stereotype older therapists as not knowing much of modern physical therapy. That they might still be so greatly influenced by Bobath/NDT, not be able to apply research to practice, being easily duped by fad treatments, and are really just practice as technicians. That being said, I’ve discriminated the same for new graduates or other younger therapists!

Theories and conceptual frameworks are vital in PT practice. If not how does one know what to do with a patient in front of oneself? You can’t know. You could defiantly guess. I find too much guessing going on and it’s disturbing. In clinical practice we should attempt to discriminate right and wrong practice, correct or incorrect, best or worst. Now if these terms are too moralistic or absolute let’s at least maintain an emphasis on objectivity and discriminate practices as more effective or less effective. Let’s get away from this sort of open minded and eclectic practice where everything goes and you can never be wrong because everything works because every patient is different.

What to you think?

Anyway, we’ll chat more about motor control theories and clinical conceptual frameworks.

Bobby

[Bobby Nabeyama]

So has anyone read Postural Control: a key issue developmental disorders by Hadders-Algra?

Guess we either don't care much of research or are fearfull of chatting about it.

[estherderu]

Hi Boby,
Am in the middle of it.....
Have made sure two of my spanish colleagues have bought it as well...

Do not have much time (no time in fact) at the moment, am busy with preparing a course and going on a BIG holiday. Will be back to really dig into it in october....... isn´t that horrible

Esther

[Bobby Nabeyama]

I see Esther is still by herself here on this site. Do pediatric therapists even care about advancement of discussions?

[gcoe]

Sorry Bobby Nabeyama

I am definitely not a paediatric physio but with my neurological background I am particularly interested in the advancement of science of motor control. For me the integration of the newer models of motor control and motor learning into practice is very fruitful and I think it is a pity that physios from all stripes don't take more seriously these valuable sources of applied science. I think Shumawaycook and Wollacott's book for a general overview is one of the best books we have. In my institution we use it as our student's text and it gives me great confidence in our teaching for all aspects of neurological physiotherapy and beyond. Years ago I met Esther Thelan and for me it changed my life and invigorated my interest in neurological physiotherapy. It opened me mind to how limited our knowledge is of how human movement develops and changes over time and in illness and disability. However I am afraid I am way too divorced from the realities of paediatric practice to contribute to your discussions in a meaningful way.

I must say the Esthederu does a stirling job of representing the paediatric physio front on this site. There are many requests with paediatric issues on this site from the public - often requests come from parents who are quite desperate for finding a way forward and her responses are always well informed, thoughtful, courteous and empathetic. I think PhysioForum has been very fortunate to have her professional involvement and dedication.

It does seem a pity that more paediatric physios don't participate on this site. It would be good to have some "consciousness raising" amongst paediatric physios about the site.

[estherderu]

dear gcoe,

Thanks you so much for the compliment!
I consider myself very lucky to be able te do this. I have the time, the place and the possibility and I love my profession.

And you are doing a very good job yourself as well!
I especially love the way you can explain neurology in a clear, concise and simple manner.

dear bobby,
I have been influenced by prof. Mijna Hadders Algra yes. Have met her on numerous occasions. She once wrote a book for paediatric physio´s in Dutch called infant motor development (2000) and for me this was the eyeopener. Finally a scientific (neurological) explanation for and of the phenomena I had seen so often. This book is a little outdated now but at the time it was the first book "intermingling" theory,anatomy and physiology and practice. A scientist who could explain part of what we were seeing.....wow....

She is still very involved in academic work with many professionals including paediatric physiotherapists at the University of Groningen.
Ontwikkelingsneurologie|Developmental Neurology


esther

[PamVersfeld]

I would like to add my appreciation of Esther's balanced and insightful responses to posts on this site.

I recently attended a 2 day course where prof Hadders-Algra presented her research - very interesting. Her thinking is very influenced by her own research with all it biases - one of these being that she is a neurologist and has a deficit view of any developmental anomaly. She also very easily puts down Esther Thelen's dynamic systems approach to the understanding of development which in fact has been a great influence on the thinking of many other researchers including physical therapists such as Beverley Ulrich and Cole Galloway. Karen Adolph's work is also an inspiration, as is that of Claus von Hofsten.
See An action perspective on motor development and control - bibliography | skillsforaction.com

Like Gcoe my own thinking has been deeply influenced by Esther Thelen's work, and those who have followed her and this influence threads through all my opinions freely expressed at About skillsforaction.com | skillsforaction.com!


Pam

[estherderu]

Dear Pam,

Your reaction is very kind and has certainly given me something to think about.

I participated in a workshop by Karen Adolphs about two years ago and was very much impressed. Have passed her name and website on to others and on this forum. I think her work is fascinating, she has publised so much and shows us how much children can do.

I see I have some catching up to do....
I am not that familiar with the other colleagues you mentioned.

I do feel that when I am reading all the information placed on your skillsforaction website, that we have a lot in common.
It has always fascinated me how well children are able to communicate their needs, solve problems if they get a chance and how difficult it is for us adults to see this. I loved the book called The aware baby by Aleta Solter. This book and her lectures made me change the way I looked and handled babies and small children.

It seems I will have to take some time off to start reading again.
Can you give me some more references and possibly websites please?

Thanking you in advance

Esther

[PamVersfeld]

Dear Esther

Perhaps a good place to start is to take a look at what is involved in learning a new motor skill. Daniel Wolpert's article "Motor learning" gives a good introduction to the most up to date conception of motor learning and control, and especially ideas related to internal models and feed-forward control. http://cbl.eng.cam.ac.uk/pub/Public/...s/WolFla10.pdf

The most up to date models of movement control take into account what is happening in the body as the trunk and limbs move and generate reactive forces that need to be counteracted, as well as the impact of the forces generated as the body makes contact with the environment.

The other important aspect of motor control is the importance of predicting what happens next, and anticipatory control to counteract events that are predicted in the future.

Enjoy the reading

Pam

[illuminatidinesh]

Hi Everyone,
Pam I read ur PDF it is interesting and thanks. Ester, it is surprising and heartening that some one from Peadiatric Physical therapy is here to help and guide us......
I have a doubt which is the latest accepted motor control theory?

[estherderu]

dear Illuminatidinesh,

I cannot speak for everyone. There are a number of hypothesis (models) on motor control and motor development circulating world wide. The ones named in this discussion are the ones I know of.
I know nothing about what the ideas and thoughts on this subject are from Russian, Japanese, South American and Chinese colleagues for example. It is very possible they also have a number of "models" we know nothing about.

I hope colleagues from these countries are willing to share their insights with us.

Esther

[PamVersfeld]

Dear All

This thread has certainly created a lot of interest. If you would like an overview of the latest developmental systems theories of motor development and approaches to intervention, take a look at the updated SfA Webmanual - Home | SfA Webmanual

The aim of this website is to provide physiotherapists with up to date information and practical ideas for applying insights from the new developmental systems theories and context/participation based approaches to intervention.

The website also hosts a new series of online CPD activities on infant development and intervention.

Best wishes

Pam

[halmax]

Hi, it depends how do you look at motor activity. Motor develoment can be seen as pure neulological, then we are talking about myelinization and development of reflexes and neurological structures. If we take into acount some nuropsychological aspects, and watch motor activity as cognitive and motor act, then we are talking about praxic activity and disorders like limb apraxia, DCD etc. (Lipemann, Luria, Hailmann, Ayres...). You can even use Piaget theory of child development to explane motor development, maby Vigotsky (his texts are more oriented toward disability issue). Also concider reading Vojta, Bobath. Herbert Heur has a lot of stuff on motor control, but mainly on different mathematical models...

[KelcieLe]

Hi, it depends how do you look at motor activity. Motor develoment can be seen as pure neulological, then we are talking about myelinization and development of reflexes and neurological structures. If we take into acount some nuropsychological aspects, and watch motor activity as cognitive and motor act, then we are talking about praxic activity and disorders like limb apraxia, DCD etc. (Lipemann, Luria, Hailmann, Ayres...). You can even use Piaget theory of child development to explane motor development, maby Vigotsky (his texts are more oriented toward disability issue). Also concider reading Vojta, Bobath. Herbert Heur has a lot of stuff on motor control, but mainly on different mathematical models...

Really helping post Halmax.