RE-EDUCATION OF INCO-ORDINATION

BY: Reeta SawlaniLecturer IPRS PUMHSWShaheed Benazeerabad

Introduction

•Reaching for a pencil, grasping a doorknob and tightrope walking-to name but a few physical actions—all involve well-coordinated movements made with well-balanced postures.

• In fact, whenever we move, three basic functions of body, like movement, balance, and coordination work together to produce graceful, purposeful motions of body parts.

Coordination•It is the smooth, rhythmical and accurate

activity performed in correct sequence of group of muscles called as coordination.

•Coordinated movements involve proper sequencing and timing of synergistic and reciprocal muscle activity, and they require proximal stability and maintenance of posture.

•Using the right muscle, at the right time with the right intensity.

•In coordinated Or asynergia

•If movement is not coordinated than it is called in coordinated Or asynergia characterized by jerky, inaccurate non purposeful movement done by the group of muscles.

In coordinated

NEUROMUSCULAR RE-EDUCATION Neuromuscular re-education is a

technique used by rehabilitation therapists to restore normal movement. 

Together, nerves and muscles work to produce movements.  Nerves send signals between muscles and brain  about when, where, and how fast to move

To educate for resumption of normal activities,

as disabled person.

•Neuromuscular re-education is one method used by rehabilitation therapists to facilitate the return of normal movement in persons with neuromuscular impairments.

•Neuromuscular impairments result from trauma, any medical condition and neurological conditions, such as stroke and traumatic brain injury. 

GOALS OF NEUROMUSCULAR REEDUCATION

•Improve balance•Improve coordination•Improve posture and proprioception. (Proprioception is sense of the relative

position of different body parts)

Principles of Reeducation•Weakness or Flaccidity•Muscle weakness and paralysis can be

analyzed with the help of muscle power and grading techniques.

•When ever muscle is paralyzed the person should under go strengthening and endurance exercises.

•Strengthening program is modified depends on the muscle power and has to be performed by patient with supervision of the therapist.

Spasticity Of Muscles•Spasticity is stiff or rigid muscles.•It may also be called unusual "tightness"

or increased muscle tone. 

•Spasticity is a muscle control disorder that is characterized by tight or stiff muscles and an inability to control those muscles.

• Aim of treatment is to reduce the tone and relax the muscles or promote muscle Relaxation, encourage effort and also encourage the rhythmical movement while treating the spasticity.

• Relaxation may be general or may be Local• Active Exercises based on everyday

movements help to make the patient as independent as possible and give him confidence.

•Stretching Exercises•PNF Techniques

Some Other Techniques to Reduce Spasticity

•Weight bearing positions: quadruped, kneeling,

•Sustained stretching in upright postures•Active contraction of antagonists to

spastic muscles•Electrical stimulation•Ice wraps/packs•Splinting (positioning, pressurized)

Alternative Nervous Pathways

•It is rare that all the available nervous pathways, by which the impulses essential for coordinated movement travel, are blocked and the purpose of Re-education is to encourage the use of those which remain, or to develop alternatives routes.

•When the other pathways are blocked this alternative route can be use.

•Using alternative pathway first time is very difficult but by the time when a person continually used this pathway, it will be more easier at each time.

•In this way a new pathway is eventually established.

Cerebellar Ataxia

•Loss of function of cerebellum which is a coordinating center , results in loss of coordinating impulses which are normally discharged from it.

•In this condition muscles become hypotonic and postural fixation is disturbed consequently balance is difficult and movements are irregular swaying and inaccurate.

Functional Role of the Cerebellum cont.Participate in three systems:1. Vestibulo-cerebellar system modulating

vestibular influences on posture & eye movement.

2. Spino-cerebellar system regulating muscle tone, posture & locomotion.

3. Cerebro-cerebellar system regulating skilled movement.

Role of the Cerebellum

•Initiation & control of voluntary movement.

•Timing of movement/muscle action. •Moment-to-moment correction of errors.

•Cerebrum may be able to compensate to some extent for the loss of cerebellar function.

•There are some Doubts that the cerebellum can still learn motor functions with ataxia

•Any improvement results from treatment by exercises probably due to increase use of pathways which remains, or may be alternative pathway like cerebrum.

•physical therapy should include an exercise program addressing five components: static balance, dynamic balance, trunk-limb coordination, stairs, and contracture prevention. 

•Aim of treatment is to restore stability of the trunk and proximal joints to provide stable background for movement.

Improve balance according to degree of disability like patients may adopt some particular posture so training given to correct that posture and maintain balance and stability

•Re educate optimal & effective performance of any actions with which the individual is having difficulty with.

•To set up a practice environment which enables the person to develop more control (accuracy) during practice

•Hypotonia main clinical feature in this disease

•Isometric Exercises•Strengthening and Endurance Exercises •PNF Techniques

Re educate control during performance of functional movements, during:

Standing up Sitting down Walking Reaching to point Take an object

10/04/2023

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