From the neurofacilitation techniques to the tissue rehabilitation
Below are some of the methods that will be taught.
Modular Rebalancing System of G. Monari (elaboration of the Kabat concept).
The method considers two basic principles of neurophysiology for motor control: temporal and spatial facilitation.
The first principle refers to the phenomenon whereby a stimulus applied to a neuronal system facilitates the passage of subsequent stimuli. The second refers to the neurobiological property whereby the response to a stimulus can be enhanced or inhibited by other stimuli converging on the same nerve cells.
Such cellular communication mechanisms would allow the restoration of sensory-motor functions through the induction of control activities by intact cells. Physical therapist-guided activities act, therefore, as a means of multi-sensory stimulation, resulting in hyperactivity and involvement of all still-functioning nerve cells. The repetition of stimuli results in sensory-motor responses fundamental to learning, which can be verbally reinforced, directing the organization of motor behavior.
The technique is based on a series of observations conducted in the world of sports and dance: it was, in fact, noted that most movements made by sportsmen and dancers followed diagonal lines with respect to the sagittal axis of the body and resulted in rotation. Subsequent studies, showed that the muscles of the extremity and trunk were functionally grouped into motor patterns consisting of diagonal-spiral movements and the combination of flexion-extension, abduction-adduction and rotations. A number of motor patterns are derived from this technique, configuring them into diagonal-spiral patterns refined for therapeutic use and classified as basic patterns.
In Italy, the Kabat concept has been further developed and updated with the system called Riequilibrio Modulare Progressivo (RMP). The RMP system emphasizes the exercise of bi-articular muscles, postural exercises, and postural transitions, with the main role of the trunk, which is considered the basis for the recovery of functional motor patterns and synergies and the pivotal center of the entire locomotor system. All exercises are combined in a progression from least to most challenging, depending on the functional level achieved by the patient. The foundation of RMP is to restore structural and postural alignment of the body's skeletal and neuromuscular systems by invoking "global" motor patterns that repeat and reconstruct the developmental stages of vertical motor control.
Bobath's method
The method, developed on empirical observations, is based on the assumption that the Central Nervous System (CNS), responding to various stimuli from the external and internal environment, is an organ of "reaction" rather than "action." According to Bobath, only a portion of actions are completely free, while most motor activities take place "automatically," being modulated by pre-existing facilitated circuits. The CNS coordinates and programs motor responses seen as products of the integration of stimuli and sensory information.
In the case of CNS injury, perception and processing abilities are greater than production abilities, resulting in an imbalance that can be remodeled through a re-learning process guided by rehabilitation work.
Perfetti Method (Cognitive Therapeutic Exercise, Comparison of Actions or Neurocognitive Rehabilitation)
The method is based on the principle that any movement has "cognitive meaning" in itself, as it puts humans in contact with their surroundings. Recovery from neurological injury is therefore understood as a learning process in a pathological condition and is also called "Therapeutic Cognitive Exercise" (ETC), as it places emphasis on the subject's awareness of different sense-motor experiences. The method aims to observe and address the relationships existing between the different higher organizational levels (CNS) and the peripheral level by relating the effectors of movement (muscles, bones, joints) to the control and coordination systems. Thus, movement is considered to be the result of processes implemented by a system that interacts with the environment according to its needs, determining a close relationship between movement and information processing.
Vojta method
The method was initially developed in the pediatric settingfinding, later, application in adults with neurological disorders as well. Vojta sensed that the use of repeated sensory stimulation, in children with cerebral palsy, counteracts the structuring of altered motor patterns. Patterns can be restored through stimulation of the three components (postural, righting and motor) that represent the building blocks of voluntary movement.
The method represents the first rehabilitation approach strongly marked by the concept of prevention, relying on early diagnosis (neurological screening of the child) and a therapeutic approach aimed at preventing secondary effects resulting from the primary damage (Central Nervous System injury). According to Vojta, the sensory-sensory deprivation resulting from the neurological injury and reduced function results in a slowdown in developmental progression and a gradual loss of even the most basic brain functions.
Hydrokinesiotherapy
Functional reeducation in water is a therapy based on the facilitation of movement through the performance of exercises carried out in tubs and/or pools with heated water at a temperature close to body temperature (31°-35°). This therapy takes advantage of the physical properties of water that allow, first of all, the partial abolition of the effect determined by the force of gravity and that offer modest resistance to the execution of movements, allowing sensory and proprioceptive stimulation.
NeuroMuscular Taping
NeuroMuscular Taping (NMT) is a biomechanical therapy that uses decompressive and, in some situations, compressive stimuli to achieve beneficial effects on the musculoskeletal, vascular, lymphatic, and neurological systems, aiming for clinical and rehabilitative purposes. It is all based on the application of special tapes (tapes) that form skin folds that, thanks to body movement, facilitate lymphatic drainage, promote blood vascularization, reduce pain, and improve musculoskeletal range of motion and consequently posture. It is a biomechanical and sensory corrective technique that, based on the body's natural healing abilities, promotes improved blood and lymphatic circulation in the treated area. In physical therapy or more simply in rehabilitation it is used to treat a variety of issues. The use of NeuroMuscular Taping offers a new, innovative and non-drug approach. Being a noninvasive therapy it complements the rehabilitation process by offering patients an alternative, effective and localized treatment. NeuroMuscular Taping offers medical and rehabilitation professionals an additional resource to improve the subject's response, reducing rehabilitation time and thus improving the patient's quality of life. In recent years, NeuroMuscular Taping has achieved important results in post-surgical orthopedic rehabilitation and neurological rehabilitation of stroke, spinal trauma, and other degenerative neurological conditions. The high level of results means that NeuroMuscular Taping is at the forefront of new therapeutic techniques.
Biological Tissue Treatment
Every one of our daily actions is based on biological processes that generate and dissipate energy in order to convert electrical, mechanical and chemical stimuli into cellular reactions suitable for the proper functioning of the human body in different situations (mechano-transduction). Therapeutic exercise, physical-instrumental therapy, and manual therapy have in common biological adaptive effects on tissues, going to modify in a morè or less stable way the composition and structure of the target biological tissue, integrating with other tissues (tensegrity): as in slimming the target tissue will be adipose tissue, in sports the target will be mainly muscle and/or tendon tissue, in rehabilitation bone and/or nerve connective tissue.
This makes it so that we cannot trivially transfer the training patterns of people with healthy tissues to subjects with dysfunctional tissues, but rather we have to consider the different adaptation times of individual tissues, which are completely different depending on the identified goals, the state of the target tissue, and the general condition of the patient, according to the axiom that results may be morè or less achievable depending not only on the training proposed according to set goals but also on the influence of contextual factors on the patient (biopsychosocial model).