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Summary physiotherapeutic theory: the cerebellum

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Summary of the cerebellum lesson given by prof. L. Moumdjian from the subject of physiotherapeutic theory. It is a summary of the powerpoint slides and additional items noted during the lesson. The slides were in English and my own notes are always in Dutch as much as possible. It is therefore a mi...

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  • December 17, 2023
  • 21
  • 2023/2024
  • Summary
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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




Nala Melis Pagina 1

, Phys.theory: the cerebellum




Nala Melis Pagina 2

, 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

Nala Melis Pagina 3

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