Rehabilitative Qigong & Tai Chi Fundamentals Painless Rehabilitation & Movement!"
Painless Rehab & Movement! Pain Physiology! Autonomic Influence! Neuromuscular Compensations! Yellow Zone! Cross Mapping
Two Nervous Systems! Somatic Nervous System! Receptors! Peripheral Nerves! Spinal Cord! Brain! Volitional! Autonomic Nervous System! Sympathetic! Fear/Fight/Flight! Parasympathetic! Safety/Rest/Heal! Perceptual
Peripheral Receptors! Mechanical! Temperature! Chemical! Nociceptive
The Spinal Cord! Peripheral to Central NS. Bridge! Structurally Sensitive! Amplifies Input! Sensory In Motor Out! Reflexive spasm
Spinal Nerves! 31 pairs of spinal nerves! > 700 muscles! 206 bones! Multiple organ systems
Spinal Cord Contribution! Central Sensitization! Hyperalgesia! Allodynia! Wind-Up! Pathways! Reflex (20x)! Ascending (input)! Descending (output)
Sensory-Motor Cortex
Brain Adaptations! Smudging! Patterned Responses! Active/Dormant! Global Effect
CEO in the Dark! The brain creates a pain experience from a summary of its incoming and stored experiences.! Pain is Out-Put! Phantom limb! Parents/children! Violinist/Dancers! Anticipation/Fear
NEW Health FACTs! Feelings! Emotions! Actions! Molecules (Pert)! Epigenetics (Lipton)! TMS (Sarno)! Postures! Reflexes (Hanna)! Connective Tissue! Behaviors! Movement Patterns (Cuddy)! Consumptions! Five Senses! Diet! Thoughts! Loops (Positive/Negative)! Limiting Beliefs! Memories! Need/Have/Ought
NEW Pain Formula! The brain creates an OUT-PUT pain experience from the summary of ALL incoming and stored information.! If! The FACTs = Threat! Then! the brain creates pain.
Autonomic Influence! Sympathetic! Heightens pain experience! Increases sensitivity! Increases muscle tension! Depresses immune system! Cortical shut-down! Reactive states! Protective movement patterns! Parasympathetic! Endorphins! Descending inhibition! Decreases muscle tension! Improves circulation! Deeper breathing! Activates immune system! Higher cortical centers! Creative movements
Neuromuscular Compensations! Mobilizers! Fast twitch (type 2)! Anaerobic! Produce torque & power! Concentric function! Fatigue easily! Often superficial! Small proprioceptive role! Tighten & Shorten*! Stabilizers! Slow twitch (type 1)! Aerobic! Maintain joint balance! Eccentric/Isometric function! Fatigue resistant! Often deeply placed! Major proprioceptive role! Weaken & lengthen* Chaitow. Muscle Energy Techniques 2006.
Agonist / Antagonist
In the Yellow Zone PAIN Work Here JUST RIGHT NO MOVEMENT
Yellow Zone Movement! Opens communication with the brain/builds trust! Re-patterns normal movement! Far to near! Asymmetrical is OK! Move further into Ease! Returns volitional control! Visual feedback! Visualization feed-forward! It always changes!
Cross Education! Research Results! Contralateral limb training! Immobilization! Stroke Rehabilitation! Single leg coordination! Motor cortex mapping
Contralateral Limb Training! Neuro-physiological adaptations associated with cross-education of strength. Jonathan P. Farthing, Ron Borowsky, Philip D. Chilibeck, Gord Binsted, Gordon E. Sarty. Brain Topogr. 2007 Winter; 20(2): 77 88.! 23 females. Right ulnar deviation. 4x/6wks. Peak torque, muscle thickness, EMG, fmri.! Strength training was highly effective for increasing strength in trained (45.3%; P < 0.01) and untrained (47.1%; P < 0.01) limbs.! After training, there was an enlarged region of activation in contralateral sensorimotor cortex and left temporal lobe during muscle contractions with the untrained left arm (P < 0.001)
Cast Immobilization Training! Changes in functional magnetic resonance imaging cortical activation with cross education to an immobilized limb. Jonathan P. Farthing, Joel R. Krentz, Charlene R. A. Magnus, Trevor S. Barss, Joel L. Lanovaz, Jacqueline Cummine, Carrie Esopenko, Gordon E. Sarty, Ron Borowsky. Med Sci Sports Exerc. 2011 August; 43(8): 1394 1405! 14 subjects. Left hand/wrist cast. Right isometric grip. Peak force, muscle thickness, EMG, fmri.! Handgrip strength of the immobilized arm of CAST-TRAIN was maintained, whereas the immobilized arm of CAST significantly decreased by 11% (P < 0.05)! Conclusion: Handgrip strength training of the free limb attenuated strength loss during unilateral immobilization. The maintenance of strength in the immobilized limb via the cross-education effect may be associated with increased motor cortex activation.
Stoke Rehabilitation! Urbin MA, Harris-Love ML, Carter AR, Lang CE. High-Intensity, Unilateral Resistance Training of a Non-Paretic Muscle Group Increases Active Range of Motion in a Severely Paretic Upper Extremity Muscle Group after Stroke.Frontiers in Neurology.! 13 subjects. >4mos post stroke. 16 sessions. Dynamic contractions of non-paretic wrist.! Results of this study demonstrate that high-intensity resistance training of a nonparetic upper extremity muscle group can enhance voluntary muscle activation and force-generating capacity of a severely paretic muscle group after stroke. There is also preliminary evidence that corticospinal adaptations may accompany these gains.
Single Leg Coordination! The contralateral effect after a single-leg coordinative training program Oehlert Oehlert K. K Dr. Universitätsklinikum Schleswig-Holstein, Campus Kiel, Klinik für Orthopädie, Kiel katharina. Heine Heine J. J Kiel. Krause Krause H. H Kiel. Varoga Varoga D. D Kiel. Rieckert Rieckert H. H Kiel. Hassenpflug Hassenpflug J. German Medical Science Düsseldorf, Köln 610! 61 Subjects. 4wk comprehensive dominant let coordination training program. Ankle discs/ stability trainers.! The coordinative abilities of both the trained and untrained leg increased after the coordinative training. The increase in coordination was significant for both legs of the exercise group as measured by the Biodex Stability System.! Our results indicate that single-leg coordinative training has both an effect on the trained leg and the contralateral leg. It seems as though that patients practice with their non-affected leg coordinative exercises and their affected leg profits indirectly. If the results of the study were confirmed in injured individuals, patients could circumvent the negative effects of immobilization or limited weight-bearing after an injury.
Cross Mapping! Work both sides! mirror/alternate! Identify differences! Exaggerate strengths! Focus on desired function! Cut & Paste
Practice! Posture! Witnessing sensations! Accordion breathing! Cross Mapping bilateral symmetry! Cloud Hands! Cross Mapping bilateral asymmetry! Horse Stance Pumping! VMO asymmetry! Flowing Motion! Yellow Zone movement! Cross Mapping bilateral symmetry