RE-EDUCATION OF INCO-ORDINATION
BY: Reeta Sawlani
Lecturer IPRS PUMHSW
Shaheed 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
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06/09/2014
