Ramesh debur
Ramesh debur
Understanding of the brain functioning Gives a direction to treatment Ability to understand concepts in
practice Deeper understanding of treatment
and effects Ability to detect change in status early
Theoretical concepts that help CNS functions
To some extent based on practical knowledge
Understanding morphology using physiology
Brain recovers the way it developed from birth
Informed assumption to established facts
Muscle Re-education Approach (1920s) Neurodevelopmental Approaches (1940-70s)
Sensorimotor Approach (Rood, 1940s) Movement Therapy Approach (Brunnstrom, 1950s) NDT Approach (Bobath, 1960-70s)
PNF Approach (Knot and Voss, 1960-70s) Motor Relearning Program for Stroke (1980s) Contemporary Task-Oriented Approach
(1990s)
Hirerchial theory Top to bottom approach Normalization of muscle tone
Mobilizers and stabilizers
Voluntary movement based on reflexes and uses reflexes to augment motor response
Development cephalocaudal
therefore treatment is
◦ toe to head
◦ flexors >extensors> abductors > adductors
Movement is towards function
Repetition is necessary
TLR and labyrinthine responses can affect sensory stimulation
TThree basic observations
◦ Stimulation of receptors - Homeostatic response via ANS
◦ Reflexive and protective response via brainstem, ANS and Spinal circuits
◦ Adaptive response that require greater integration of higher levels of CNS
1. fast brief stimulus – large synchronous motor output
2. fast repetitive – maintained response
3. maintained sensory – maintained motor response
4. slow rhythmical sensory – deactivates body and mind
PNF :
Steady joint
compression
Stretch
Light touch moving
Fast brusing
Icing
Resistance
Vestibular
stimulation :
positioning etc
Intrinsic stretch
Secondary ending
stretch
Stretch pressure
Normal warmth
Gentle shaking or walking
Slow stroking
Slow icing
Uses Uses
Modulate muscle tone
Re educate movements
Pure sensory feed back
Make patient aware “aware” of the joints
Alter reflex patterns
Slow rolling
Light joint compression
Tendionus pressure
Maintained stretch
AdvantagesAdvantages Strong reactions ( if used properly) Transient responses Does not require the cooperation of
the patient as the responses are automatic
Easy to apply Immediate outcome
Disadvantages Disadvantages No responses under altered conditions No Long term effects Very less evidence in support Change of thinking Change of knowledge base has
outdated this method as a standalone therapy
SummarySummary Elementary method of treatment Uses body responses to cause change Action - Reaction principle Can be used in the initial phases of
recovery