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What is the Biomechanical approach?
- This approach addresses physical disabilities.
- Techniques in this approach derive from kinetics= the science of the motions of objects & the forces acting on them. To some extent, the principles of statics, the study of the forces acting on objects at rest are used.
- The goal of this approach is;
- 1 - evaluate specific physical limitations in ROM, strength, & endurance.
- 2. restore these functions.
- 3. prevent or reduce deformity.
In the biomechanical approach what type of disorders are addressed?
The biomechanical approach is most appropriate for pts whose CNS(functions to produce controlled, well-moduated regular & adjusted movement) is intact, but who have lower motor neuron disorders(e.g. peripheral nerve injuries, Guillain-Barre' syndrome, spinal cord injuries, & primary muscle diseases(e.g. muscular dystrophy) or orthopedic disorders.
rheumatoid arthritis - osteoarthritis - fractures - amputation - hand trauma or burns.
Pts need to be able to control isolated movements & specific movement patterns but may have weakness, low endurance or joint limitation.
The biomechanical principles are also applied in ergonomics & work hardening, with an emphasis on proper positioning.
This approach addresses the performance capacity level of the model of human occupation & focuses on physical skills (e.g., lifting the hand) & body structures & functions that support them(e.g. ROM, strength).
Describe the methods used with the Sensorimotor & Motor Learning Approaches & what disorders are treated using this approach.
The methods used in this approach were developed for treatment of patients who have CNS dysfunction(cannot coordinate & produce such movement smoothly or with ease). These methods belong to various theories of motor recovery.
Sensorimotor approaches to treatment use neurophysiologica
l(pertaining to the study of the physical & chemical nature of the nervous system), mechanisms to normalize muscle tone & elicit more normal motor responses. They provide controlled input to the nervous system; this controlled input is meant to stimulate specific responses.
Some approaches use reflex mechanisms
, & the sequence of treatment may be based on the recapitulation of ontogenetic development. In other words , these approaches might employ primitive reflexes such as those that infants display.
- Motor learning is a more recent approach that is associated with the sensorimotor approach & focuses on the acquisition of motor skills through practice & feedback.
- The motor training by therapists, with opportunities for pts to create their own movement solutions to challenges. The context or practice environment for movement activities is a major focus.
- The motor control approach addresses the volition & habituation & performance capacity components of the MOHO. The primary focus is the performance of motor functions.
- Volition is involved as the person is engaged through practice in a variety of situations & the generation of new movement patterns.
What are the names of the sensory stimulis commonly used to influence motor responses?
Proprioceptive stimulation - are stretching, weight bearing & resistance that affect the joints & muscle receptors.
Cutaneous stimulation - Is the stimuli of touch, temperature, & pain acting upon the exteroceptors,located immediately under the skin. This stimulation can be used to facilitate or inhibit muscle responses.
The combination of both may be used to elicit voluntary control of specific muscles.
What are the sustained injuries by a diseased process or a structural or genetic defect, or a traumatic event. affecting the CNS that could be treated by the sensorimotor treatment approach?
- Cerebrovascular accident(CVA)(Stroke), closed head injury.
- Cerebral Palsy.
Sensorimotor treatment approaches work to normalize muscle tone, to facilitate symmetrical posture, & to improve balance. Achievement of these objectives can help to restore coordinated & purposeful movements & a return to independence.
When selecting a specific sensorimotor approach what are the factors to consider?
- The patients strengths & weaknesses, the therapist's preference, & the philosophy of a particular treatment setting.
- 1st examine motor performance skills within the context of a functional activity.
An example would be, when observing a pt reach for a shirt hanging in a closet, the ot would assess the pt's ability to maintain balance while coordinating forward reach to retrieve the shirt.
While working together with OTA must demonstrate sufficient competence with knowledge & skills for safe application.
The OTA who these techniques can do so only with specific directions from the occupational therapist.
The OTA always must be thoroughly trained & properly supervised when he or she is using these techniques. Instruction about the nature of the technique, the specific procedure for application, the expected response, & possible risks & contraindications must be provided to the OTA by the OTR.
How many sorsorimotor treatment approaches that are most common & name them and list the treatments used?
- There are 4 types of approaches.
- 1.The Rood approach drawing from developmental & neurophysiological technques
2. The Brunnstrom - The movement therapy in hemiplegia approach.
3. The proprioceptive neuromuscluar approach. Using the neurophysiological principles to the treatment of paralysis resulting from poliomyelitis = is a contagious viral disease that affects the anterior horn cells of the gray matter of the spinal cord & motor nuclei or the brain stem.It results in a flaccid paralysis that may be local or widespread.The lower extremities, accessory muscles of respiration, & muscles that promote swallowing are primarily affected, but upper extremity involvement may also occur. The deep tendon reflexes may be absent.
& multiple sclerosis.
4. The neurodevelopmental (Bobath) approach.
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