Proprioceptive Sensory Motor Training for Enhancing Movement & Motor Control

Changing the Brain for Movement, Pain & Function:

Proprioceptive Sensory Motor Training & Primitive Reflex Inhibition for Problem Clients

Course Description

This course provides a rehabilitation option for clients with poor coordination or cannot learn motor control exercise. It has other uses for neurology, paediatrics and in helping regular clients learn exercises more quickly.

A sub group of patients have difficulty understanding the exercises or education we give them. These patients have significant deficits in sensory motor function, learning skills, and have primitive reflexes in the nervous system. Research shows that there is a strong relationship between sensory motor function, primitive reflexes and neurocognitive function. Reduced sensory motor function and the presence of primitive reflexes significantly affects normal motor control and makes it difficult for patients to learn specific motor control exercise.

During this two day course, the clinical application of sensory motor testing is described in detail along with relevant physiology. The relationship between learning difficulties, neurocognitive function and sensory motor function is also covered along with the relationship to psychological influences such as pain coping and fear avoidance.

The Motor Control Abilities Questionnaire is an instrument developed to identify patients who have difficulty understanding stability and movement control exercises. The use of this questionnaire will be described and how sensory motor rehabilitation and primitive reflex inhibition can be used to improve neurocognitive function and motor control. The assessment and rehabilitation of evidence based tests of sensory motor function are reviewed along with key primitive reflexes. The course emphasizes a structured model for clinical problem solving with appropriate clinical starting points and suitable progression of therapeutic exercise.

No Prerequisite

Course Objectives:  

  • Identify clients who will unlikely progress with specific stability exercises by using the Motor Control Abilities Questionnaire and a screening assessment
  • Assess and rehabilitate sensory motor function and key primitive reflexes and recognize how they influence pain, movement, stability and neurocognitive function
  • Appreciate the types of motor and neurocognitive deficits that occur with pain
  • Prescribe exercises for patients to improve neurocognitive function and general coordination
  • Apply problem solving strategies to make exercises easier and harder for all patients

What will you get from this course that you may not already have?

Sensory Motor Function
Proprioception is one component of the whole sensory motor system. We also need to consider vision, tactility, the vestibular system, auditory function & midline crossing, and relate these to the client’s problem.

Primitive Reflexes
Understand the role of primitive reflexes in pain, neurocognitive function and motor control. This has a huge influence on correcting movement, rehab strategies and learning skills. This is also important for neurological rehab.

CNS Coordination – A New Sub-Classification
Our clinical reasoning promotes a diagnosis of movement pattern control, tissue, pain mechanisms, psychology and CNS Coordination. The latter represents a new, but significant sub-classification, which represents the neurocognitive and sensory motor functions of the CNS.

Motor Control Ability Screening
What about the people who can`t seem to learn the exercises we teach them? You will learn how to use the Motor Control Abilities Questionnaire and a sensory motor function assessment to screen people for the ability to learn specific motor control exercises. You will learn alternative treatment options to rehabilitate this problem population.

Neurocognitive Function & Learning Difficulties
Appreciate the importance of neurocognitive based learning skills in rehabilitation.

Motor Control Problem Solving
Problem solving with some clients can be difficult. We have developed a Universal Problem Solving Model of Motor Control to help you make exercises easier or harder. We have to give people exercises they can do, not ones they can’t.

Program & Pre-course Reading

 

Useful Web Address www.positscience.com

Suggested pre-course reading

Revision of the Sub-classification course (if taken)

Flor H et al 2001 Effect of sensory discrimination training on cortical reorganisation and phantom limb pain. The Lancet. 357: 1763-1764

Gibbons SGT 2011 Neurocognitive and sensorimotor deficits represent an important sub-classification for musculoskeletal disorders – Central Nervous System Coordination. Icelandic Physical Therapy Journal. 10-12
Available at http://smarterehab.dyndns.org/publications

Goddard S 2005 Reflexes, Learning and Behavior. Fern Ridge Press. Eugene, Oregon. USA

Jull G et al 2007 Retraining cervical joint position sense: the effect of two exercise regimes. Journal of Orthopaedic Research. 25: 404-412

Humphreys B, Irgens P 2002 The effect of a rehabilitation exercise program on head repositioning accuracy and reported levels of pain in chronic neck pain subjects. Journal of Whiplash and Related Disorders. 1(1):99–112.

Jordan-Black JA 2005 The effects of the Primary Movement programme on the academic performance of children attending ordinary primary school. Journal of Research in Special Educational Needs. 5 (3): 101–111

McAuley E, Kramer AF, Colcombe SJ 2004 Cardiovascular fitness and neurocognitive function in older Adults: a brief review. Brain, Behavior, and Immunity. 18: 214–220

McCabe CS et al 2005 Simulating sensory–motor incongruence in healthy volunteers: implications for a cortical model of pain. Rheumatology. 44:509–516

McPhillips M, et al 2000 Effects of replicating primary-reflex movements on specific reading difficulties in children: a randomized, double-blind, controlled trial. The Lancet 355: 537-340

McPhillips M, Sheehy N 2004 Prevalence of persistent primary reflexes and motor problems in children with reading difficulties. Dyslexia 10: 316-338

Moseley GL, Zalucki NM, Wiech K 2008 Tactile discrimination, but not tactile stimulation alone, reduces chronic limb pain. Pain. 137: 600–608

Norton JA et al 2008 Persistent mirror movements for over sixty years: The underlying mechanisms. Clinical Neurophysiology 119: 80–87

Revel M, et al 1994 Changes in cervicocephalic kinesthesia after a proprioceptive rehabilitation program in patients with neck pain: a randomized controlled study. Arch Phys Med Rehabil 75:895-9

Reynolds D et al 2003 Evaluation of an exercise-based treatment for children with reading difficulties. Dyslexia 9: 164-166

Treleaven J 2008 Sensorimotor disturbances in neck disorders affecting postural stability, head and eye movement control. Manual Therapy. 13: 2-11

Free articles available at: http://www.ncbi.nlm.nih.gov/sites/gquery

Allin M, M Rooney, T Griffiths, M Cuddy, J Wyatt, L Rifkin, and R Murray Neurological abnormalities in young adults born preterm. J Neurol Neurosurg Psychiatry. 2006 April; 77(4): 495–499.

Jensen JP, U Grøn, and H Pakkenberg Comparison of three primitive reflexes in neurological patients and in normal individuals. J Neurol Neurosurg Psychiatry. 1983 February; 46(2): 162–167.

McGibbon CA, David E Krebs, Stephen W Parker, Donna M Scarborough, Peter M Wayne, and Steven L Wolf 2005 Tai Chi and vestibular rehabilitation improve vestibulopathic gait via different neuromuscular mechanisms: Preliminary report. BMC Neurol. 5: 3

Ole K. Harlem and Arve Lönnum. A Clinical Study of the Abdominal Skin Reflexes in Newborn Infants. Arch Dis Child. 1957 April; 32(162): 127–130.

Riemann BL et al 2002 The sensorimotor system, part 1: the physiologic basis of functional joint stability. Journal of Athletic Training 37(1): 71-79

Riemann BL et al 2002 The sensorimotor system, part 2: the physiologic basis of functional joint stability. Journal of Athletic Training 37(1): 80-84

Schott J and M Rossor. The grasp and other primitive reflexes. J Neurol Neurosurg Psychiatry. 2003 May; 74(5): 558–560.

Edwards S, Sarwark JF 2005 Infant and Child Motor Development. Clinical Orthopaedics and Related Research. Number 434: 33–39

Influence of Fatigue in Neuromuscular Control of Spinal Stability Kevin P. Granata, Greg P. Slota, and Sara E. Wilson Hum Factors. Author manuscript; available in PMC 2006 November 2. PMCID: PMC1633714

Reposition Sense of Lumbar Curvature with Flexed and Asymmetric Lifting Postures
Sara E. Wilson and Kevin P. Granata Spine (Phila Pa 1976). Author manuscript; available in PMC 2007 February 5. PMCID: PMC1790962

Can sustained arousal explain the Chronic Fatigue Syndrome? Vegard B Wyller, Hege R Eriksen, and Kirsti Malterud Behav Brain Funct. 2009; 5: 10. Published online 2009 February 23. doi: 10.1186/1744-9081-5-10. PMCID: PMC2654901

 

Program
Day 1
8:30 – 9:00 Overview of motor system changes with pain & Sub-classification
9:00 – 9:30 Role of sensory motor function
9:30 – 10:00 CNS Coordination Disorder: Clinical Prediction Rules for Diagnosis and Rehabilitation
10:00 – 10:30 Break
10:30– 11:00 Development & clinical use of the Motor Control Abilities Questionnaire
11:00– 12:00 Postural stability assessment & rehabilitation
12:00 – 1:00 Lunch
1:00 – 3:00 Oculomotor function assessment & rehabilitation
3:00 – 3:15 Break
3:15 – 3:45 Midline crossing assessment & rehabilitation
3:45 – 4:30 Proprioception assessment & rehabilitation
Day 2
8:30 – 9:30 Tactility assessment & rehabilitation
9:30 – 10:15 Trunk reflexes assessment & rehabilitation
10:15– 10:30 Break
10:30– 11:15 Trunk reflexes continued
11:15– 12:00 Lower limb reflexes assessment & rehabilitation
12:00 – 1:00 Lunch
1:00 – 2:00 Hand reflexes assessment & rehabilitation
2:00 – 3:00 Facial reflexes assessment & rehabilitation
3:00– 3:15 Break
3:15 – 3:30 Active exercise, primitive reflexes, enrichment concepts, computer based learning and EEG
3:30– 4:00 Problem solving & questions
4:00 – 4:30 Clinical Integration & Summary

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