Lecture 6 Historical Approaches- voice over

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Historical Approaches:

Historical Approaches Neurorehabilitation Interventions

Objectives:

Objectives Understand the historical context of various therapeutic approaches Understand the basic principles and key concepts of the historical approaches Understand where the historical approaches fit into the current science of motor control Understand how the historical approaches fit into current OT practice Identify facilitatory and inhibitory neuromuscular techniques

Historic Timeline:

H istoric Timeline Neurodevelopmental Treatment (NDT) - Karl and Berta Bobath,1940s Proprioceptive Neuromuscular Facilitation (PNF) - Dr. Herman Kabat , 1940s Brunnstrom – Signe Brunnstrom, 1940s Rood – Margaret Rood, 1940s Affolter – Felicie Affolter , late 1970s-early 1980s

Basic Principles and Key Concepts:

Basic Principles and Key Concepts Neurodevelopmental Treatment (NDT) Motor output controlled by giving sensory input- handling techniques and Key Points of Control Focus on postural alignment and symmetry Treatment moves along normal developmental patterns Proprioceptive Neuromuscular Treatment (PNF) Increase client’s ability to move or remain stable Guide motion by appropriate grips and resistance Help client achieve coordinated motion through appropriate timing of handling techniques Facilitation of movement patterns, “spiral” in nature

Basic Principles and Key Concepts:

Basic Principles and Key Concepts Brunnstrom Post stroke client’s go back to developmentally older movement patterns Therapist's role is to move client through these stages of recovery Use of reflexes, synergies and associated reactions to evoke movement Rood Tone and motor control coeffect each other and flexion and extension patterns coeffect each other Repetition of muscular responses creates movement patterns The sequence of developing movement: 1. mobility 2. stability 3. mobility superimposed on stability ( H eavy W ork) 4. mobility and stability (Skill)

Basic Principles and Key Concepts:

Basic Principles and Key Concepts Affolter Relationship between tactile-kinesthetic input (T-K) input and problem solving T-K system is primary and auditory-visual system is secondary Treatment technique of non-verbal guiding to facilitate perceptual-cognitive interaction Emphasizes appropriate input rather than successful output Defined clients as Hectic or Quiet individuals

Contemporary Practice:

Contemporary Practice What was the theory of movement at the time these approaches were developed? What do all these approaches share? How do these historical approaches fit into the current science of motor control and contemporary OT practice?

Neuromuscular Treatment Techniques:

Neuromuscular Treatment Techniques Facilitation Techniques Manual contacts-surface specific to facilitate movement Quick stretches to initiate movement Resistance to guide movement Weight bearing Symmetrical posture and alignment to facilitate movement Quick Vibration Q uick Icing Light touch or brushing Tapping over muscle belly Using associated reactions- bilateral rowing

Neuromuscular Treatment Techniques:

Neuromuscular Treatment Techniques Inhibition Techniques W eight bearing Truck rotation Slow stroking Positioning Warmth Gentle shaking or rocking Sustained icing Sustained vibration

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