Ramesh debur

 Understanding of the brain functioning

 Gives a direction to treatment
 Ability to understand concepts in practice
 Deeper understanding of treatment and
effects
 Ability to detect change in status early
 Theoretical concepts that help CNS functions
 To some extent based on practical knowledge
 Understanding morphology using physiology
 Brain recovers the way it developed from birth
 Informed assumption to established facts
 Muscle Re-education Approach (1920s)
 Neurodevelopmental Approaches (1940-70s)
 Sensorimotor Approach (Rood, 1940s)
 Movement Therapy Approach (Brunnstrom, 1950s)
 NDT Approach (Bobath, 1960-70s)
 PNF Approach (Knot and Voss, 1960-70s)
 Motor Relearning Program for Stroke (1980s)
 Contemporary Task-Oriented Approach
(1990s)
 Hirerchial theory
 Top to bottom approach
 Normalization of muscle tone

 Mobilizers and stabilizers

 Voluntary movement based on reflexes and
uses reflexes to augment motor response
 Development cephalocaudal
 therefore treatment is
◦ toe to head

◦ flexors >extensors> abductors > adductors

 Movement is towards function
 Repetition is necessary
LR and labyrinthine responses can affect sensory
stimulation

Three basic observations

◦ Stimulation of receptors - Homeostatic response via ANS

◦ Reflexive and protective response via brainstem, ANS and

Spinal circuits

◦ Adaptive response that require greater integration of higher levels

of CNS
1. fast brief stimulus –large synchronous
motor output
2. fast repetitive –maintained response
3. maintained sensory –maintained motor
response
4. slowrhythmical sensory –deactivates
body and mind
  PNF :
 Light touch moving
 Steady joint compression
 Fast brusing
 Stretch

 Icing
 Intrinsic stretch  Resistance

 Secondary ending  Vestibular stimulation :

stretch positioning etc
 Stretch pressure
 Normal warmth

 Gentle shaking or walking

 Slowstroking

 Slowicing
Us e s

 Modulate muscle tone

 Re educate movements

 Pure sensory feed back

 Make patient aware “

aware”of the joints

 Alter reflex patterns

 Slowrolling

 Light joint compression

 Tendionus pressure

 Maintained stretch
Advantag e s
 Strong reactions ( if used properly)
 Transient responses
 Does not require the cooperation of the
patient as the responses are automatic
 Easy to apply
 Immediate outcome
Dis advantag e s
 No responses under altered conditions
 No Long term effects
 Very less evidence in support
 Change of thinking
 Change of knowledge base has outdated
this method as a standalone therapy
S ummary
 Elementary method of treatment
 Uses body responses to cause change
 Action - Reaction principle
 Can be used in the initial phases of
recovery