Motor relearning programme
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The Motor Relearning Programme (MRP) focuses on retraining motor control through an understanding of normal movement and addressing motor dysfunction by engaging patients in real-life activities. It incorporates seven essential functions of daily life, such as upper limb and oro-facial functions, with a structured approach that includes analysis, practice, and feedback to enhance recovery. Key factors for effective rehabilitation include early intervention, consistent goals, and a motivating environment.
Motor relearning programme
- 1. Motor Relearning Programme Dr. Maheshwari Harishchsndre Assistant Professor M.P.Th (Neurosciences) DVVPF College of Physiotherapy, Ahmednagar
- 2. Objectives 1. Explain the motor relearning programme 2. Describe steps in the execution of the programme 4/11/2018 2MRP
- 3. Contents • What is MRP • Factors of MRP • Effectiveness of MRP • Sections of MRP • Steps of MRP • Equipments used • Quality of rehabilitation 4/11/2018 3MRP
- 4. MRP • Retraining of motor control basing on understanding of normal movement & analysis of motor dysfunction. • Emphasis of MRP is on practice of specific activities, the training of cognitive control over muscles & movt. Components of activities & conscious elimination of unnecessary muscle activity. • In rehabilitation programme involve – real life activities included. 4/11/2018 4MRP
- 5. • Concentrate over the essential movement components such as – standing & walking • Based on 3 factors – 1. Elimination of unnecessary muscle activity 2. Feedback 3. Practice 4/11/2018 5MRP
- 6. • Relearning of the everyday activities contained in which patient was skilled before the condition . For effective use of MRP therapist should have the following problem solving skill- i.e recognition analysis decision making action taking re-evaluation 4/11/2018 6MRP
- 7. Effectiveness of MRP 1. Recognition & analysis the problem 2. Select the most essential missing component 3. Explain clearly to the patient by speech & demonstration 4. Monitor the patients performance &give verbal feedback4/11/2018 7MRP
- 8. 5. Re-evaluate throughout each session 6. Positive feedback 7. Provide an enriched environment in which patient will be motivated towards recovery of mental & physical abilities 4/11/2018 8MRP
- 9. Sections of MRP • 7 sections – representing the essential functions of everyday life 1. Upper limb function 2. Orofacial function 3. Sitting up from supine 4. Sitting 5. Standing up & sitting down 6. Standing 7. walking4/11/2018 9MRP
- 10. Steps of MRP 1. Analysis of function – • Observation • Comparison • Analysis 2. Practice of missing components • Explanation + instruction • Practice (verbal feedback & manual guidance)4/11/2018 10MRP
- 11. 3. Practice of activity • Explanation + instruction • Practice • Progression –increase complexity, add variety, decrease feedback + guidance 4. Transference of learning • Opportunity for practice • Consistency of practice • Involvement of relatives & staff • Positive reinforcement • Stimulating enviornment4/11/2018 11MRP
- 12. Upper limb function 1. The ability to see what one is doing? 2. The ability to make postural adjustments which occur with arm movt 3. Sensory information Essential component – reaching shoulder in abduction, flexion, extension, elbow flexion & extension. • Major functions of hand is grasp, release & manipulate objects4/11/2018 12MRP
- 13. • Step 1 – Analysis – common problem & compensatory strategies • Arm & hand • Analysis of painful shoulder • Step 2&3 – practice of UL function • Step 4 – transference of training into daily life • He/she must not suffer secondary injury, not allowed to develop non-learned use phenomenon, conc over essential component 4/11/2018 13MRP
- 14. Oro-facial function • Activities like – swallowing, facial expression, ventilation, speech production. • So affect eating, communication & socialization. • Resultant drooling of saliva or water, aspiration & difficulty ingesting the food. • Swallowing task – essential components are – jaw closure- lip closure- elevation of the post 3rd of tongue – close of oral cavity –elevation of lat border of tongue. 4/11/2018 14MRP
- 15. • Step 1 - Analysis – observation of alignment & movt of lips, jaw, tongue, eating, drooling • Lack of control over oro- facial mus • Will result in – • Step 2 &3 - position , intraoral techniques, practice • Step 4 - feedback 4/11/2018 15MRP
- 16. Sitting up from supine • Essential components – turning on side rotation , flexion of neck, shoulder along with protraction. • Step 1 – Analysis- • Step 2&3 – practice of missing component • Step 4 – transference daily life 4/11/2018 16MRP
- 17. sitting • Essential component – body alignment • Step 1 – Analysis- • Step 2&3 – practice of missing component • Step 4 – transference daily life 4/11/2018 17MRP
- 18. Standing up & sitting down • Essential components – foot placement, trunk forward with hip flexion, extension of neck & spine • Sitting component – trunk pattern, extension of neck & spine, knee flexion. • Step 1 – Analysis- • Step 2&3 – practice of missing component • Step 4 – transference daily life 4/11/2018 18MRP
- 19. Standing • Essential components – postural adjustment, feet position, erect trunk, hip in front of ankles. • Step 1 – Analysis- • Step 2&3 – practice of missing component • Step 4 – transference daily life 4/11/2018 19MRP
- 20. walking • Essential components – • Missing components • Step 1 – Analysis- • Step 2&3 – practice of missing component • Step 4 – transference daily life 4/11/2018 20MRP
- 21. • It is not necessary for a patient to perfect on one section, before going on to another section • MRP should commence as soon as the patient is medically stable. • If bed ridden – start the programme which he/she can manage- like oro-facial function, upper limb function. 4/11/2018 21MRP
- 22. • Three imp. Point in practice of MRP 1. Activities or motor tasks are practice either entirely or broken down into their components 2. Techniques – verbal & visual feedback, instruction & manual guidance 3. Method of progression – should not waste time in practicing what he/she can do 4/11/2018 22MRP
- 23. Equipments used • Low bed of convenient height- for practice of standing up & sitting down • Several small steps • Common objects for retraining hand function • Walking sticks (if necessary)4/11/2018 23MRP
- 24. • Factors improved Quality of rehabilitation 1. Early start 2. Rehabilitation plan 3. Consistency of goal 4. Motivation 5. Mental stimulation 6. Educational programme 7. Planning for discharge 4/11/2018 24MRP
- 25. Summary • MRP • Effectiveness • sections • Steps • Equipments • Quality of rehabilitation 4/11/2018 25MRP
- 26. Questions • Motor relearning programme - 15 M • Write in detail any one section of MRP -5M • Enumerate sections of MRP – 3M 4/11/2018 26MRP