Program Neurodynamic Integration of neurodynamics into neurorehabilitation focusing on adults with a brain lesion Part 1: 17 th 21 st of September 2018 Part 2: 22 nd 26 th of October 2018 Course leader Nora Kern MSc OMT, Advanced Bobath Instructor IBITA, INN Development and Main Instructor, NOI teacher neurology, PT Munich, Germany Week 1: Week 2: Focus on neurodynamic theory, tests, test analysis, movement analysis Focus on integrating neurodynamic knowledge into assessment and treatment of adults after a lesion to the central nervous system, following a proper clinical reasoning, completed with joint techniques and aspects on perceptual disorders. Adaptions of the program might be necessary. Please bring short trousers for practical work and anatomy books. Reading list is available. Books from David Butler and Michael Shacklock
INN : INTEGRATION OF NEURODYNAMICS INTO NEUROREHABILITATION Course Description: A 10 day s course on the assessment and treatment of problems related to the loss of normal neurodynamics in patients with lesions to the central nervous system The course includes: Lectures explaining normal biomechanics and physiological properties of the CNS Neurodynamic tests Theory about changed neurodynamics after neurological lesions, including perception disorders and malalignment Seminars on movement analysis of therapeutic and functional activities of daily life with special regard on neurodynamics Assessment and treatment of adults after a CNS lesion, including handling, positioning, facilitation techniques from early intensive to late rehabilitation stage Introduction into manual mobilization techniques, adapted to neurological conditions, of the spine and some peripheral joints, combined with neural mobilization Demonstration of patient assessment and treatment by the course leader Practical sessions with the course participants working on each other and self-experiences Assessment and treatment of patients by the participants, specifically focused on changed neurodynamics after a CNS lesion Supervision, feedback and discussion after each treatment session Course Objectives: The course aims at teaching the participants how to: Assess the mobility of the nervous system as a whole with specific neurodynamic tests and palpation techniques for peripheral nerves Evaluate the quality of the resistance in the nervous system which is influencing normal mobility, muscle tone and selective active movements Differentiation between neural and target tissues as the cause of immobility and evasive movements and postures Use neurodynamics as treatment intervention to regain the mobility of the nervous system in order to overcome problems of compensatory = evasive postures, disturbed sensation, distorted perception, abnormal patterns of movement and contractures Use correction of postures and positions as an indirect way to mobilize the nervous system Use target tissue mobilization techniques for joints in order to overcome the loss of joint mobility as an additional local problem Facilitate normal selective movement patterns after nervous system mobilization Evaluate the treatment outcome by evident or individually adapted measurement tools Use verbal and non-verbal communication skills to support the treatment effect Establish an adequate home-program.
Part 1 Monday, 17/09/18 08.30 Arrival, registration and breakfast 09.15 Course opening, organization and presentation of the course participants 10.15 Coffee 10.30 Lecture Introduction into the subject 13.30 Lecture ff Theory of neurodynamics, patho-neurodynamics and communication, a break included Tuesday, 18/09/18 09.00 Introduction and Practical work Tests for the lower limb and neuraxis, differentiation tests for target tissues, movement diagram, adaptations for patients with central lesions, examples of daily live activities, release positions and their influence on movement behaviour, a break included 13.30 Practical work Continuation lower limb, a break included Wednesday, 19/09/18 09.00 Practical work Neurodynamic tests upper limb, adaptations for patients with central lesions, examples of daily live activities, release positions and their influence on movement behaviour, a break included
13.30 Practical work Continuation upper limb 15.00 Break 15.15 Lecture Assessment and treatment of patients after a CNS lesion, contraindications and precautions, including aspects of communication 17.00 Group work Analysis and facilitation of daily life activities with a special focus on neural mobility, speed, rhythm, repetition, rotation, ROM, external feedback, grades of movement and the component concept during daily life activities Includes: lying to sitting, sit to stand, transfer, variations of dressing, walking. Additional tasks might be used. Thursday, 20/09/18 09.00 Presentation of the group work, a break included 13.30 Practical work Continuation presentations and facilitation, a break included Friday, 21/09/18 09.00 Demonstration of a patient by the course instructor: assessment and treatment, followed by a discussion 10.45 Coffee 11.00 Lecture The importance of correction of posture and positions with self-experiences 13.30 Practical work Palpation of peripheral nerves, used in assessment and treatment, combined with components of neurodynamic tests 15.00 Questions and discussion of this week, some tasks to work with during the time to the second part
16.00 End of week 1 Part 2 Monday, 22/10/18 09.00 Welcome and discussion / presentation of the intermediate tasks, experiences and questions from the interval 10.30 Break 10.45 Practical work Repetition of the neurodynamic tests, compare mobility and evasive movements with reversed test components, the rhythm of mobilization 13.15! Preparations for the assessment and treatment of the course patients for the course participants (2 physiotherapists with one patient) and organization of the room for the assessment and treatment of the course patients 14.00 Assessment and treatment of the patients by the course participants 15.30 Break and notation of their treatment 16.00 Feedback to the treatment, proposals for further treatment development 17.00 Lecture Principles of passive joint mobilization, mobilization techniques of the spine - lumbar and thoracic part Tuesday, 23/10/18 08.30 Practical work Mobilization of the spine (thoracic and lumbar) and the ribs, in combination with components of neurodynamic tests, and reasoning for prone position, a break included 13.30 Organization of the room for the re-assessment and treatment of the course patients 14.00 Re-assessment and treatment of the patients by the course participants
15.30 Coffee 15.45 Practical work Aspects of walking and active standing, neural and target tissue mobilization Wednesday, 24/10/18 09.00 Practical work Mobilization techniques for the upper limb, combinations of neural and target tissue mobilization Specific problems concerning the upper limb, like learned non-use, painful shoulder, CRPS, a break included 13.30 Organization of the room and preparation of the treatment 14.00 Re-assessment and treatment of the course patients by the participants 15.30 Coffee 15.45 Feedback to the treatment and the progression of treatment Thursday, 25/10/18 09.00 Practical work Mobilization techniques for the cervical spine, also in combination with components of neurodynamic tests, a break included 13.30 Organization of the room and preparation of the treatment 14.00 Re-assessment and treatment of the course patients by the participants 15.30 Coffee 15.45 Practical work Additions and repetition according to the needs of the course patients
Friday, 26/10/18 09.00 Lecture Home program for patients with a lesion of the central nervous system, aspects of auto-mobilization of neural tissues and encouraging selective movements 11.00 Break, organization of the room and preparation of the treatment 11.30! Last re-assessment and treatment of the course patients by the participants 13.00! Lunch 13.45 A small rapport about the treatment should be done in writing 14.00 Coffee and summary of the treatment, last questions and discussion, feedback to the course 15.30 End of the course