Coordination.
Coordination of movement involves the appropriate timing and positioning of the body during movement. For example, during walking the arms are supposed to swing reciprocally with the legs. Impaired coordination may look like the right arm swinging forward as the right leg steps forward. It may also look like the inability to reach and grasp an object. Some patients have difficulty ordering their movements in order to perform a task smoothly. Through task-specific interventions, feedback, and bilateral movements, patients can improve their coordination for proper movement. Any one task can also be broken down into segments in order to practice them individually - called task segmentation.
Practice and Feedback
As we all know, practice is one of the best ways to improve performance. It is expected that a patient will make mistakes, which is critical to relearning the task and resulting in brain reorganization. Feedback has been shown to be most effective when given on a schedule. Too much feedback causes the patient to rely on the feedback for learning, while too little feedback causes the patient to perform inaccurate repetitions. Feedback can also be provided about the performance of the task or the end results of the task. Ultimately, the most successful method for a patient to learn is to practice the specific task several times and receive overall performance and result feedback every few trials.
As we all know, practice is one of the best ways to improve performance. It is expected that a patient will make mistakes, which is critical to relearning the task and resulting in brain reorganization. Feedback has been shown to be most effective when given on a schedule. Too much feedback causes the patient to rely on the feedback for learning, while too little feedback causes the patient to perform inaccurate repetitions. Feedback can also be provided about the performance of the task or the end results of the task. Ultimately, the most successful method for a patient to learn is to practice the specific task several times and receive overall performance and result feedback every few trials.
Coordination of Walking
Notice that both arms and legs have a role in walking. The reciprocal swing creates rotation of the trunk and causes forward momentum of the body - almost like a wind-up. Step by step, the gait cycle consists of 1) Initial contact of the forward heel, 2) Heel off on the trail leg, 3) Single limb support, 4) Initial contact of other foot, and 5) Heel off on original leg. Now imagine a patient who has difficulty moving their right arm. Not only will their gait be uncoordinated, but it will also be slower because of the lack of forward momentum. |
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Coordination of Reaching
Reaching for a glass of water also appears to be a novel task, but imagine that your hand will not grip and your shoulder will not move forward toward the glass. At that point, it may be necessary to break down the task into its separate components to practice them. 1) Shoulder forward flexion and elbow extension (move the limb toward the glass), 2) Slight forearm supination and wrist extension and digit extension and abduction (opening the hand), 3) Firmly grasp the glass, 4) Slight forearm pronation and wrist to neutral, 5) Shoulder extension and elbow flexion (pull the glass back toward you). |