Summary physiotherapeutic theory: the cerebellum

Phys.theory: the cerebellum
FUNCTIONAL ANATOMY AND NEUROPHYSIOLOGY
 coordinatie
- Motor plan
- Position sense
- Feedback
- Balance
 Bijdragen cerebellumaan een papier zien & vastnemen
- Visuele iinput (iets zine)= sens infonaar somatosens regio
- Integreren motor plan ik moet reiken
 Naar motor cortexnaar RMnaar spieren
 + naar cerebellumefference copyFB tussen geplande & uitgevoerde bew
o Corrigeren indien nodig
o Cerebellum moet snel reageren
 Probleem vermis cerebellum= ↑posturale controle prob
 Lat.hemisferen aangedaan= ↑fine texture, dysartia
 Vest. Cortical cerebellum aangedaan=↑vestibulo-ocular disf., oogbew
 Pathways
- 1. UMN to LMN to SC to muscle = motor plan
- 2. Copy of motor plan will be send to the cerebellum -> information of the intention of the movement
- 3. Informaition from muscles back to cerebellum (position sense)
- 4. Then there is feedback from the cerebellum to the motor cortex
 Any lesion/disruption of these pathways cause different problems


CEREBELLAR PEDUNCLES AND LOBES
 3 pedicules




FUNCTIONAL NEUROPHYSIOLOGY




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, Phys.theory: the cerebellum




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, Phys.theory: the cerebellum
 CEREBELLUM SYSTEM – IN-AND OUTPUTS
- Inputs:
 Comparator
 linking intention of movement with actual performance
- Outputs: Motor output via 3 deep cerebellar nuclei in white matter
 Fastigial nuclei
 Interposed nuclei
 Dentate nuclei
 Motor execution and motor planning: modulation of motor
output (UMN)
- One other output via vestibular nuclei
 Balance and eye movements
 multiple effectors
- If damage:
 Incoordination
 postural imbalance
 eye movement deficits
 but preserved muscle strength and sensation
o cerebellum hier niet verantwoordelijk voor


FUNCTIONAL ANATOMY OF THE CEREBELLUM
 Spinocerebellum: vermis and intermediate hemispheres
- Sensory information
- Control actual movement execution (on-line control): gross limb movements & normal muscle tone
- Ruggenmergcerebellum
 Cerebrocerebellum: lateral hemispheres
- Cortico-pontine-cerebellum-thalamus-cortex
- Fine, distal, voluntary movements
- Planning and preparation of the movement – timing
- Evalulatin of sensory outcome of movement – motor learning
 Vestibulocerebellum: flocculondular lobe
- Vestibular & visual information
- Equilibrium (control of axial muscles) & VOR

Heterogenity in cerebellar patients
 Bogaert, Romano, Cabaraux, Feys, Moumdjian, 2023, Disability & Rehabilitation
- 28 articles with a total of 38 different patients were included.
- Wie zijn P? Wat hebben P?




CEREBELLAR SYMPTOMS
CEREBELLAR ATAXIA
 ATAXIA: Incoordination of limbs, posture, and gait.
- An umbrella term for the disorder of the control of force and timing of movements leading to
abnormalities of speed, range, rhythm, starting, and stopping.
- Slowed movement initiation
- Force regulation deficits
- Dysdiadochokinesis

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