Movement building levels - Through his research, N.A. Bernstein (1896-1966) showed and proved that motor activity is carried out not through a reflex arc (as Pavlov and his followers believed), but through the so-called reflex ring (due to the presence of feedback). This allowed Bernstein to build a grounded and proven theory of level construction of movements.

Key ideas

1. In the organization of a specific movement, several levels are usually involved at once: the one on which the movement is built and all the underlying ones. In a sense, this is similar to a military operation: its general course and tasks are determined at one of the command levels, this level and the lower ones usually participate in the implementation of the operation, ending with the performers (soldiers).

2. One and the same movement can be built on different leading levels (initiated by different levels), with different quality of performance, but still the same. Running, for example, can be built at the level C, D or E. In the first case, the features of running are almost not controlled by consciousness, it reflects a simple "run" or "running there". In the second and third cases, the control of consciousness over the running process is much higher: specific features of running are controlled, communication with some objects (for example, a soccer ball), or even the use of running not to move in space, but for some complex tasks (for example, a coach can depict with your run how some other person is running; in the end, running can - if you really want to - even transfer Morse code).

3. Levels of movement construction have a "permanent place of residence" in separate "layers" of the central nervous system, in which the levels of the spinal cord, oblong, subcortical centers, and cortex are distinguished. Each level is associated with specific, phylogenetically developed motor manifestations; each level has its own class of movements.

Level A

Tonus level. The lowest and phylogenetically the most ancient (its roots must be sought in the distant past, when the living has just learned to move). In humans, it is responsible for muscle tone. This level receives signals from muscle proprioceptors, thus reporting on the degree of muscle tension. A typical independent manifestation of this level is body tremors from cold or fear.

Level B

Synergy level. Receiving information from level A, as well as "installations" from higher levels, this level organizes the work of "temporary ensembles" (synergies). That is, the main task of this level is to coordinate the tension of individual muscles. A typical independent manifestation of this level is stretching, involuntary facial expressions, simple reflexes (for example, pulling a hand away from a hot one).

Level C

Spatial field level. Level C receives information from level B, "attitudes" from higher levels, and also - which is very important - collects all available information from the senses about external space. At this level, simple, non-objective movements in space are built. Running, waving hands are typical independent manifestations.

Level D

The level of substantive actions. Its localization is already in the cerebral cortex. He is responsible for organizing interaction with objects. Including at this level, as a result of experience, ideas about the basic physical characteristics of surrounding objects are postponed. Of great importance for the functioning of this level is the concept of a goal, that is, the desired position of objects as a result of an action.

Level E

The level of intellectual motor acts. Highest level. This level includes such movements as speech, writing, symbolic or coded speech. In a sense, this level could be called “non-objective”, because, unlike level D, here the movements are determined not by the objective, but by the abstract meaning. If, for example, a person writes a note to his friend, then physically he has contact only with paper and pencil, but the line that forms on paper is determined by a whole galaxy of abstract meanings: the idea of ​​an absent person, his personality traits, goals and objectives in relation to this person, about the possibility of realizing these goals and objectives through writing, as well as other meanings.

All human actions are expressed in movements.

Movement is a complex of psychophysiological functions implemented by the dynamic apparatus of a person.

Thanks to movements, a person affects the world and changes it, but the movements themselves also change.

Rubinstein emphasizes: human movements are the ability to carry out an action aimed at solving a specific problem. The nature or content of the task determines the movement.

Since the time of Sechenov, voluntary and involuntary have been distinguished.

Basic properties of movement:

1. Speed;
2. Force;
3. Pace
4. Rhythm
5. Accuracy and accuracy
6. Plasticity and agility

Movement types

Rubinstein highlights 6 types of movements:

1. Posture movement (muscular apparatus) - static reflexes that ensure the maintenance and change in body posture;
2. Locomotion movement(associated with movement) - features are distinguished in gait and posture;
3. Expressive movements of the face and the whole body(facial expressions and pantomime);
4. Semantic movements(for example, taking off your hat, shaking hands);
5. Speech as a motor function(dynamics, rhythm, intonation, stress);
6. Labor movement- movements that exist in various types of labor operations.

developed the problem of the mechanisms of organizing human movements and actions. Before him, there was classical physiology. Bernstein created non-classical physiology.

The difference between classical and non-classical physiology:

1. Classical physiology relies on the mechanism of the S-R model;
2. Classical physiology is animal physiology, where the principle of reactivity has contributed. She had little contact with practice. Non-classical physiology turned to the study of humans. Object the studies were the natural movements of a normal, intact organism.
3. Bernstein's physiology was based on the principle of integrity. He argued with Pavlov that a reflex is not an element of an action, but an elementary action, an integral act that begins and continues until completion.
4. Bernstein opposed the principle of activity to the principle of reactivity. That is, all processes of reception (acceptance of energy) and centers that process information are a manifestation of activity.

In 1947 the book was published "About building movement".

In 1966, the year of death Alexander Nikolaevich Bernstein, his last book was published "Essays on the physiology of movements and the physiology of activity" for its concept.

The concept of "model of the required future"

Alexander Nikolaevich Bernstein introduced the concept of "model of the required future", considering it as one of the forms of displaying the world by a living organism. The second form is the reflection of the past and the present. Along with this, the brain "reflects" (constructs) the situation of the future, which has not yet become reality, which its biological needs are urged to realize. Only a clear image of the required future can serve as a basis for formulating a problem and programming its solution.

In contrast to the model that has become, the model of the future has a probabilistic character.

The principle of sensory corrections

Bernstein proposed a completely new principle of motion control, calling it the principle of sensory corrections. This means corrections made to motor impulses based on sensory information about the course of movement. The result of any complex movement depends not only on the actual control signals, but also on a number of additional factors. The common property of these factors is to make changes in the planned course of movements. Movement, even the most elementary one, is always built "here and now", and does not follow automatically - each time the same thing - following the stimulus that caused it.

The ultimate goal of the movement can only be achieved if corrections (corrections) are constantly made to it. The central nervous system must know what the real fate of the current movement is, that is, afferent signals containing information about the real course of movement must continuously enter it, and then process them into correction signals.

Factors influencing the course of movement:

1. Reactive forces- involuntary reactions that occur in the systems of muscles, tendons, bones, and so on. If you wave your hand strongly, then reactive forces will develop in other parts of the body, which will change their position and tone. For example, if a child climbs onto the couch and starts throwing the ball from it, then by throwing the ball, he can fly off the couch himself.
2. Inertial forces- if you raise your hand sharply, then it will take off only due to those motor impulses that are sent to the muscle, but from some moment they will move by inertia (that is, longer than necessary).
3. External forces(external resistance) - these are obstacles that can get in the way of the program being executed. If movement is directed at an object, then it necessarily meets its resistance, which is not always predictable.
4. Initial muscle condition- (this is the position of the hand, the degree of muscle contraction, etc.) the state changes in the course of movement along with a change in its length, as well as as a result of its fatigue, etc. Therefore, the same control impulse, having come to the muscle, can have completely different motor effects.

The action of all these factors determine the need for continuous accounting of information about the state of the locomotor system and the direct course of movement. This information was named Feedback signals ... Feedback signals from movements are often paralleled, that is, they are received simultaneously through several channels. For example, when a person walks, he feels his steps with the help of a muscle sense and at the same time can see and hear them.

Movement building levels

Bernstein is the creator of the theory of levels of construction of movements. He found that, depending on what information the feedback signals carry, afferent signals arrive at different sensory centers of the brain and, accordingly, switch to motor pathways at different levels.

The level should be understood as morphological "layers" in the central nervous system. So the levels of the spinal cord and medulla oblongata, the level of subcortical centers, and the levels of the cortex were identified.

Each level has specific motor manifestations inherent only to it; it implements its own class of movements.

Level A- the lowest and phylogenetically most ancient ( rubrospinal)... To this level signals are received from muscle proprioceptors(receptors located in the muscles of the body), reporting the degree of muscle tension, as well as from the organs of balance.

Level A participates in the organization of any movement in conjunction with other levels and almost never leads a person... There are movements that are independently regulated by level A: involuntary tremors, teeth chattering from cold and fear, trembling of the violinist's finger, and so on.

Level B- Bernstein is called level of synergies(from the Greek. acting together; synergists are muscles that act together to carry out one specific movement). By the name of the anatomical substrate, it is called thalamo-pallidary... At this level signals from muscle-articular receptors are processed, which report on the relative position and movements of body parts.

Level B participates in the organization of movements of higher levels, taking on the task internal coordination, highly coordinated movements of the whole body. He is responsible for the automation of various motor skills, expressive facial expressions and pantomical movements, expressively colored... The proper movements of this level include those that do not require taking into account the external space: freestyle gymnastics, stretching, facial expressions, etc.

Level C- Bernstein calls the level of the spatial field. By the name of the anatomical substrate - pyramidal strial... It receives signals from sight, hearing, touch, that is, all information about the external space... These are all displacement movements: walking, climbing, running, jumping, various acrobatic movements, throwing the ball, playing tennis, aiming movements (playing billiards, aiming a telescope).

Level D - level of objective action... it cortical level... By the name of the anatomical substrate - parieto-premotor... He is in charge of organization of actions with objects and is specific to a person... It includes all tool actions, all everyday movements, work, driving. The movements of this level are consistent with the logic of the subject. This is not so much a movement as an action. In them, the motor composition is not fixed, but the final result is given. For this level, the method of performing an action, a set of motor operations is indifferent.... For example, you can open a bottle with a corkscrew, you can knock out the cork by hitting the bottom, push the cork inside, etc. In all cases, the result is the same.

Level E - level of intellectual and motor acts, first of all speech movements, writing movements, movements of symbolic speech (gestures of the deaf and dumb). The anatomical substrate of movements at this level is not very clear, but Bernstein emphasized the participation frontal cortex brain, referring to the work of Luria.

Should be considered:

1. Several levels are involved in the organization of complex actions. The one on which the actions are based is called the leader, and the rest are the underlying ones.
2. Formally, one and the same action can be built on different levels. For example, a circular hand movement can be obtained at level A, or at level B, or at level C, or at level D.

What determines the fact of building movement at one level or another?

The leading level of construction of movement is determined by the meaning, or the task of the movement. That is, physiology is determined by completely non-physiological things, namely the goal of a person's action.

Thus, Bernstein introduced the target determination of the organism's behavior.

Bernstein's contribution

Bernstein's ideas are of great importance for psychology. He made great contributions to several branches of psychology:
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Part 14 -
Part 15 -
Part 16 - Actions and movements. Levels of building movements (according to N.A. Bernstein)
Part 17 -
Part 18 -

Movement building levels. Sensory corrections and two cycles of interactions as a principle of self-regulation of the motor system in health and disease. Skill education theory. Classification of movement disorders in cerebral palsy on the basis of a defective level of coordination.
Movement is a quality inherent in all living things, be it the flow of fluid in plants, blood cells in the vascular bed, the movement of animals and humans in space, or socially conditioned actions of an individual.
The formation of a movement, the improvement of its qualities, such as speed, accuracy, smoothness, etc., is a process that obeys the universal laws of the construction of movements. It is based on the improvement of coordination (joint - from the Latin ordinatio - ordering, interconnection, alignment. In biology - the relative development of organs and parts of the body in their historical development).
The laws of building movements were first defined by our compatriot N.A. Bernstein in the forties - fifties. The encyclopedia informs: “Bernstein Nikolai Aleksandrovich (1896-1966) - neuro- and psychophysiologist, creator of the physiology of activity. His research on the physiology of movements became the theoretical basis of modern biomechanics, some of his ideas anticipated a number of provisions of cybernetics. " On the basis of the laws he deduced, the science of artificial control systems, manipulators, robots developed. His scientific fate, unfortunately, resembles the fate of progressive biologists and geneticists of that time.
Bernstein's principles were then deciphered and concretized by many researchers (Anokhin P.K., Gurfinkel V.S., 1960, and others).
Human movements have a beginning in their development, a period when the qualities of movement (speed, accuracy, etc.) reach perfection, and involution - extinction, the loss of these qualities.
This principle is most noticeable in the formation of locomotion, in particular, walking (locomotion - from the Latin lokus - place and motio - movement. In biology, it is a cyclically repeating regular sum of automatic movements that ensure active movement in space - walking, swimming, bird flight etc.).
We have all observed how the awkward, imprecise movements of a child 1 - 1.5 years old become in their own way cute and graceful by 3 - 5 years old.
At the age of puberty, hormonal, disturbances again make movements angular, sharp, awkward. By old age, the control mechanisms wear out, and the movements become fussy, uncertain. An elderly person stumbles for a long time before descending from the footboard of the bus, stepping over a puddle, as if trying on space. It is more and more difficult to maintain stability when walking, and the old person deliberately shortens the portable period of the step, since support on one leg at this moment carries the risk of loss of stability - the gait becomes shuffling.
The huge influence of emotions on the pattern of movements is known: the walking of a prisoner and a winner is not comparable, although it consists of the same structural elements. The movements of the ballerina, the mime are a silent expression of the entire gamut of feelings from tragedy to triumph, the deaf-and-dumb movements of the hands and face replace speech. Movements can depict a dying swan and even melted ice cream and drying cheese.
Such perfection of movement is not inherited. The infant does not have the qualitative characteristics of the movements of the father and mother. He again goes through the entire path of development of movements - from the most primitive to highly coordinated and socially significant actions. What is this path, how is it connected with the development of brain structures and peripheral mechanisms, how is the development of a skill, the improvement of the qualities of movement - these questions are answered by the theory of construction of movements proposed by Bernstein. It includes several basic provisions:
the first provision is about the unity of onto- and phylogenesis of movements; the second provision is about the stepwise development of movements, about the levels of building movements in the central nervous system;
the third provision is about the reflex ring and sensory corrections;
the fourth provision is about two cycles of interaction; the fifth provision is about skill development.
Let us dwell on each of these postulates in more detail.
Movement is a property common to the entire animal world. Ultimately, it is a struggle for life. It depends on the qualities of movement - “you will be eaten or you will be eaten”, which is the essence of the law of natural selection: the strongest survives, possessing high speed, dexterity, endurance, quick reaction, the ability to hit the target, protected by a shell, etc. complex, repeatedly duplicated at all stages of development, the structures of the brain that control movement, therefore, the process of improving the coordination mechanisms is so long and careful, and therefore, in case of local damage to the brain by injury or illness, movement, although it acquires a pathological character, does not disappear altogether. Nature does not lose in this process any of her earlier acquisitions.
The formation of human movements, including locomotion, in ontogeny repeat phylogenesis (ontogeny - from the Greek ontos - being and genesis - origin. In biology, ontogeny is the process of individual development, phylogeny (from the Greek phylon - clan, tribe), the historical development of the world organisms - species, classes, etc.).
In phylogeny, the process of control, coordination of actions took its origin in unicellular organisms, where a signal of danger or proximity of prey is transmitted by a contact path, which is chemotaxis (from the Greek chemo - chemistry and tachis - device). In biology, chemotaxis is the movement of the simplest organisms under the influence of changes in the concentration of chemical stimuli. The response to irritation is possible only in the immediate vicinity of the irritant. The next stage of evolution is multicellular organisms. The mechanism for coordinating the functions of the multicellular system becomes more complicated. At this stage of development of regulation, each cell secretes into the intercellular space the products of its vital activity, communicating information about itself to the entire system. This is a humoral way of control, structurally and functionally more differentiated. A notable stage in evolution was the appearance of elongated forms of living objects. The appearance of this trait was a progress of evolution, since the oblong shape reduces the front of danger for the animal. But it also gives rise to a lot of problems in control, since the parts of the body located behind the main - head - end must be protected and obedient, must be ready to perform a more complex motor task, that is, they must be more highly coordinated in their actions. ... For the fulfillment of motor tasks of this plan, evolution generates a remote way of perceiving an object - a receptor apparatus appears (from the Latin receptor - receiving, receptio - acceptance). In biology, receptors are the endings of sensitive nerve fibers or specialized cells - the retina of the eye, inner ear, etc., that transform irritation perceived from the outside (exteroceptors) or from the internal environment of the body (interoceptors) into nervous excitement transmitted to the central nervous system. Telereceptors (from the Greek She - far, far away) - receptors that receive signals at a distance - this is a mechanism of sight, hearing, etc. The appearance of telereceptors is seen as a leap, a revolution in the development of movements, since this is already the ability to see in advance prey or danger, prepare for the performance of the corresponding motor task - to ensure their safety or to take possession of the victim. The task becomes more complicated, and at the same time the control and executive apparatuses become more complicated - the focus of control centers appears - the brain, the musculoskeletal system is being improved. N.A. Bernstein writes that the appearance of the striated muscle in phylogeny was the mystery of evolution. This acquisition of nature had both positive and negative (in terms of management) consequences. The increase in strength capabilities, facilitation of solving complex motor tasks, the speed of response reactions, posture stability, endurance during prolonged work were positive.
It became possible not only trunk movement, but also movement with the help of limbs - walking, flying, swimming, etc. Negative, if I may say so, was the need to complicate the control systems and the executive apparatus of movements - muscular and skeletal systems. The structure of the muscle changes dramatically. The muscle is therefore called striated, because it consists of alternating, distinct from each other, structural elements visible microscopically as red and white transverse stripes.
The structure is due to the function. Muscle from the point of view of control works on the principle of "all or nothing". Under these conditions, it is difficult to dose the effort adequate to the motor task being solved (in fact, coordination), and nature endows the muscle with a fibrous structure, the ability to include not all fibers in the work, but the required number of fibers at a given moment, and “shock absorbers”, which are connective tissue interlayers (white stripes between red ones) that provide smooth movement. For the function of such a muscle, a rigid system of support and movement is needed - a skeleton. The skeleton performs not only a motor, but also a protective function (tortoise shell, skull, which protects the delicate tissue of the brain from damage). The skeleton must be rigid, but at the same time very mobile, obedient, those. there is a need for movable and sedentary joints that have a shape corresponding to the function and the number of degrees of freedom defined for each joint.
The degree of freedom in biomechanics is the ability to move in a specific direction. For a blocky joint, two degrees of freedom are possible (for example, for the knee joint, these are flexion and extension).
In parallel, the control mechanisms are being improved. The central nervous system becomes more and more complex, more highly differentiated brain structures appear. The process of development of cerebral governing structures is not unsystematic, not chaotic, but obeys completely definite laws. In a huge, multimillion world of brain cells, a hierarchy is built in a certain sequence and within strictly defined time limits of its formation - the subordination of the lower brain structures to the higher ones. Hierarchy (from the Greek hieros - sacred, ogsyo - power) - the arrangement of parts or elements of the whole in order from the highest to the lowest. In the theory of organization of functions, this is a management principle.
We turn to deciphering the second position of Bernstein's theory, namely, to the concept of levels of construction of movements in onto- and phylogenesis. The improvement of the mechanisms of the manager and executive apparatus was briefly described earlier. From a comparison of the biomechanical and neurophysiological characteristics of movements, in particular locomotions, Bernstein concludes that the differentiated movements of higher animals and humans are a product of improving control mechanisms with a lower organization.

Table I
Phylo- and ontogenesis of movement regulation (according to N.A. Bernstein)

systems by creating structures, which he called the levels of building movements.
To decipher this position, he introduces the term function localization. Localization (from Lat. Lokus, lokalis - place, local), according to Bernstein's definition, is a complex of brain structures responsible for performing a certain class of movements. A class of movements is movements that are characteristic of an animal at a certain stage of its motor development. (Further, this last concept will be characterized more broadly.) He emphasizes that the term localization of function is not a topic - topographic anatomy of the brain (from the Greek topos - place, grapho - I write), but the function and morphological content embedded in this concept are similar on the function and arrangement of blocks of radio receiver panels, when separate parts of the whole are not necessarily always nearby, in the same place, as topographic anatomy dictates. Moreover, the maturation of brain structures included in the concept of localization can be extended over time, when some elements are already ready to perform their function, while others are in the stage of formation. This, apparently, can explain the enormous complexity of the education of certain movements, when a delay in the development of one of the elements of localization makes it impossible at the moment to bring up a certain movement - be it playing the piano, sliding on skates or self-service skills. That is why it is advisable to start training in sports or learning the art of dance and playing musical instruments at a certain age. This can explain the complexity, a huge range, but also a certain pattern of the pathology of posture and walking in cerebral palsy.
The difference between the concepts of topics and localization is illustrated by an example when, when certain brain structures are damaged, the patient cannot complete the task “raise your hand,” but when asked to remove the cap, he will easily and freely raise the same hand.
Based on the foregoing, Bernstein proposes a scheme for constructing movements or levels of coordination in phylo- and ontogenesis.
Each level of coordination includes an afferent system, a center, and an efferent system. (Afferent - from Latin afferens - bringing, efferent - from Latin efferens - carrying out.) In biology, respectively, it transfers a nerve impulse to the center or from the center to the working organ.
We have collected in a table Bernstein's information on the pattern of building movement or coordination (Table I).
In the diagram, for each level of coordination, the morphological substrate of the central nervous system, the age of its final formation, the afferent system, the class of movements organized by this level of coordination, and the specific elements of posture and locomotion of a person brought into control by this level are indicated.

Coordination levels of the prelocomotor period: rubrospinal, thalamo-pallidary. striate-pyramidal, consisting of two sublevels - striatal and pyramidal.
Then follow the levels of regulation of movements, when locomotion has already been formed: parietal-premotor (the level of object-related actions and semantic goals) and a group of higher cortical levels that provide writing, speech, etc., the coverage of which is not included in the task of this book.
The rubrospinal level is the most ancient - paleokinetic (from the Greek palaios - ancient, kinesis - movement) - the level of coordination of movements.
Its name includes the Latin definition of the red nucleus of the brain (nucleus - nucleus, rubrum - red) and the nuclei of the spinal cord (from Latin spina - ridge, in anatomy - spinal - spinal cord).
Its morphological substrate is afferents of the vestibular apparatus, receptors of the skin, tendons, muscles and joint capsules, receptors of cross reflexes of paired limbs and interlimb (from lat.reflexxus - turned back, reflected, in biology - the body's response to irritation of receptors), reflexes of internal organs: vasomotor, urinary, defecation.
It completes its development in utero. The class of movements provided by this level of coordination consists of movements of a swimming nature - slow or rapid, continuous or suddenly turning into immobility, movements in which almost 100% of the body musculature is involved. Their character resembles the movement of fish.
The thalamo-pallidary level is another mechanism for regulating movements, ready to function even before birth. Its name is due to Latin terms: talamus - visual hillock, in anatomy - the main part of the diencephalon, the main subcortical center, directing impulses of all types of sensitivity - temperature, pain, etc. - to the brain stem, subcortical nodes and cerebral cortex. Pallidum (from Latin globus pallidum - pallidum) in humans regulates autonomic functions. This level provides the main tremendous synergy of walking with the rhythmic sequence of almost 100% of the skeletal muscles. (Synergy - from the Greek sinergBs - acting together. In biology, synergists are muscles that act together to carry out one specific movement, for example, inhalation, in which intercostal, interchondral and diaphragmatic muscles are simultaneously involved.)
The thalamo-pallidary level in conjunction with the rubrospinal level provides an anti-gravity balance mechanism and a certain pattern of fetal movements in the amniotic fluid of the uterine cavity.
It should be noted here that in works on anthropology (from the Greek antropos - a person, logos - a word, teaching) there is information that the age dynamics of the trabecular structure of the vertebrae speaks of the fetal spine as a functioning organ.
Curious from this point of view is the discovery of American scientists, who proved that the fetus already hears for 8 - 12 weeks. This interesting fact would be established as follows: the child's father, pressing his head to the mother's belly, hummed the same melody. After birth, the baby always clearly reacted to this melody, calmed down and stopped crying.
Clinicians are well aware that the bucking movements of the fetus occur at quite definite periods of its development so clearly that the time of movement is one of the criteria for determining the duration of pregnancy.
It can be assumed that in a child with a complicated birth, who will be diagnosed with cerebral palsy, the most ancient mechanism of coordination of movements is already defective. In this case, many features of the course of pregnancy and childbirth will become clear, such as late movement of the fetus, its incorrect position (transverse, etc.) in the uterine cavity, incorrect insertion of the head when passing through the birth canal, entanglement with the umbilical cord, one end of which motionlessly attached to the wall of the uterine cavity (for example, a small puppy tied to a booth, wrapped in a chain, may die), fast or, on the contrary, slow labor, premature or late birth. All these signs are quite often noted in the history of children with cerebral palsy. This idea is also suggested by the fact that motor disorders in cerebral palsy, with all their diversity, are classified into certain groups in which the pattern of movements is the same type. Yes, and it is difficult to assume that obstetricians in Russia, the USA, India, etc. are equally careless during childbirth.
From these positions, birth injuries - peripheral paralysis of the hands, fractures of the collarbones, hematomas and other complications could be considered not as a cause, but as a consequence - a consequence of a disturbed program of fetal movements. Proceeding from this, one should probably study with the help of ultrasound or other research methods the patterns of fetal movements, their pattern, and if signs of risk are found, offer a cesarean section instead of stimulating the uterine labor, which in this situation will only increase fetal hypoxia.
The afferent system of this level of regulation remains the receptors of the vestibular apparatus, which are designed to signal the position of body parts in space (otolith apparatus) and the speed and direction of movement (semicircular canals of the inner ear). The labyrinthine system, the red nucleus, the optic tubercle, as well as the cerebellar nuclei are normally formed at the time of birth and can fully function.
There are grounds to assume that complications of pregnancy and childbirth may come from the defectiveness of the structural elements of the rubrospinal and thalamo-pallidary levels of movement construction, expressed in varying degrees of severity and causing the further pathogenesis of deformities in the posture and walking of a child with cerebral palsy after birth. The baby is born “thalamo-pallidary,” and the movements of the newborn are dictated by this matured level of coordination. The class of movements regulated by the rubrospinal level of coordination is superimposed on movements of the thalamopallidal level. At the same time, nature does not lose its early mechanisms of coordination, and each subsequent, more highly differentiated level changes the characteristics of movement in the direction of their complication, improvement in accordance with a more complex motor task, using the expedient elements of a more primitive class of movements.
So, smooth, alternating with immobility, continuous movements of the rubrospinal level (similar to athetoid hyperkinesis) pass into the area of ​​autonomic functions, such as intestinal peristalsis, contractions of the vascular wall, the work of the sphincters of the bladder and anus. The walking synergy of the thalamo-pallidary level of coordination, which includes almost all skeletal muscles, serves as the foundation for the organization of bipedal gait, instead of the multi-legged and trunk movement of lower animals (Table I). In the evolution of higher animals and humans, nature also uses such primitive methods of control that are inherent in unicellular organisms. An example is the movement of blood cells in the vascular bed. Studies have shown that this is not a process of passive movement of cells in the blood plasma stream, but active, regulated movement of blood cells.
The class of movements of the thalamo-pallidary level includes, as follows from the diagram, global flexion synergy. Clinically, it looks like this: if you ask the patient to bend one leg at the knee, there is always simultaneous automatic flexion in the hip, knee and ankle joints of both legs (Fig. 1 A, B). Isolated movement is not possible. The patient, who is kneeling, falls forward or cannot at all take an upright position on the knees, folding like a penknife, but can nevertheless maintain an upright position of the torso in a sitting position with bent legs.
With a severe degree of defectiveness at this level, a person cannot sit down on his own, seated, does not maintain a sitting posture.
Tracing the evolution of the child's movements, it can be observed that up to a certain age a healthy child also cannot perform this task, but then, together with the maturation of structures and the following on the hierarchical ladder of the striatal level, the motor synergies seem to be localized, limited in the volume of functioning muscles and joints. and thus more differentiated and purposeful postures and movements become possible. Such differentiation is possible with the maturation, as mentioned above, of the striatal level of coordination, when stepping synergy begins to correlate with the features of space - obstacles, unevenness of the soil, steps, etc. Striatum - from Lat. korpus striatum - striped body. In anatomy - highly differential

A. Patient with global flexion synergy. The attempt to flex the right knee joint is accompanied by synergistic flexion in the hip and knee joints, dorsiflexion in the hip and knee joints, dorsiflexion of the feet, and an increase in the depth of the lumbar lordosis. Isolated movement is not possible. B. EMG of the flexor muscles of the left leg. An attempt to perform flexion in the right (contralateral) knee joint is accompanied by high electrical activity of the flexor muscles of the left leg.

rendered formation of the brain, playing the role of a regulator and brake of the gross reflex activity of the pallidum. It is known that a child who is just starting to walk still “does not know heights”, does not step over obstacles, etc.
Global, large-scale motor synergies are replaced by more localized ones. This process normally ends by 2 years. A sign of localization of this kind of motor synergy is the so-called tibial synkinesia of Strumpel, which he described in the 1920s. He regarded it as a neurological symptom serving as a differential sign of a lesion of the pyramidal pathway. The pyramidal level of movement regulation, according to Bernstein, is next to the striatal level, that is, Stryumpel's data indirectly confirm the validity of the classification of the levels of movement construction.
Strumpel's tibial synkinesis is clinically interpreted as automatic dorsiflexion and supination of the foot with simultaneous plantar flexion of the first toe of this foot. Analysis of the electromyographic and biomechanical structure of walking allows us to assert that this synkinesis (from the Greek sun - together, kinema, kinematos - movement) is an element of locomotion in a healthy person and serves to transfer the foot over the support. It becomes clearly noticeable only in extreme situations: at a high pace of walking, when overcoming sudden obstacles.
With inadequate control of the pyramidal level of coordination, tibial synkinesia, not being limited in the amplitude of the previously indicated movements and the time of their manifestation within the appropriate range, becomes pathological and determines such features of posture and walking in cerebral palsy as ankle instability. joint in the sagittal plane, a significant weakening of the posterior impulse when walking, the posture of the so-called triple flexion when standing.
The pyramidal level completes the prelocomotor period of coordination development. This level brings into the movement its semantic meaning (go there, bring this and that, etc.). A sign of the formation of this level in locomotion is the ability to perform isolated movement.
If the pyramidal level of coordination is insufficient, as indicated above, it is difficult or completely impossible, for example, dorsiflexion of the foot. When asked to do only this movement, its isolated flexion occurs in a minimal volume, and when the command “bend the knee” the foot is automatically bent, sometimes until the back of the foot touches the surface of the lower leg. A similar situation is observed in an electromyographic study, when the maximum EMG amplitude during automatic flexion of the foot in the presence of tibial synkinesia is twice as high as the maximum EMG amplitude when trying to perform isolated dorsiflexion of the foot (Fig. 2 A, B, C).
The pyramidal level of coordination matures by the age of two, and with the end of its maturation, locomotion is formed in full

Rice. 2 (A, B, C) - Patient with Strumpel's tibial synkinesis.
A. Voluntary isolated dorsiflexion of the left foot is minimal (within 10 °). B. An attempt to bend the knee of the left leg is accompanied by automatic dorsiflexion of the foot of this leg. B. EMG of the tibialis anterior muscle when trying to produce maximum dorsiflexion of the foot of this leg (upper curve). EMG of the anterior tibial - the muscle is significantly increased in amplitude when trying to bend the knee of the same leg (lower curve).

me. Consequently, the scheme for constructing movements gives us an idea of ​​the process of the phased organization of locomotion, and for each level it is possible to determine a differential feature. So, for the thalamo-pallidary level, this is global flexion synergy, for the striatal level, tibial Strumpel synkinesis, and for the pyramidal level, voluntary isolated dorsiflexion of the foot. Even after these levels are finally formed, locomotion does not freeze in its development, its elements undergo changes caused by hormonal disturbances of adolescence or decay, deterioration of coordination mechanisms in old age, as well as damage caused to the brain by trauma or illness. In this sense, the pathology of posture and walking in cerebral palsy can be interpreted as a result of the development of initially defective brain structures responsible for coordination at each stage of ontogenesis of locomotion.
Bernstein's next postulate is the principle of a reflex ring, or otherwise - feedback, or so-called sensory corrections (sensory - from Latin sensus - perception, feeling, sensation). These formulations define the same concept.
Bernstein was the first to introduce into neurophysiology the concept of a reflex ring as a form of feedback, having entered into a dramatic discussion for himself with the great Pavlov, who built his theory of organization and improvement of function on the concept of a reflex arc, thus excluding feedback.
Movement represents, according to Bernstein, two cycles of interactions: peripheral and central (pic. 3).
The peripheral motor apparatus carries out its activity through complex interaction with the external environment. The measure of muscle tension depends both on the innervation state of the muscle and on the value of the articular angle, i.e. from the instantaneous position occupied by the system of links. It follows that muscle tension is one of the reasons for movement, since it is a force that is applied to the link and forces it to change its position. On the other hand, the movement of the links, accompanied by a change in the articular angles, changes the distance between the points of muscle attachment and thereby causes a change in its tension. Here there is a cyclical form of interaction characteristic of physiology: muscle tensions affect the course of movement, and movements affect muscle tension. Such cyclical interactions are well known in mechanics and are expressed in mathematical language. Above the peripheral system of cyclical interactions, another is built up, the activity of which is also cyclical.
This is the central nervous system with all its many apparatus. Here, there are taecTO interactions of a different order. First of all, the primary effector impulse from the command device, directed from the central nervous system through the cells of the anterior horns to the muscular system, sets the latter in motion or changes the state of its movement. This movement or change in movement is perceived by nerve windows.

Tendons, muscles and joint capsules, which belong to the proprioceptive nervous apparatus. They transmit information about changes in movement through affector pathways. Taking into account this impulse, as well as visual, auditory, the central nervous system sends a new impulse, making adjustments to the initial motor impulse, that is, there is a cyclical nature of interactions, which indicates a reflex ring, the presence of feedback or sensory correction.
The passive motor apparatus consists of movable bone links that form kinematic chains, which are characterized by degrees of freedom of mobility.
The transition from one degree of freedom to two or more marks the emergence of the need for choice. Automatic, continuous, expedient selection becomes necessary.
The kinematic chain will become controllable only if it is able to assign certain, desirable for us trajectories of movement for each of the elements of the chain and make these elements move along the designated path.
“In overcoming the excess degrees of freedom of the moving organ, that is, in the transformation of the latter into a controllable system, and the task of coordinating movements lies”. Bernstein calls the principle of coordination the principle of sensory corrections.
The foregoing fully explains why disorders in the effector apparatus of the central nervous system, as a rule, do not entail pure disorders of coordination, giving only syndromes of paralysis, paresis, contractures, etc., and why malfunctions in afferent systems necessarily cause atactic type movement disorders , i.e. coordination disorders.
All forms of organic coordination disorders known in the clinic are always associated with diseases of the receptor apparatus and their pathways: vestibular apparatus (labyrinthine or vestibular ataxia), posterior columns of the spinal cord conducting proprioceptive and tactile impulses (tabetic ataxia), reciprocal systems of the cerebellum (cerebellar ataxia) ...
In humans, compensation is possible that can overcome organic ataxia to one degree or another. They are always carried out by including a new type of sensitivity (visual, auditory, etc.) into the motor process.
All types of afferentations of the body take part in the implementation of sensory corrections in different cases and to varying degrees.
Using the terminology of Sherrington, Bernstein calls the entire set of receptor functions of this kind “propriocepticone” in a broad functional sense.
It is a sensory signaling system for postures, articulation angles, speeds, muscle strains and strains. The muscle, causing by its activity changes in the movement of the kinematic chain, irritates the sensitive endings of the proprioceptors, and these signals, closing in the CNS to the effector pathways, make changes in the effector flow (i.e., there is a reflex ring). Coordination in this understanding is not some kind of precision or subtlety of effector impulses, but a special group of physiological mechanisms that create a continuous organized cyclic interaction between the affector and effector processes.
Since every movement that has real meaning overcomes internal and external forces on its way, its whole essence lies in an expedient struggle against them.
The motor task and the forces that must be overcome to solve it are dictated by the external world and are not subject to the individual.
In order to correctly solve a motor problem, it is necessary during the entire motor act, from beginning to end, to verify it with the help of the senses, to monitor and control every moment: is the solution of the problem going as it should, and every moment to make the necessary corrections. The mechanism of these motion corrections is sensory correction. The defect of one or another type of sensitivity most necessary for movement and the sensory corrections they provide leads to severe violations of motor coordination.
The movement cannot be carried out according to only one internal laws of the balance of excitations and inhibitions, because from the very first moment it will be disturbed by external forces unknown to the body in advance and beyond its control, and the forces of mutual collisions and recoil in long and movable chains of limbs, and the resistance of the external environment ...
The role and activity of the body's sensitive afferent systems only begins from the moment they give the trigger signal for the next movement. As soon as it began, in response to the effective first impulses in all sensitive devices of the locomotor apparatus (in the organs of musculo-articular sensitivity, first of all), afferent impulses appear, signaling how the movement began and how it proceeded. These test sensory signals determine the next necessary sensory corrections in the brain.
Based on this, the fundamental form of the nervous process in the implementation of a semantic motor act is, according to Bernstein, the form of a reflex ring.
When performing a motor task, sensitive systems provide two different functions: a signal-starting service and a service that controls the effect of movement and ensures its controllability.
The study of the control of integral semantic motor acts presented the afferent systems of the body in a completely different light. An analysis of the coordination structure of a motor act and its disorders in pathology, a study of how movements are controlled in a circular process such as a “reflex ring” showed that afferent systems signal the brain about the course of movement and provide a basis for sensory corrections not “raw sensory signals, isolated from each other on the basis of quality (separately tactile, kinesthetic, visual, etc.), and vice versa. These perceptions, which provide motion control, always have the character of whole complex syntheses, deeply worked out by the brain complexes of various sensations, fastened by numerous traces of previous sensations stored in memory, impressions from previous movements in space. “The more complex the motor task, the more difficult and further away from primary raw sensations is that sensory (sensory) synthesis that serves this level, the more internal brain processing, comprehension, ordering and even schematization of primary sensations that are generalized in it”.
All the consistent evolutionary complication and enrichment of sensory syntheses went along the line of eliminating distortions and inaccuracies of individual sense organs, ensuring a verification of their readings, and comprehension.
All the sequentially formed levels of the construction of movements (as they are also denoted by the modern physiology of motor acts) have a very different evolutionary age, they have also been preserved in humans, having formed a whole hierarchical ladder of mutual subordination, and the highest of them belongs exclusively to humans (the level of speech and writing) ... The most ancient lower levels, formed in animals with their own brain substrates and lists of motor tasks that are feasible for them, have survived in humans and continue to control the most ancient, semanticly primitive motor acts (swallowing, swimming, walking, etc.).
“At the beginning of the formation of a new individual motor skill, almost all corrections are surrogately carried out by the leading level - the initiator, but soon the position changes, each of the technical aspects and details of the complex movement performed, sooner or later finds for itself among the lower levels one whose afferentations are most adequate to this detail in the qualities of the sensory corrections it provides. Gradually, as a result of a series of successive switches and jumps, a complex multi-level structure is formed, headed by a leading level that is adequate to the semantic structure of the motor act and realizes only the most basic, semantic corrections. “Under his conducting, a number of background levels are involved in the execution of movements, which serve the background or technical components of movement, tone, innervation and denervation, reciprocal inhibition, complex synergies, etc.” (N.A. Bernstein).
The process of switching the technical components of motion control to the lower, background, levels is what is usually called motion automation.
In any movement, whatever its level height, only one leading level is realized.
The essence of the automation process, which sometimes requires a long time and persistent exercise, consists precisely in the development of the central nervous system of a plan for the distribution of backgrounds described above, in the determination of the motor composition of the movement.
Determination of the motor composition is sometimes referred to by neurologists as "drawing up a movement plan."
Initially, to maintain a stable stride length, the child uses proprioceptive mechanisms and makes a “post factum” correction, then a more perfect “ante factum” correction technique enters (from Lat. Post and ante - after and before the fact, respectively).
The phenomenon of preliminary corrections serves in all cases as a later and more perfect form of coordination in comparison with the mechanism of secondary corrections.
At the beginning of mastering the movement, the beginner strains all the antagonist muscles, in advance and with a margin, incapacitates all degrees of freedom, leaving one or two of the movements most necessary for a given base.
At the next stage of the exercise, having already mastered it, when and in what direction the next impulse of reactive force will reach it, the subject allows himself to gradually, one after another, release the degrees of freedom fixed to that extent in order to prevent reactive forces, which gives a sharp energy saving, i.e. That is, it fights against reactive forces. In the third stage of the development of movement, the struggle with reactive forces has a different character, when they turn from hindrances into useful forces.
Sensory corrections are a stimulus both in the development of movements and in the process of their further improvement in the age aspect. Moreover, Bernstein defines the process of organizing movement within his class as evolutionary, and the transition to a new class of movements, caused by the emergence of a more differentiated level of coordination, as revolutionary, spasmodic. Movements of a higher level of regulation appear within a lower-organized class, reach a maximum development, and signs of previous movements that are irrational from the point of view of a new motor task are displaced.
For example, the motor automatisms of global flexion synergy are gradually being replaced by more localized automatisms of tibial synkinesis. At the same time, the biomechanical and electrophysiological characteristics of walking change, which make it possible to perform more complex motor tasks, such as the differentiation of the phases of the support period of the step, the ability to overcome unevenness of the soil, a higher pace of walking, etc.
Ultimately, it is sensory corrections that solve these problems. After all, the executive muscular apparatus, all muscle work is controlled by impulses coming from the cells of the anterior horns of the spinal cord, according to the principle: impulse - muscle contraction. All coordination “disassembly” (with what force to contract the muscle, when, how long, etc.) occur at the supraspinal levels - at the levels of coordination indicated by Bernstein, that is, to the cells of the anterior horns of the spinal cord. Thus, the “final path” in neurological terminology is the same for all the diversity and complexity of the suprasegmental CNS apparatus.
Posture, walking characteristics, therefore, are formed at suprasegmental levels, and sensory corrections are the instrument of this process.
This principle is very important in the sense that with cerebral palsy, that is, with central paralysis, it is apparently inappropriate to talk about the loss of muscle strength as the reason for limiting the range of motion in the joint (this is characteristic only of peripheral paralysis, where it is interrupted or the final - efferent - path is damaged), but we should talk about a violation of the coordination of movements - discoordination, dyskinesia (from the Greek dys ... and Latin dis ... - a prefix meaning difficulty, violation, loss of something). From these positions, it is logical to consider the essence of the methods of orthopedic correction of posture and walking in cerebral palsy.
All means used by orthopedics aim to ultimately influence the nature of sensory corrections, whether it is a decrease in the flow of sensory impulses when fixing a joint with a splint or orthopedic apparatus, or the use of cold to enhance the flow of impulses. The latter is achieved, for example, by the method of Michel la Mathieu, when with flexion contracture of the wrist joint and finger joints, further rather strong and prolonged flexion produced by the doctor and intensifying the afferent flow causes an increase in the volume of extensor movements. The same role is played by the so-called treatment-load suit - the cosmonaut's suit, proposed for use in cerebral palsy. With the help of longitudinal elastic rods, going from the shoulder girdle to the waist and from the waist to the feet, sensory impulses to the coordination structures of the brain, which are responsible for the regulation of antigravitational functions, are enhanced. Indeed, when using the suit, we observed a significant increase in the stability of posture and walking in children with cerebral palsy. Although it should be noted that in this case, it is impossible to exclude inappropriate biomechanical compensations for increasing the stability of the posture, such as a change in the depth of the curvature of the spine, increased imitation synkinesis, etc.
Surgical intervention also significantly affects the flow of sensory impulses: myo- and tenotomy (from the Greek mfs - muscle, tome - a segment, tendo - from Latin - tendon; in medicine - dissection of muscles and tendons), arthrodesis (from the Greek arthron - joint, de - from Latin and des - from French - absence) exclude movements in the joints and practically stop the flow of proprioceptive impulses. This explains the antispasmodic effect of operations for cerebral palsy, which extends far beyond the area of ​​intervention. Sometimes one dissection of the rectus femoris muscle with rectus syndrome normalizes the entire posture.
Muscle transplantation also alters the afferent flow, thus incorporating into the mechanism of sensory corrections. This provision forces us to take a stricter approach to indications for surgical operations in terms of age. Global synergy, for example, makes the effect of any operation difficult to predict, as does the combination of equinus with tibial synkinesis.
The most favorable result is in patients with cerebral palsy with insufficient pyramidal level of regulation, that is, when the prelocotor period has basically completed its formation and we practically cannot predict the result of “thalamo-pallidary patients” with cerebral palsy, since the period of formation of locomotion has just begun development.
These and other complications will be reported in more detail in the chapter on the principles of surgical correction of posture and walking in cerebral palsy.
Sensory corrections are the basis not only for the organization of movements in ontogenesis, but also a mechanism for their improvement, as evidenced by the theory of skills training in sports, work, as well as the organization of locomotions. N.A. Bernshtein in his theory highlights the main structural components of the locomotor act: the alternation of the support and transfer periods, the period of double support.
According to the principle of equality of action and counteraction, the efforts of the legs are equal and opposite to the efforts of the support reactions, that is, the force effects of the supporting surface on the body of the walking person. This is the vertical component of the step (see Ch. IV).
The longitudinal component is the most informative.
The impulses of force that determine the movement of the leg when walking are by no means limited to one pair of simple reciprocal impulses for each double step.
When studying the development of running in children, it was found that normally in children from 2 to 5 years old, the organization of the transfer period begins and the greatest innovations appear in the proximal points of the leg, while the distal ones remain stable for a long time.
From 2 to 5 years, the longitudinal curves of the thighs reveal the running adjustment of the walking time already in full, while the curves of the foot have not yet differentiated themselves from walking even in the reference period.
This predominant course of evolution from top to bottom from proximal points to distal points leads N.A. Bernstein to the following physiological generalization. (Since this information is extremely important for an orthopedist, especially a surgeon who corrects posture and walking in cerebral palsy, it seems appropriate to cite the entire text of the author.) proximal muscles. Another thing is much more probable. The proximal points of the leg (for example, the hip joint) are surrounded by a much more powerful array of muscles than the distal ones (foot), and at the same time, the moments of inertia of the links closest to the first parts of the link are undoubtedly less than the moments of inertia of the distal links. Therefore, it is much easier for the muscles of the hip group to move the upper segments of the thigh from their place than the foot, to displace which they have to move the entire inert leg from top to bottom. This is also related to the fact that the (relative) velocities of the distal links are, as a rule, higher than the proximal ones. Consequently, the kinetic energies of the former are also greater and it is more difficult to overcome them. The distal links play a role in relation to the entire leg, reminiscent of the role of a heavy pendulum ”.
It follows that, given its strength, it is incomparably easier for a nervous effector impulse to slip into the proximal curve and be reflected in it in the form of a noticeable dynamic wave than to be able to break through the entire thickness of the inertial resistance of the distal system. In order to be felt in the latter, the effector impulse must have a significant force or reach “on time” - at such a moment when the distal system is in especially favorable conditions for its perception.
In what this favorable moment can be expressed, it is still difficult to say, and here, apparently, a large field for research opens up: maybe just a favorable position of the limb is important here, which provides the muscles with the greatest biomechanical efficiency of action, maybe this favorable moment is a turning point speed, when inertial resistances are most weakly perceptible, maybe, finally, this is the moment of a particularly sensitive tuning of the muscular apparatus, created here by this or that confluence of proprioceptive signals.
One way or another, the control of the distal links requires greater dexterity, a higher coordination technique in the sense of the ability to improve the right, optimal moment, to give just the right impulse just at the right time. If this time is missed even for a fraction of a second, then the impulse will no longer “pass,” that is, it will not give any noticeable effect on the periphery.
It should be noted that we are not talking about small coordinated movements of the distal segments like the movements of the fingers, but about global, extensive, extrapyramidal displacements of the distal segments of the limb. The dynamics of these latter ultimately depends on the same hip muscles as the dynamics of the proximal points of the leg.
But the distal dynamics becomes richly dissected into biodynamic details not when these details appear in the effector impulse and begin to be reflected in the dynamics of the compliant proximal points, but only when the functional attunement of the effector and receptor is established and when the effector n.s. learns to capture fleeting moments of functional conduction. Dynamic dismemberment is accompanied by a particularly great wealth of power “overflows” in the distal links, which testifies to a very fine control of the dynamics of an external, biomechanical order.
In a complex multi-link pendulum, which in the biomechanical sense is a leg, the dynamic interaction of links, the play of reactive forces, complex oscillatory chains, etc., are very diverse and abundant. And the fact that they are not obscured by a trained master, but are reflected in such abundance in dynamic curves, speaks of a very subtle reactive adaptability of the neuro-motor apparatus to proprioceptive signaling.
A higher degree of dismemberment of the distal force curves is a sign of the ability to catch moments of least resistance, in other words, to utilize most fully the entire external rich play of forces and, possibly, the entire physiological (involuntary) range of reciprocal and other, more complex reactive processes on the muscular periphery ”.
This material, which is relatively difficult for the clinician, is cited in order to emphasize that surgical extremism in the issues of transplantation and lengthening of muscles that control movements in the foot joints in children with cerebral palsy is hardly legitimate until the walking stereotype is finally formed. It should be noted that the motor development of a child with cerebral palsy almost always lags behind by 2 - 3 years. If we take into account Bernstein's information, walking and running normally mature by 5 years.
Further, the author states the presence of three stages of walking involution in the age aspect.
1. Decreased function of the structural mechanisms of walking, but greater control of consciousness.
2. Alert consciousness is replaced by fussiness, small step movements.
3. Explicit disintegration of motor structures.
The splitting of the previously unified coordination is noted.
Thus, ontogenetic material has shown with certainty that the dynamic structure of walking arises, passes through a number of regular stages of development, and just as naturally involutions in old age.
Most important in principle here is that this development is associated with very distinct qualitative changes in the very structure of walking.
In terms of morphology, this structure passes in early ontogenesis through:
a) the stage of reciprocal innervation primitive;
b) the stage of gradual development of morphological elements;
c) the stage of excessive proliferation of these elements;
d) the stage of the reverse development of the infantile elements and the final organization of an integral and proportional form.
“With regard to motor coordination, the biodynamic structure of walking also goes through a number of qualitatively different stages of development: at the very beginning, there is a symptom of hypofunction of proprioceptive coordination in general, followed by the stage of developing proprioceptive coordination post factum (compensatory or secondary coordination).
Ante factum coordination (dosage or primary coordination), which is organized much later, develops much less frequently. ”
So, Bernstein's theory of the construction of movements gives an idea of ​​the neurophysiological and biomechanical structure of movement in the process of its formation and improvement. It includes the fundamental provisions:
1. Ontogeny of human movements repeats phylogeny, which allows us to speak about the universality of the scheme of constructing movements proposed by the author, and, therefore, the legitimacy of applying these laws to various disorders in the human motor sphere, including cerebral palsy.
2. The level of coordination is morphologically strictly marked and includes certain structures of the brain, afferent and efferent receptor systems capable of regulating specific classes of movements.
3. The qualities of movements are not inherited, but acquired. Improving the qualities of movement is a process consisting of stages of maturation of brain structures that coordinate certain classes of movements specific to this level. This process has a stepwise nature. Bernstein calls the totality of the complex of cerebral coordination structures and the class of movements specific for it the level of the construction of movements. For each class of movements, we have defined a feature - an indicator specific to this class of movements.
For the thalamo-pallidary level, this is global flexion synergy, for the striatal level, tibial synkinesis of the Strumpel, for the pyramidal level, the ability to produce voluntary isolated dorsiflexion of the foot, isolated movement of the fingers.
4. In ontogenetic development, nature uses all the previously acquired coordination mechanisms, from primitive ones, passing in humans into the sphere of vegetation, to GREAT social actions. From each class of movements, nature in ontogenesis uses elements that are appropriate for the fulfillment of a motor task by inhibiting movements that are not needed for a new, more complex coordinating task. This function is performed by the next, more highly organized level of coordination.
5. The basis of coordination is the mechanism of sensory correction, two cycles of interaction and the mechanism of skill development.
6. Comparative analysis of the qualitative characteristics of movements in the process of their ontogenesis in the norm and clinical symptom complexes of posture and walking disorders in cerebral palsy allows us to draw clear parallels. Based on this, there is reason to believe that cerebral palsy is not a disease with a residual stage, but the result of the maturation of an initially defective brain, which manifests itself already in utero. The similarity of movements of a certain class and the symptomatology of movement disorders in cerebral palsy makes it possible to classify the pathology of posture and walking in cerebral palsy according to the defective level of coordination, while taking into account the sufficient conventionality of this scheme.
7. A child is normally born “thalamo-pallidary”. During the first two years, it goes through two more stages of the prelocomotor period of the development of coordinating mechanisms - striate and pyramidal. In children with cerebral palsy, the pyramidal level does not reach its full maturity. The more late and more defective the maturation of the brain structures responsible for the coordination of motor functions occurs in a given patient, the more difficult it is to predict the result of treatment and the more cautious, apparently, one should approach the appointment of radical, in particular surgical, methods of treatment.
8., The prelocomotor period ends its development by 2 years in the norm. This means that all the elements needed to maintain a stable upright posture and walking are in place. Nevertheless, Bernstein points out that such constituent parts of locomotion as the phases of support, elements of running, complete their development by the age of 3, and all the constituents of normal locomotion by the age of 5. Children with cerebral palsy lag significantly behind in the development of motor skills - by 2 and 3 years. In this regard, it should be noted that the prognosis of any surgical intervention in children younger than 6 - 7 years old is difficult and the result does not always coincide with the desired one.

A significant contribution to the understanding of the formation of motor skills in the learning process was made by theoretical research by N.A. Bernstein. He proved: under the influence of motor actions, the body becomes stronger, more enduring, more agile, more skillful. This property of the body was called exercise. Repetitions of motional exercises are needed in order to solve the set motional problem over and over again, each time more successfully, and thus to look for the best ways to solve it. Repeated solutions of this problem are also necessary because in natural conditions external circumstances are not exactly the same, just as the course of solving a motor problem itself is not repeated twice in a row in the same way. Any repetition of movement, according to N.A. Bernstein, "there is repetition without repetition." The child needs to gain experience in a variedly modified motor task assigned to him and her external environment, and, above all, in the whole variety of those impressions with the help of which sensory corrections of this movement are made. This is necessary in order to adapt to even a slight and unexpected change in the situation or the motor task itself.

The nervous system plays an important role in the development of a motor skill. To develop a motor skill, the brain needs a fairly long exercise.

Due to the huge excess of the child's degrees of freedom of movement, no motor impulses to the muscles, no matter how accurate they are, can by themselves provide the correct movement according to his desire. Changing the conditions for performing a movement is possible only when the sensory correction mechanism is activated. To experience all the sensations that will form the basis of the studied movement, and to prepare the basis for sensory correction, repeated repetition of the motor action is necessary.

Skill building is a semantic chain action in which not a single link can be skipped. The formation of a motor skill is under the control of the nervous system and is represented in it by a multilevel motor control system. Any motor act can be built only thanks to a strict hierarchy of brain levels. There are five levels in total: "A", "B", "C", "D", "E". Each of the levels has its own serving brigade of sense organs (efferents).

Level one-"A": "You are in good shape"... Level "A" is the very first and lowest. The activity of each level is associated with certain parts of the nervous system. For level "A" - this is a part of the spinal cord, the lowest parts of the cerebellum and all the nerve centers located there - the nuclei. Level "A" regulates muscle tone (the readiness of the muscles and nerves supplying them to receive and effectively execute the command-impulse from the center), which is important for the formation of body support. At this level, involuntary actions of trembling movements are carried out - trembling from cold or when the temperature rises; nervous trembling from excitement or flinching from a sudden sharp sound, beam of light, etc.

Level "A" guides the construction of some voluntary actions: vibration-rhythmic actions (for example, fanning); adopting and maintaining a certain posture, including the posture of the child. With a beautiful posture - the head is raised, the body is straightened, the movements are free. The adjustment of the plastic muscle tone, carried out by the "A" level, largely depends on the cervico-tonic reflex (position of the head and neck).

Level two-"V": movement - stamp. This is the level of friendly movements and standard cliches. He is very important, as he directs the "locomotor" mechanism, equipped with four limb-propellers. Anatomically, level "B" is provided by the largest subcortical nuclei. This level processes and sends to the brain information about the magnitude of the articular angles, about the speed of movement in the joints, about the force and direction of pressure on the muscles and deep tissues of the limbs of the trunk.

Level "B" ensures accurate motion reproduction. A rhythmic, rocking movement, for example, the movement of a hand when walking, exactly repeats the previous one, as a result, as it were, the same actions are stamped. That is why level "B" is called the level of dies, so precisely the movements at this level are repeated.

Level "B" defines three essential qualities that are necessary for building movements:

1) involvement in the work of dozens of muscles that carry out movement;

2) the ability to lead movement in time in a harmonious and well-organized manner;

3) following from the previous one - the ability to chased repetition of movements not only in time, but also in the pattern of the action.

A person needs to "churn out" movements, otherwise all the enormous wealth of muscular actions would come to a chaotic, controlled state. Movement-cliches are also necessary because they are carried out without the participation of consciousness, thereby freeing up the brain systems for a variety of activities.

Level "B" independently manages a few actions not related to the surrounding space. He receives mainly information about the actions of his own body: this is an involuntary movement of stretching after sleep, motor manifestations of emotions, including grimaces on the face (by facial expression, some movements of the body, arms, shoulders, you can determine the emotional state of the child), bends, bends body, undulating rhythmic movements, including some dance ones.

Since level "B" is not associated with the vestibular system (with the organs of balance, the cerebellum) and has weak connections with the sense of sight, smell, he readily takes over all the internal, "rough" elaboration of a complex movement, carried out in the depths of the human body. He, as it were, conducts the internal coordination preparation of walking, running, formalizing all the actions of this set of friendly movements: he prepares a walking pattern, the basis for the movement of arms and legs, without which movement on any plane - smooth or uneven - will be impossible. But this is done in an abstract form, outside a specific setting, although our walking is done somewhere, on some surface, past some obstacles, along irregularities, steps, turns, etc. nevertheless, these circumstances are not available to level "B". They die while walking and overcomes the next level - level "C".

Level three-"C": man and space... This level of N.A. Bernstein called the level of the spatial field and considered one of the most responsible in the construction of movements. In contrast to the previous levels, level "C" has a number of important distinctive features.

First, it is connected to the outside world. The closest relationship with him is the most important quality of the "C" level.

Secondly, telereceptors are already working at the level "C", and first of all, vision, which infinitely expands and increases the volume and quality of information entering the body.

The third feature of the spatial field is its immovability. Thanks to qualitatively processed information, which reflects past experience (and the baby acquires it already in the cradle), the child perceives the immobility of the world around him. The movements performed under the guidance of level "C" do not contain elements of repetition or alternation.

Another important property of a spatial field is its metricity and geometricity. A careful assessment of the distances, sizes and shapes of objects determines the most important quality of such actions of a child as accuracy, accuracy, without which his inaccurate actions would not have reached the goal.

Thanks to these qualities, the "C" level directs especially important movements of the human body. These movements always "lead from somewhere, somewhere and for some reason." They “carry, press, pull, take, tear, throw. They have a beginning and an end, an attack and an achievement, a swing and a throw ”, i.e. the movements of this level are of a translocative nature and necessarily adapt to the space in which they proceed. This quality is one of the most important for the movements of this level, which is why it is called "spatial".

ON. Bernstein notes that the previous level "B" (lying below) constructs walking - a complex motor act, in which dozens of muscles and joints take part. But this walking remains an abstract, as it were, "exhibition" model, with which you can get acquainted and even admire it. But walking will become an expedient action only after the level "C" is included in its implementation. Then the foot walking on the ground will "take into account" and adapt to all the unevenness and difficulties of the road, determine the optimal stride length and frequency of movements that will be most economical for the pedestrian. If it is walking on a staircase, the foot will step on the speck or middle of the step, and the length of the stride will adjust exactly to the distance between the two steps. If the steps turn out to be uneven, chipped, then the leg will "try" to bypass these irregularities or adapt to them with the least damage to the walking person.

Level "C" is characterized by the ability to vary the actions without compromising the accuracy of the movement. In this case, the final result is necessarily achieved. This level is also characterized by the variability and interchangeability of motor components, as well as the switchability of movement from one organ to another (so, having learned to write with the right hand, the child, if necessary, transfers this skill to the left hand).

At the same time, the techniques of movements themselves can be switched: the child can walk, run, crawl, jump on one or two legs before the clothed object.

Level C has another very important quality: the ability to modify movements, i.e. the child's search for new ways and opportunities in the implementation of unfamiliar actions. It is irreplaceable in the learning process, in the process of creating a new motor skill, a new skill.

What independent movements are carried out at the C level? Their number is so great that it is impossible to list them. ON. Bernstein singles out only the main groups of these; movements:

1) moving, moving the whole body in space - walking, running, climbing, crawling, swimming, walking on a tightrope, skiing, skating, cycling, rowing, jumping up, long, deep, tricking;

2) "noncomotor" movements of the whole body in space - various exercises on gymnastic apparatus, acrobatics;

3) movements - manipulation with space - of individual parts of the body, most often of the hands: touches indicating gestures;

4) moving things in space - grasping, catching a moving object, shifting it, transferring, winding, lifting weights, etc .;

5) all ballistic movements - throwing, playing tennis and towns;

6) aiming movements - the goalkeeper's setting-expectant movements in football and hockey;

7) imitative and copying movements - sketching, depicting an object or action with gestures, i.e. pictorial pantomime.

Level "C" plays an important role in sports, acrobatic movements. It has few labor movements that require division of actions. Labor actions are performed at higher levels "D" and "E". Thus, level "C" is a link between actions, movements and the space in which the child lives and acts.

Level four-"D": regulates actions that are unique to humans. These actions are provided by the area of ​​the cerebral hemispheres.

The complexity of the level "D" is so great, and knowledge about it is so small, that until now it is not possible to find out all the functions of the level. The main thing in performing movements of the "D" level is the semantic side of the action with the object.

The sense organs (sight, touch, etc.) receive and transmit to the brain all information about an object and help determine what exactly and in what sequence can and should be done with this object. It is important that level "D" assesses not its size, weight, color, but its topology - a scheme that explains qualitative; the ratio of the individual parts of the subject.

The principle of topology applies not only to the objects themselves, but also to the actions performed at the "D" level. Their implementation occurs according to a single scheme (remove, tie, etc., although the implementation of these actions involves many ways). Angrier; important is not only the order of each of the elements of the action, but the certain time spent on a separate operation. The resulting chain process provides a meaningful action, for example: putting on and buttoning a coat, lubricating skis; ointment, etc.

It is the “D” level that provides not just the movement of the object, but its semantic use in order to change the surrounding reality, to bring it as close as possible to the model of the “desired future” that the child creates mentally before the start of each action.

A distinctive quality of all actions of this level is their high automatism, i.e. they are performed without active control of consciousness, which, of course, is possible only after repeated exercises and training.

Another important feature of this level is related to the difference in the actions of the right and left hands. At all the already listed wounds, levels, this difference was almost imperceptible. Both during walking and when gripping any object, both hands act in the same way, and the left hand easily replaces the right one.

And only at the level of semantic actions ("D") this difference becomes decisive: the letter is written with the right hand, the spoon is pulled into the mouth with the right hand. It is possible to retrain to work with the left hand, but it is very, very difficult and certainly not fast (for a left-handed person, the opposite is true).

Now let's list the main groups of actions defined by such a high level:

The first group combines movements with a small number of automatic actions: feeling, comparing and choosing an object, any meaningful actions of the child;

The second group contains actions, significantly supported by the level "C", semantic actions taking place in space; actions involving level "B"; sleight of hand exercises;

The third group unites the actions of all the previous groups, first of all, this writing and speech - the movement of the lips and tongue.

Finally, the predominance of the "D" level is manifested during movement during massage and self-massage. Thus, there are no such meaningful actions that would not be directed by the "D" level.

Level five-"E", located even higher than the previous one, creates a motive for a motor act and carries out its main semantic correction. He finally brings the result of the movement in line with the intention, with the very model that the child created mentally before starting his action. This level, in addition to speech and writing, directs the richest arsenal of choreographic, improvisational and other improvisational actions, the study and description of which has not yet been fully disclosed, but represents a fascinating area of ​​research. Understanding the multilevel system of regulation of movements allows not only to form, but also to correct motor skills, to identify disorders and diseases of the brain, which leads to the solution of the most important task of improving the child's health.

However, motion control is rarely represented at any level. Most often, 3-4 levels are involved in the motor action.

Ultimately, the theory of levels of building movements can be presented as follows:

· Level "A" - the lowest and phylogenetically very important;

· "B" - the level of synergy (unnecessary movements). It processes signals from the muscle-articular receptors, which report on the relative position and movement of body parts. He participates in the organization of movements of a higher level: facial expressions, stretching, rhythm, etc .;

· "C" - the level of the spatial field. He is responsible for moving movements: walking, running, climbing, etc .;

· "D" - the level of objective actions. This is the cerebral-cortical level, which is in charge of organizing actions with objects; being a monopoly human level, it reflects as much movement as action;

· "E" - the level of intellectual motor actions.

Every movement of the child is unique. It carries in itself the realization of new and new potential motor capabilities, reflecting at the same time a new level of their adaptive reactions. “The dialectic of the development of a skill consists precisely in the fact that where there is development, there, therefore, each next performance is better than the previous one, that is, does not repeat it ... ".

Hence follows the practical formulation of the question: "How to teach children the correct movement, if the method of repeated repetition of exercises is unacceptable here?" We find the answer to this question in the works of N.A. Bernstein, who believed that the essence of mastering skills is not "repeating and not beating the movement", but in improving the multi-level system of building movements. "A correctly conducted exercise repeats over and over again not the means used to solve a given motor problem, but the process of solving this problem, changing and improving the means from time to time."

The formation of a flexible skill is significantly influenced by the natural conditions for its implementation by children in everyday activities, in organized forms of motor activity. At the same time, the conditions for the fulfillment of the movement are never the same, as well as the process of solving motor tasks itself. The functional, neuropsychic state of the child is also different at every moment of the movement.

The formation of a motor skill is a process of creating a dynamic stereotype in the interaction of the first and second signaling systems with a predominant value of the second signaling nervous system.

The development of motor skills in a child is of great importance. They provide him with the ability to perform movements with the least energy expenditure and with the greatest effect, ensure the rational use of his motor abilities.

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A significant contribution to the understanding of the formation of motor skills in the learning process was made by theoretical research by N.A. Bernstein. He proved: under the influence of motor actions, the body becomes stronger, more enduring, more agile, more skillful. This property of the body was called exercise. Repetitions of motional exercises are needed in order to solve the set motional problem over and over again, each time more successfully, and thus to look for the best ways to solve it. Repeated solutions of this problem are also necessary because in natural conditions external circumstances are not exactly the same, just as the course of solving a motor problem itself is not repeated twice in a row in the same way. Any repetition of movement, according to N.A. Bernstein, "there is repetition without repetition." The child needs to gain experience in a variedly modified motor task assigned to him and her external environment, and, above all, in the whole variety of those impressions with the help of which sensory corrections of this movement are made. This is necessary in order to adapt to even a slight and unexpected change in the situation or the motor task itself.

The nervous system plays an important role in the development of a motor skill. To develop a motor skill, the brain needs a fairly long exercise.

Due to the huge excess of the child's degrees of freedom of movement, no motor impulses to the muscles, no matter how accurate they are, can by themselves provide the correct movement according to his desire. Changing the conditions for performing a movement is possible only when the sensory correction mechanism is activated. To experience all the sensations that will form the basis of the studied movement, and to prepare the basis for sensory correction, repeated repetition of the motor action is necessary.

Skill building is a semantic chain action in which not a single link can be skipped. The formation of a motor skill is under the control of the nervous system and is represented in it by a multilevel motor control system. Any motor act can be built only thanks to a strict hierarchy of brain levels. There are five levels in total: "A", "B", "C", "D", "E". Each of the levels has its own serving brigade of sense organs (efferents).

Level one - "A": "You are in good shape"

Level "A" is the very first and lowest. The activity of each level is associated with certain parts of the nervous system. For level "A" - this is a part of the spinal cord, the lowest parts of the cerebellum and all the nerve centers located there - the nuclei. Level "A" regulates muscle tone (the readiness of the muscles and nerves supplying them to receive and effectively execute the command-impulse from the center), which is important for the formation of body support. At this level, involuntary actions of trembling movements are carried out - trembling from cold or when the temperature rises; nervous trembling from excitement or flinching from a sudden sharp sound, beam of light, etc.

Level "A" guides the construction of some voluntary actions: vibration-rhythmic actions (for example, fanning); adopting and maintaining a certain posture, including the posture of the child. With a beautiful posture - the head is raised, the body is straightened, the movements are free. The adjustment of the plastic muscle tone, carried out by the "A" level, largely depends on the cervico-tonic reflex (position of the head and neck).

Level two - "B":

movement - stamp. This is the level of friendly movements and standard cliches. He is very important, as he directs the "locomotor" mechanism, equipped with four limb-propellers. Anatomically, level "B" is provided by the largest subcortical nuclei. This level processes and sends to the brain information about the magnitude of the articular angles, about the speed of movement in the joints, about the force and direction of pressure on the muscles and deep tissues of the limbs of the trunk.

Level "B" ensures accurate motion reproduction. A rhythmic, rocking movement, for example, the movement of a hand when walking, exactly repeats the previous one, as a result, as it were, the same actions are stamped. That is why level "B" is called the level of dies, so precisely the movements at this level are repeated.