Rood's approach is a neurophysiological technique developed in 1940 based on reflex models of motor control. It uses sensory stimulation to normalize tone and elicit desired muscle responses based on developmental sequences. The key concepts are:
1. Categorizing muscles as tonic or phasic for stability or mobility.
2. Using ontogenic sequences of motor and vital functions development.
3. Applying appropriate sensory stimuli like touch or vibration to proprioceptive, exteroceptive, and vestibular receptors.
4. Manipulating the autonomic nervous system with techniques like icing or warming.
This presentation is detail about Volta therapy which is commonly used in paediatric neurological conditions and also for adults. this presentation explains what are the various techniques, methods of application of Volta therapy, indications, contraindications, etc.
NDT, BOBATH TECHNIQUE, BASIC IDEA OF BOBATH, CONCEPT OF BOBATH, NEUROPHYSIOLOGY OF NDT, ICF MODEL, PRINCIPLES OF TREATMENT OF NDT IN STROKE AND CP, AUTOMATIC AND EQUILIBRIUM REACTIONS, KEY POINTS OF CONTROL, FACILITATION, INHIBITION AND HANDLING IN NDT
At the end of the lecture, the students should be able to:
Discuss the theoretical basis of the neurodevelopmental approaches
Discuss the concepts and principles underlying the Bobath approach
Discuss the concepts and principles underlying the Brunnstrom approach
Hierachical theory- says that higher centers control on lower center; but when higher center damage then this inhibitory control from the higher center is loss which leads to exageration of the movt.
In normal individual, these occur a smooth, rhythmic movt. Because there is a presence of control from higher center on lower center.
Controlled use of sensory stimulus.
Specific Motor response
Normalization of muscle tone
Use of Developmental sequences.
Sensorimotor development = from lower to higher level.
Use of activity to demand a purposeful response.
Practice of sensory motor response is necessary for motor learning.
This presentation is detail about Volta therapy which is commonly used in paediatric neurological conditions and also for adults. this presentation explains what are the various techniques, methods of application of Volta therapy, indications, contraindications, etc.
NDT, BOBATH TECHNIQUE, BASIC IDEA OF BOBATH, CONCEPT OF BOBATH, NEUROPHYSIOLOGY OF NDT, ICF MODEL, PRINCIPLES OF TREATMENT OF NDT IN STROKE AND CP, AUTOMATIC AND EQUILIBRIUM REACTIONS, KEY POINTS OF CONTROL, FACILITATION, INHIBITION AND HANDLING IN NDT
At the end of the lecture, the students should be able to:
Discuss the theoretical basis of the neurodevelopmental approaches
Discuss the concepts and principles underlying the Bobath approach
Discuss the concepts and principles underlying the Brunnstrom approach
Hierachical theory- says that higher centers control on lower center; but when higher center damage then this inhibitory control from the higher center is loss which leads to exageration of the movt.
In normal individual, these occur a smooth, rhythmic movt. Because there is a presence of control from higher center on lower center.
Controlled use of sensory stimulus.
Specific Motor response
Normalization of muscle tone
Use of Developmental sequences.
Sensorimotor development = from lower to higher level.
Use of activity to demand a purposeful response.
Practice of sensory motor response is necessary for motor learning.
Introduction, principles of sensory re-education hypersensitivity and hyposensitivity, stages of training after nerve repair, uses and benefits, sensory reeducation in stroke - its principle. Actve and passive Sensory reeducation in stroke, orofacial sensory retraining
Retraining of motor control basing on understanding of normal movement & analysis of motor dysfunction.
Emphasis of MRP is on practice of specific activities, the training of cognitive control over muscles & movt. Components of activities & conscious elimination of unnecessary muscle activity.
In rehabilitation programme involve – real life activities included.
Brunnstrom Approach
Brunnstrom's Approach (SIGNE BRUNNSTROM)
Objectives: ➢ Discuss the concepts and principles underlying Brunnstrom’s approach ➢ Brunnstrom recovery stages ➢ Treatment principles & techniques
★ Brunnstrom’s approach was developed by the physical therapist from Sweden in the early 1950’s
★ Brunnstrom used motor control theory and observations of the patients'
★ Procedure: In a “trial & error” fashion ★ Later modified: in light of neurophysiological knowledge
Introduction: Reflex Theory Movement is controlled by stimulus-response. Reflexes are the basis for movement: reflexes are combined into actions that create behavior. Hierarchical Theory Characterized by a top-down structure, in which higher centers are always in charge of lower centers.
● When the CNS is injured, as, in a cerebrovascular accident, an individual goes through an “evolution in reverse”. Movement becomes primitive, reflexive, and automatic.
● Changes in tone and the presence of reflexes are considered a normal process of recovery.
● Movement recovery tends to be stereotypic.
● Patients exhibit only a few stereotypic movement patterns: Basic Limb Synergies.
● Based on observations of recovery following a stroke, this approach makes use of associated reactions, tonic reflexes, and the development of basic limb synergies to facilitate movements.
● The use of such a procedure is temporary.
Basic Limb Synergies:
● Normal synergistic movements are purposeful movements with maximum precision and minimum waste of energy.
● Basic limb synergy (BLS) does not permit the different combinations of muscles.
● BLS is considered primitive, automatic, and reflexive due to loss of inhibitory control from higher centers.
● Mass movement patterns in response to a stimulus or voluntary effort both Gross flexor movement (Flexor Synergy) Gross extensor movement (Extensor Synergy) Combination of the strongest component of the synergies (Mixed Synergy)
● Appear during the early spastic period of recovery
Upper Limb Flexor Synergy: Scapula: Retraction / Elevation Shoulder: Abduction and External rotation Elbow: Flexion Forearm: Supination Wrist and Finger: Flexion Lower Limb Extensor Synergy: Pelvis: posterior tilt Hip: Extension, Adduction & Internal rotation Knee: Extension Ankle: Plantarflexion Toes: Flexion Upper Limb Extensor Synergy: Scapula: Protraction / Depression Shoulder: Adduction and Internal rotation Elbow: Extension Forearm: Pronation Wrist: Extension Finger: Flexion Lower Limb Flexor Synergy: Pelvis: anterior tilt Hip: Flexion, Abduction & External rotation Knee: Flexion Ankle: Dorsiflexion Toes: Extension
Upper Limb Mixed Synergy: Scapula retraction Shoulder add.+IR Elbow flexion Forearm pronation Wrist & fingers flexion Lower Limb Mixed Synergy: Pelvis post tilt hip add.+IR Knee extension Ankle & toes plantarflexion
Rubrospinal tract Vestibulospinal tract
Associated Reactions
Primitive Reflexes
This is the presentation which was delivered to third year Bachelor of Physiotherapy students at Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Nepal. Different schools of thoughts in manual therapy are the part of curriculum for the undergraduate students at KUSMS.
Vojta technique is neuromuscular approach deals with all the conditions of CNS and Musculoskeletal system.
Contents :
Introduction
Definition
What is REFLEX LOCOMOTION
Indication
Stimulating Points
Reflex locomotion
Reflex Rolling phase 1
Reflex Rolling phase 2
Reflex creeping
Effects of Vojta technique
This presentation give an upto date insightful information on balance/postural assessment and key domains of Occupational Therapy during assessment of balance using different scales.
Brian Mulligan described novel concept of the simultaneous application of therapist applied accessory mobilizations and patient generated active movements
Concept given by Shacklock (modern concept) and Butler (old concept), a method of assessment as well as treatment of peripheral neurological system by physiotherapists.
Part-I: The current slideshow: theoretical aspect of neurodynamics.
Part-II: Assessment of peripheral nervous system on the basis of neurodynamic concepts: Date: 01/04/2020
Part-III: treatment part: Date: 03/04/2020
Part-IV: Self neurodynamics: 05/04/2020
Introduction, principles of sensory re-education hypersensitivity and hyposensitivity, stages of training after nerve repair, uses and benefits, sensory reeducation in stroke - its principle. Actve and passive Sensory reeducation in stroke, orofacial sensory retraining
Retraining of motor control basing on understanding of normal movement & analysis of motor dysfunction.
Emphasis of MRP is on practice of specific activities, the training of cognitive control over muscles & movt. Components of activities & conscious elimination of unnecessary muscle activity.
In rehabilitation programme involve – real life activities included.
Brunnstrom Approach
Brunnstrom's Approach (SIGNE BRUNNSTROM)
Objectives: ➢ Discuss the concepts and principles underlying Brunnstrom’s approach ➢ Brunnstrom recovery stages ➢ Treatment principles & techniques
★ Brunnstrom’s approach was developed by the physical therapist from Sweden in the early 1950’s
★ Brunnstrom used motor control theory and observations of the patients'
★ Procedure: In a “trial & error” fashion ★ Later modified: in light of neurophysiological knowledge
Introduction: Reflex Theory Movement is controlled by stimulus-response. Reflexes are the basis for movement: reflexes are combined into actions that create behavior. Hierarchical Theory Characterized by a top-down structure, in which higher centers are always in charge of lower centers.
● When the CNS is injured, as, in a cerebrovascular accident, an individual goes through an “evolution in reverse”. Movement becomes primitive, reflexive, and automatic.
● Changes in tone and the presence of reflexes are considered a normal process of recovery.
● Movement recovery tends to be stereotypic.
● Patients exhibit only a few stereotypic movement patterns: Basic Limb Synergies.
● Based on observations of recovery following a stroke, this approach makes use of associated reactions, tonic reflexes, and the development of basic limb synergies to facilitate movements.
● The use of such a procedure is temporary.
Basic Limb Synergies:
● Normal synergistic movements are purposeful movements with maximum precision and minimum waste of energy.
● Basic limb synergy (BLS) does not permit the different combinations of muscles.
● BLS is considered primitive, automatic, and reflexive due to loss of inhibitory control from higher centers.
● Mass movement patterns in response to a stimulus or voluntary effort both Gross flexor movement (Flexor Synergy) Gross extensor movement (Extensor Synergy) Combination of the strongest component of the synergies (Mixed Synergy)
● Appear during the early spastic period of recovery
Upper Limb Flexor Synergy: Scapula: Retraction / Elevation Shoulder: Abduction and External rotation Elbow: Flexion Forearm: Supination Wrist and Finger: Flexion Lower Limb Extensor Synergy: Pelvis: posterior tilt Hip: Extension, Adduction & Internal rotation Knee: Extension Ankle: Plantarflexion Toes: Flexion Upper Limb Extensor Synergy: Scapula: Protraction / Depression Shoulder: Adduction and Internal rotation Elbow: Extension Forearm: Pronation Wrist: Extension Finger: Flexion Lower Limb Flexor Synergy: Pelvis: anterior tilt Hip: Flexion, Abduction & External rotation Knee: Flexion Ankle: Dorsiflexion Toes: Extension
Upper Limb Mixed Synergy: Scapula retraction Shoulder add.+IR Elbow flexion Forearm pronation Wrist & fingers flexion Lower Limb Mixed Synergy: Pelvis post tilt hip add.+IR Knee extension Ankle & toes plantarflexion
Rubrospinal tract Vestibulospinal tract
Associated Reactions
Primitive Reflexes
This is the presentation which was delivered to third year Bachelor of Physiotherapy students at Kathmandu University School of Medical Sciences (KUSMS), Dhulikhel, Nepal. Different schools of thoughts in manual therapy are the part of curriculum for the undergraduate students at KUSMS.
Vojta technique is neuromuscular approach deals with all the conditions of CNS and Musculoskeletal system.
Contents :
Introduction
Definition
What is REFLEX LOCOMOTION
Indication
Stimulating Points
Reflex locomotion
Reflex Rolling phase 1
Reflex Rolling phase 2
Reflex creeping
Effects of Vojta technique
This presentation give an upto date insightful information on balance/postural assessment and key domains of Occupational Therapy during assessment of balance using different scales.
Brian Mulligan described novel concept of the simultaneous application of therapist applied accessory mobilizations and patient generated active movements
Concept given by Shacklock (modern concept) and Butler (old concept), a method of assessment as well as treatment of peripheral neurological system by physiotherapists.
Part-I: The current slideshow: theoretical aspect of neurodynamics.
Part-II: Assessment of peripheral nervous system on the basis of neurodynamic concepts: Date: 01/04/2020
Part-III: treatment part: Date: 03/04/2020
Part-IV: Self neurodynamics: 05/04/2020
Principles and application of various Neurological Approaches. Comprises of PNF, ROODS, NDT, BOBATH, SENSORY INTEGRATION, BRUNNSTORM, VOJTA, Motor Re-learning Approach , Neural Tissue Mobilization
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
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June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
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- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
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Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
3. Introduction
• Rood approach is a neurophysiological
approach developed by Margaret Rood in
1940 based on reflex or hierarchical model
of the central nervous system.
• Rood's basic concept was that motor
patterns are developed from primitive
reflexes through proper sensory stimuli to
the appropriate sensory receptors in
normal sequential developmental pattern
to improve motor performance.
3
4. 4
PRINCIPLES
Basic principles of Rood Approach are:
• 1. Normalization of tone: Using appropriate sensory stimuli for evocating
the desired muscular response is the basic principle of Rood approach.
• 2. Onto genic developmental sequence: Rood recommended the use of
onto genic developmental sequence. According to Rood, sensory motor
control is developmentally based, so that during treatment therapist must
assess current level of development and then try to reach next higher levels
of control.
• 3. Purposeful movement: Rood used purposeful activities which can help
to get the desired movement pattern from the patient.
• 4. Repetition of movement: Rood encouraged to use repetitive
movements for motor learning.
5. BASIC CONCEPTS
OF ROODS
APPROACH
According to Rood, sensory input is required for
normalization of tone and evocation of desired
muscular responses. Sensory stimulus and their
relationship to motor functions play a major role
in the analysis of dysfunction and in the
application of the treatment.
5
Rood's four basic concepts are
1. Mobility and stability muscles(Tonic and phasic)
2. The Onto genic Sequence
3. Appropriate sensory stimulation
4. Manipulation of the autonomic nervous system
6. 6
1.Mobility and stability muscles(tonic and phasic)
• According to Rood approach, muscle groups are categorized according to the type of work they do and
their responses to specific stimuli.
• Phasic muscles (also known as light work muscles or mobility muscle) are the muscle groups
responsible for skilled movement patterns with reciprocal inhibition of antagonist muscles e.g. the
flexors and adductors.
• Tonic muscles (also known as heavy work muscles or stability muscle) are the muscle groups
responsible for joint stability with co-contraction of muscles which are antagonists in normal
movement.
• Though some muscles perform both light and heavy work functions, Rood mentioned specific
properties of phasic and tonic muscles. Phasic muscles are fast glycolytic fiber type, superficial and
usually one joint muscle. They have high metabolic cost and rapidly fatigue. Tonic muscles are
different from phasic. The muscles are slow oxidative fiber type, deep and usually single joint type.
These are Pennate, the large area of attachment muscle, has low metabolic cost and slow fatigue.
7. 7
2.The Ontogenic Sequence
Rood introduced two categories of onto genic sequences :
a. The Motor development sequence
• The motor development sequence finally leads to skilled and finely coordinated movements. The ontogenic
motor patterns are:
• i. Supine withdrawal
• ii. Roll over
• iii. Pivot prone
• iv. Neck co-contraction.
• v. Prone on elbow
• vi. Quadruped
• vii. Standing
• viii. Walking
8. Rood also categorized these patterns under the following four phases, using the concepts of light
and heavy work:
• i. Mobility or reciprocal innervations: It is a nearly mobility pattern, primarily reflex governed
by spinal and supraspinal centers. It includes supine withdrawal, roll over, and pivot prone.
• ii. Stability or co-contraction: It is defined as simultaneous contractions of antagonists and
agonists, working together to stabilize and maintain the posture of the body. It includes pivot
prone, neck co-contraction, prone on elbow, quadruped and standing.
• iii. Mobility superimposed on stability: It is defined as a movement of proximal limb segments
with the distal ends of limbs fixed on the base of support. It includes weight shifting in prone on
elbows, quadruped, and to and fro rocking that later on can be promoted to crawling in different
directions.
• iv. Skill or Distal mobility with proximal stability: It is defined as skilled work with the
emphasis on the movement of distal portions of the body in a finely coordinated pattern that
require control from the highest cortical level.
8
9. 9
b. The vital functions sequence
The vital functions sequence finally leads to well-articulated speech. The ontogenic patterns are:
i. Inspiration
ii. Expiration
iii. Sucking
iv. Swallowing liquids
v. Phonation
vi. Chewing and swallowing solids
vii. Speech
10. 3. Appropriate sensory stimulation
• The relearning of muscular activity is based on the phenomena of summation which activates or
deactivates the sensory receptors, utilizing afferent input to affect the anterior horn cell of the spinal
cord. Rood utilized the anterior horn cell excitability by using sensory stimulus. According to Rood,
there are four types of receptors which can be stimulated and in order to get desired muscular
response:
• i. Proprioceptive receptors
• ii. Exteroceptive receptors
• iii. Vestibular receptors
• iv. Special sense organs
10
11. 4. Manipulation of the autonomic nervous system
9/3/20XX Presentation Title 11
Rood introduced two groups of autonomic nervous system stimuli:
• i. Sympathetic Nervous System Stimuli: It includes icing, unpleasant smells or tastes, sharp and short vocal
commands, bright flashing lights, fast tempo and arrhythmical music.
• ii. Parasympathetic Nervous System Stimuli: It includes slow, rhythmical, repetitive rocking, rolling,
shaking, stroking the skin over the paravertebral muscles, soft and low voice, neutral warmth, contact on
palms of hands, soles of feet, upper lip or abdomen, decreased light, soft music and pleasant odors.
13. Facilitatory & Inhibitory
Techniques
• To initiate a movement response, we should try to increase the neuronal activity -it refers as facilitation
• To decrease the capacity to initiate a movement response we should try to decrease the neuronal
activity -it refers as inhibition.
• The sensory stimulation technique can be used separately or grouped according to the receptors
activated, the nature of stimulation (intensity, duration and frequency) need to be adjusted and
readjusted to meet the individual needs of the patient.
TECHNIQUES USED ARE-
• Proprioceptive stimulation techniques.
• Extroceptive stimulation techniques.
• Vestibular stimulation techniques.
• Special senses (vision, hearing, smell ) stimulation techniques.
• Autonomic nervous system stimulation techniques
13
14. Proprioceptive Stimulation
Techniques
14
• Stretch:
Quick and Prolonged Stretch. Application of this technique may include tapping which is commonly used in three forms; on tendon,
on muscle belly and with the use of gravity.
The quick stretch produce a relatively short-lived contraction of the agonist muscle and short-lived inhibition of the antagonist muscle.
Prolonged and firm stretch produces inhibition of muscle responses which may help in reducing hypertonicity, e.g., Bobath's neuro-
developmental technique, inhibitory splinting and casting technique.
• Vibration:
The high frequency vibration is driven from vibrator that optimally operates at a frequency of 100–200 Hz and at amplitude of 1–2
mA. This type of vibration produce facilitation of muscle contraction through what is known as tonic vibration reflex. This facilitatory
effect sustained for a brief time after application. Therefore, it can be used for stimulating muscles whose primary function is one of
tonic holding.
The low frequency stimulation 5-50 Hz has an inhibitory effect on muscle through its activation of spindle secondary endings and
Golgi tendon organs.
• Approximation or compression of the joint surfaces:
Facilitates posture extensors which are needed to stabilize the body.
Approximation can be applied slowly to inhibit muscle control or in jerky manner to facilitate muscle control.
The application may be manually and/or by using weight bearing postures.
Joint awareness may be improved by approximation which will lead to enhancing motor control.
15. Extroceptive Stimulation
Techniques
• Touch:
• It is one of the simple ways of facilitation of muscle activity by eliciting the phasic, protective
withdrawal reflexes. The location of the stimulus and its intensity play the important role in
the magnitude of reaction.
• Application of the touch can be manually using brief, light stroke, brief swipe ice cube,
noxious stimulus and/or light pinching.
• Brushing:
• It facilitates the movement responses; Application can be manually or by using battery-
operated brush.
• Skin overlying muscle can facilitate it and enhances static holding postural extensors and will
have immediate and long latency responses.
9/3/20XX Presentation Title 15
16. 9/3/20XX Presentation Title 16
• Icing for a long period:
• Icing given for more than 20 minutes can inhibit muscle activity and postural tone (locally).
• Application of the prolonged ice can be used clinically by four types; ice chips, ice wraps, ice pack and
immersion in cold water.
• Neutral warmth:
• It is one of the most common way to inhibit postural tone and muscle activity. It acts through stimulating
the thermo receptors and activating of parasympathetic responses. Usually, 10-20 minutes are sufficient
period to produce effect.
• The application may be by wrapping body part with towels, hot packs, tepid baths and air splints.
• Maintained Touch:
• It can be used to produce a general calming effect and generalized inhibition. Firm manual contacts
(pressure to midline abdomen, back are the commonly used techniques).
• Slow stroking:
• It is another technique used to produce a generalized calming effect by the activation of Autonomic
Nervous System.
• It may be applied by using a flat hand over the paravertebral muscles from cervical to sacral regions. The
generally calming effect can decrease muscle tone. 3-5 minutes of stroking is sufficient to produce the
effect.
17. Vestibular Stimulation Techniques
• Total body inhibition can be achieved by slow rocking, slow anterior-posterior movement,
slow horizontal movement, slow vertical movement and slow linear movement.
• Total body facilitation can be achieved by rolling patterns, a rocking pattern on elbows and
extended elbows and crawling. Also spinning induces tonal responses and causes a strong
facilitation of movement through the overflow of impulses to higher centers.
• A facilitation of postural extensors is another effect of vestibular stimulation if it is used by a
rapid way anterior-posterior or angular acceleration of the head and body while the child in
prone position.
• The inverted position is commonly used now to achieve a total body inhibition, while it may
be used to increase to in certain extensors.
9/3/20XX Presentation Title 17
18. Special Senses Stimulation
Techniques
18
• Visual system:
• May be used to produce a decrease or an increase in firing of sensory afferent fibers and have an overall effect on CNS
excitation.
• Cool colors, a darkened room and monotone color schemes all tend to have an inhibitory effect on muscle tone, a
calming mood and generalized inhibitory response.
• On the other hand a facilitatory effect can be gained by intermittent visual stimuli, bright colors, bright light and a
random color scheme.
• If the sensory component of the tactile, proprioceptive or vestibular system has been lost or severely damaged the visual
stimulus may consider an effective alternative.
• Auditory System :
• As a treatment technique, it depends on the quality, quantity and effect of voice. The therapist's voice can be considered
a very important therapeutic tool to produce a facilitatory or inhibitory response on muscle tone and activity. The same
effect may also be gained by music.
• Auditory biofeedback is a very important and famous therapeutic modality which depends on intact auditory system.
• Olfactory System:
• May be used as a treatment modality especially during feeding procedures. Some odors such as vanilla and banana may
be used to facilitate sucking movement. Withdrawal patterns can be facilitated with ammonia and vinegar.
• Therapist should use olfactory system as a treatment technique under restricted precautions because its arousal and
emotional effect.
19. ANS Stimulation Techniques
There are four treatment procedures can be used to affect on movement and muscle tone
throughout ANS reaction which normally produce a parasympathetic response:
• Slow stroking over the paravertebral areas will cause inhibition.
• Inverted tonic labyrinthine therapy.
• Slow, smooth, passive movement within pain free range.
• Maintained deep pressure on the abdomen, palms, soles of the feet, and perineal area may
cause a reduction of tone or hyperactivity.
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