Stergiou Nicholas, Harbourne Regina, Cavanaugh James
HPER Biomechanics Laboratory, University of Nebraska at Omaha, USA.
J Neurol Phys Ther. 2006 Sep;30(3):120-9. doi: 10.1097/01.npt.0000281949.48193.d9.
Variability is a natural and important feature of human movement. Using existing theoretical frameworks as a foundation, we propose a new model to explain movement variability as it relates to motor learning and health. We contend that mature motor skills and healthy states are associated with an optimal amount of movement variability. This variability also has form and is characterized by a chaotic structure. Less than optimal movement variability characterizes biological systems that are overly rigid and unchanging, whereas greater than optimal variability characterizes systems that are noisy and unstable. Both situations characterize systems that are less adaptable to perturbations, such as those associated with abnormal motor development or unhealthy states. From our perspective, the goal of neurologic physical therapy should be to foster the development of this optimal amount of movement variability by incorporating a rich repertoire of movement strategies. The development of such a repertoire can be enhanced by incorporating a multitude of experiences within the therapeutic milieu. Promoting complex variation in human movement allows either motor development or the recovery of function after injury not to be hard coded, but determined instead by the active engagement of the individual within their environment. Measurement tools derived from nonlinear dynamics that characterize the complexity of movement variability provide useful means of testing these propositions. To illustrate, we present 2 clinical case studies, one pediatric and one adult, where we applied our theoretical framework to measuring change in postural control.
变异性是人类运动的一个自然且重要的特征。我们以现有的理论框架为基础，提出一个新模型来解释与运动学习和健康相关的运动变异性。我们认为，成熟的运动技能和健康状态与最佳的运动变异性量相关。这种变异性也有其形式，其特征是具有混沌结构。运动变异性低于最佳水平表征生物系统过于僵化且不变，而高于最佳变异性则表征系统嘈杂且不稳定。这两种情况都表征系统对诸如与异常运动发育或不健康状态相关的扰动适应性较差。从我们的角度来看，神经物理治疗的目标应该是通过纳入丰富的运动策略来促进这种最佳运动变异性量的发展。通过在治疗环境中纳入多种体验，可以增强这种策略库的发展。促进人类运动的复杂变化使得运动发育或损伤后功能的恢复不是硬编码的，而是由个体在其环境中的积极参与来决定。源自非线性动力学的测量工具，用于表征运动变异性的复杂性，为检验这些命题提供了有用的方法。为了说明这一点，我们展示了两个临床案例研究，一个是儿科案例，一个是成人案例，在这些案例中我们应用我们的理论框架来测量姿势控制的变化。
