Movement Analysis, Sub-classification and Neuromuscular retraining for the person with Neurological impairment: B) Lower limb and Gait

This course is the second part of a two part series addressing Neuromuscular Retraining for the Person with Neurological Impairment. Assessment of global “muscle imbalance” in the shoulder girdle and lumbo-pelvic trunk region are completed as a direct follow-on from Part A. Rehab strategies for improving low threshold recruitment efficiency in the global stabiliser muscle system and improving extensibility in the global mobiliser muscles are demonstrated. On completion of the shoulder and lumbar regions the rest of the course focuses on gait: understanding normal gait components, and the effect of restrictions on control of gait. Assessment focuses on gait components to diagnose the site of uncontrolled movements (lumbo-pelvic region, hip, knee, foot) and the direction into which there is control failure. Rehab is therefore very specific to individual disability patterns and remains as functionally relevant as possible. Uncontrolled motion is also assessed at the knee in tibial rotation or hyperextension ‘control deficit’, and at the ankle and foot. Testing of the key global stabiliser muscles (such as Popliteus, Tibialis Anterior and Posterior) for control of these sites is important for specific rehab of recruitment dysfunction in the lower leg. All the motor control retraining strategies suggested in this very practically orientated course can be integrated into your management of the more cognitively aware person with neurological impairment to maximise their recovery potential.

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