TUBÍA METHOD FOR MOVEMENT REHABILITATION <ul><li>Applications: </li></ul><ul><li>Recovery from proper sequels of acquired brain injury: </li></ul><ul><li>- Cerebro-vascular accidents (stroke) (CVA) </li></ul><ul><li>- Traumatic brain injury (TBI) (main lesion in frontal lobe) </li></ul><ul><li>2. Improvement of the movement control in Parkinson </li></ul><ul><li>3. Motor and cognitive development in: </li></ul><ul><li>- Intellectual disability </li></ul><ul><li>- Blindness </li></ul><ul><li>- Mild cerebral palsy </li></ul>
PROGRAMME OF RHYTHMIC EXERCISES WITH MUSIC This Method comprises: a programme of rhythmic exercises of progressive complexity and they are performed with a selected musical repertory because of its psychomotor, emotional and proprioceptive sensory inducement. RHYTHMIC EXERCISES: exercises of bodily rhythmics and a dancing technique . MUSIC: it belongs to all types and all rhythms. The therapy consists in a training and this traning is complex motor and cognitive learning.
<ul><li>In each exercise the patient to rehabilitate has to start conjunctly 4 functions: </li></ul><ul><li>Motor functions: the movement he is trying to do </li></ul><ul><li>2. Sensory functions: to do the movement according to the music sets the pace </li></ul><ul><li>3. Cognitive functions: the movements have rhythmic schemes and sequences </li></ul><ul><li>Motivational processes: To put the will power and the necessary state of mood to concentrate in overcome the difficulties </li></ul><ul><li>This effort is seen favoured thanks to the music and rhythmic movement </li></ul>
<ul><li>TUBÍA METHOD AND NEUROPLASTICITY: </li></ul><ul><li>- It provides a harmonic technique to the field of the neurorehabilitation </li></ul><ul><li>It contributes to the stream of scientific thinking of the neuroplasticity: brain shows it is able of a functional reorganization to recovery losts functions because of acquired brain injury. </li></ul><ul><li>This functional reorganization is not spontaneous but activity-dependent, and occurs because of healthy neurons make the role of injured neurons which have lost it and by neuronal reconstruction around the lesion. </li></ul><ul><li> </li></ul>
Taking in consideration that functional recovery depends on the activity: The activity to perform with rehabilitating goals will must to have a logical and progressive arrangement in difficulty both motor and cognitive, like every learning has it: - To learn to read and write - To learn mathematics - To learn physics - To learn to play football and basket-ball - To learn to play the piano with sol-fa, etc. Development of rehabilitation techniques demands to the researcher to know the movement by self-experience and to theorize the movement from its practical knowledge.
<ul><li>Procedure in the Tubía Method </li></ul><ul><li>PROGRAMME OF RHYTHMIC EXERCISES WITH MUSIC COMPRISES: </li></ul><ul><li>Walking exercises: </li></ul><ul><li>- natural walking exercises </li></ul><ul><li>- complementary walking exercises </li></ul><ul><li>- exercises for the good hold of the foot and the plumb of the weight </li></ul><ul><li>2. Lateral displacements and turning of the body </li></ul><ul><li>3. Swinging </li></ul><ul><li>4. Rotation </li></ul><ul><li>5. Pronation-supination </li></ul>
6. Exercises with the arms contributing:: - to their proper movement - to the thoracic and on the whole trunk mobility - to the arm-legs coordination 7. Gestures that orientate and make planning of movement easier 8. Percussions: - with the feet, with the hands, with small sticks 9. Exercises with the hands and fingers
10. Movement control exercises: - to initiate and to maintain it, to stop it, to change direction - to give it the adequate measure in the space and in the time; spatial and temporal articulations 11. Exercises which favour the balance control Exercises of weight and plumb dominion 12. Exercises which favour the control of spatial and bodily orientation 13. Exercises which favour the mobilization of the shoulders and axial musculature. Exercises which favour the mobilization of the hips
14. Visuomotor coordination exercises: spatial references and rhythm dinamics on the space 15. Movement rhythmic sequences and ballroom dancing 16. Cognitive exercises which work on: - attention, observation, concentration - motor planning: perception, comprehension learning and performance of movements, - keeping in mind, cynesthetic memory, capacity of sequenciation, capacity of changing, alternating movements - space and body orientation - temporary orientation - the intention
Before starting training: Motor assessment following a protocol which also includes a personalized description During the training: Each exercise is itself a proof : If an exercise is overcome it means that some cualitative aspect of movement control has improved If the patient progresses he must continue (improvements in gait, in the lateral displacements, in the hands movement, etc.) We need consider the factors that will influence recovery.
CHRONIC HEMIPLEGIA: STROKE (CVA) Fig. 1:Cerebral infarct in the right middle cerebral artery territory Fig. 2: Cerebral infarct in the left middle cerebral artery territory
CHRONIC HEMIPARESIS IN THE LEFT SIDE: Traumatic brain injury (TBI) Fig. 3:Dependent walking Fig. 4:Weight bearing on the right leg, external rotation left leg, shuffling gait left foot, permanent flexion of forearm and wrist, fingers: paralysis; thumb: paresis