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2014-02-15 13:37:36
rehab II 212

Rehabilitation principles: theoretical approach to tx
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  1. Margaret Rood
    • Motor development- designs of movement
    •      -mobility,stability,controlled mobility, skill
    • Sensory stimulation-facilitation or inhibition
    •     -phasic - pertaining to movement
    •       -quick stretch, light touch,tapping,traction
    •     -tonic-holding,stationary,stability
    •        -approximation,joint compression
  2. Neurodevelopmental Technique was developed by?  (NDT)
    • Berta Bobath-for tx of CP and adult hemiplegia (ATNR,STNR)
    • - Release of (primitive)abnorma postural reflexes that inhibit righting and equilibrium reactions(stuck in reflex, wont have primitive)
    • - Achieve a balance between muscle groups, decrease the effects of abnormal tone
  3. Neurodevelopment Con't
    Based on development sequence (POE,tall kneeling)
  4. Primary tx principles
    • -Change abnormal patterns of movement with dynamic reflex inhibiting patterns
    • -Use key points of control- neck,spine,shoulders,pelvis,toes and ankles, fingers and wrists
    • -Achieve a balance between muscle groups, decrease effects of abnormal tone
    • - practice outside of abnormal synergies
  5. NDT Principles
    • -Practice (repetition) movement out of obligatory tendencies
    • -Body on limb before limb on body(prox before distal movement)
    • -Tone is usaully mixed, not flaccid or spactic
    • -Movement pattern versus individual muscle strenghthening
  6. NDT  Principles Con't
    • -Address alignment of trunk and limbs to promote more normal movement (can't superimpose normal movement over malaligned joints)
    • - Work toward symmetrical postures in all planes to increse midline orientation
    • -incorporate involved side in all activities
  7. Functional Outcomes
    • -Control a posture (stability)
    • -Postural adjustment (controlled mobility)-wt shifting
    • -Transition-changing the BOS
    • -Active support of the limbs (controlled mobility)
    • -Use of limbs for reach (skill)
    • -Hand and foot manipulation (skill)
  8. Brunnstrom Principles
    • -Synergies-Fx movement pattern based on heirarchical model
    • -Cutaneous sensory stimulation and resisted muscle contractions for overflow to recruit involved musculature
    • -Encourage limb synergy early in recovery
    • -Use of selected primitive postural reflexes to elicit voluntary movement
  9. Synergies
    • -PNF- normal synergy movement
    • -CNS links muscles into functional patterns, basic organizational units for movement and posture
    • -motor pattern-postural or movement pattern within the CNS
    • -can be normal or abnormal
  10. Motor Behavior
    Basic limb synergies
    • UE Flexion-scap retraction/elevation, ER, abd 90*, elbow flexion, supination, wrist and finger flexion
    • UE Extension- protraction, IR, add, elbow ext, pronation
    • LE Flexion-hip flex, abd and ER, knee flex 90*, DF, inv, toe ext
    • LE Extension-pelvic retraction, hip ext, add and IR, knee ext, PF and inv, toe flex -interaction of synergies
  11. PNF
    • -Kabat, Knott and Voss
    • - based on hieratchical model
    • -strengthen muscles in mass movement patterns in which they were designed to function
    • (spiral and diagonal, cross midline)
  12. PNF techniques
    • two diagonal patterns for each body part (flex/ext) including rotational movement and movement across midline
    • -SR,AR,RI,HR,CR,RS