This document provides an overview of physiotherapy interventions for patients with motor control diseases. It discusses that interventions have evolved from empirical knowledge to being evidence-based. The therapist's role is to determine a patient's strengths/limitations and develop a collaborative plan of care considering the task, individual, and environment. Interventions are organized from restorative to promote optimal function, to impairment-specific, to augmented using hands-on assistance for limited mobility, to compensatory for severe impairment using altered movements. A variety of motor learning strategies and interventions are presented including functional training, strength/flexibility exercises, balance/coordination training, gait rehabilitation, neurodevelopmental techniques, and assistive strategies.

1. DISCOVER . LEARN .
EMPOWER
Physiotherapy Intervention for Patients
with Motor Control Diseases
INSTITUTE OF APPLIED HEALTH
SCIENCES
DEPARTMENT: PHYSIOTHERAPY
Bachelor of Physiotherapy
Subject Name: Advanced Physiotherapeutic
Management of Neurological Conditions
Subject Code: PTC-459
Faculty name: Dr. Monika Rani (PT)
Lecture no. 26

2. Introduction
• Neurorehabilitation interventions have evolved over time for
the management of patients with disorders of motor function.
Many treatment ideas emerged from empirical knowledge and
clinical practice. Theory was applied to explain the success of
these interventions and to organize them into a coherent
treatment philosophy. Our understanding of motor function
and its theoretical base has changed over the years.
• Emphasis on evidence-based practice has resulted in
increased validation of therapeutic interventions through
research.

3. • The therapist’s role is to accurately determine the patient’s
strengths and limitations and to develop a collaborative POC
that includes goals and outcomes that match the patient’s
unique needs. For examples of general goals and outcomes for
patients with disorders of motor function. The therapist must
also determine an appropriate level of intensity, frequency, and
duration of treatment. An important framework for practice is
based on current understanding that movement arises from the
interaction of three basic elements: the task, the individual, and
the environment. All three components must be considered in
developing a successful POC.
• The interventions are organized from top to bottom starting
with restorative interventions that are designed to promote and
restore optimal functional capacity. These include functional
training, defined as activity-based, task-oriented intervention
that uses normal patterns to accomplish the task and motor
learning strategies. The next level includes impairment-specific
and augmented interventions.

4. • Augmented interventions include hands-
on assistance (guided or assisted movements)
and neuromotor development training and are
designed to “jumpstart” functional recovery
for involved individuals with limited motor
function and independent movements. Finally,
some individuals will require compensatory
interventions in the presence of severe
impairment, poor prognosis, and multiple co-
morbidities.
• These interventions are designed to promote
optimal function using altered movement
patterns and strategies using all body
segments. A focus on preventive intervention
is also important. Some activities designed to
minimize impairments and disabilities also
fall into this category. For example, the
patient with stroke who presents with a
flaccid and weak shoulder is given a
protective sling to wear during transfer
training to reduce the likelihood of shoulder

5. • Interventions may be used concurrently or in
some cases sequentially. For example, the
patient with weak hip and knee extensors and
limited range of motion (ROM) in hip extension
will not be successful in accomplishing sit-
to-stand transitions until LE strength is
increased and ROM is improved. The following
section of the chapter presents an overview of
motor learning strategies and therapeutic
interventions.

7. Motor Learning Strategies

9. Functional Induced Recovery

10. • 3) Impairment Intervention
• a) Intervention to improve strength, power and endurance
• i) Strength training
• ii) Muscle endurance and fatigue
• iii) Aerobic training
• b) Intervention to improve flexibility
• i) ROM exercises
• ii) Passive stretching
• iii) Facilitated stretching
• iv) Stretching and positioning for the patient with Spasticity
• v) Serial cast
• vi) ROM for the patient with hypotonia
• c) Intervention to improve Postural Control and Balance
• d) Intervention to improve Coordination and Agility
• e) Intervention to improve Gait and Locomotion

11. • 4) Augmented Interventions
• a) NDT
• b) Neuromuscular Facilitation
• c) Sensory Stimulation Techniques
• d) Biofeedback
• e) Neuromuscular Electrical Stimulation
• 5) Compensatory Interventions
• 6) Patient/Client related Instructions
•

12. Thank you..
Questions???