Course Description
Movement is a foundation of physiotherapy rehabilitation. A sub group of patients have very poor coordination and this can interfere with traditional rehab (e.g., eloquently termed "motor morons" in Canada). Other patients just seem to have tightness in muscles that does not go way. While others have little movement with too much joint protection. This can be due to retained primitive reflexes.

Primitive reflexes (PR) are brain stem-mediated, complex automatic movement patterns that commence in utero. If PR are present they will influence normal motor control and can interfere with normal rehabilitation.

There are numerous causes of PR being present in neurologically intact adults (e.g., atypical birth history or developmental milestones especially walking and crawling; concussion). Numerous conditions are known to have retained primitive reflexes (e.g., ADHD, Developmental Coordination Disorder, dyslexia, addictions, scoliosis, DM, chronic LBP, chronic WAD, post concussion syndrome, chronic shoulder pain, stroke, TBI).

The treatment of primitive reflexes can be used clinically in different ways to :

• reduce individual muscle tone in chronically short muscles (e.g., hamstrings, gastrocnemius)

• increase range of motion (e.g., upper cervical flexion, glenohumeral joint medial rotation)

• improve general coordination (e.g., clumsiness, proprioception, postural stability)

• target specific problems (e.g., toe walkers, some torticollis)

• facilitate pelvic floor rehab (e.g., pelvic floor asymmetry)

• improve motor imagery (e.g., midline and musculoskeletal body image deficits)

• normalize muscle tone (e.g., stroke)

During this course we will cover the assessment and rehabilitation of primitive reflexes in detail. Strategies for treatment in the clinic and home exercise will be covered. Specific examples will be used to show how primitive reflex inhibition can immediately improve movement and motor behavior.

The course material has other uses for neurology, concussion, pediatrics and in helping regular clients learn exercises more quickly.

There are no pre-requisites for this course

Testimonials

"This course is a game changer. Sean continues to push physiotherapists to think beyond the standard orthopedic model, incorporating neurological, neuro-developmental, functional medicine and original research into a model that answers so many questions regarding each patient's unique pain experience. His midline and musculoskeletal body image work is revolutionary"
"Finally, I have a way to treat motor morons"
Brent Lewis Physiotherapist, Moncton NB, Canada

“I can't recommend Sean Gibbons and Smarterehab courses enough. I have found the sub-classification system to be easy to use and revolutionary in removing a lot of the guesswork in my patient management. The courses have been transformative in my practice in that it has wide applicability across a spectrum of conditions that would normally constitute ‘difficult’ patients. I can't recommend these courses highly enough!
Chris Barber MCSP BSc (Hons)
Musculoskeletal & Sports Physiotherapist, Director: Advanced Physiotherapy Centres Ltd.

"As a clinic owner and have seen a trend in Canadian physiotherapy towards spinal manipulation and needling techniques. While these techniques are valuable, the transformative learning that takes place in a SMARTERehab course is the direction I am dedicated to bringing our profession. As Physiotherapists, if we wish to distinguish ourselves from chiropractors, massage therapists, athletic therapists, osteopaths etc., we need to move away from technique based therapy. Sean is masterful at explaining the complex relationship between Central Sensitization, Central Pain, Sensori-Motor Function and how it relates to Motor Control dysfunction and pain. No other approach I have seen, heard of, or even read about does such a complete job of integrating neurological rehabilitation techniques and treatment. I now have junior therapists who are able to reason their way through the most complex of chronic pain cases and can formulate treatment plans that are effective and get results. Most importantly they can explain to these patients the nature of their problem in a way that they can understand. It is so rewarding to see patients, empowered with this knowledge, resolve problems that have sometimes existed for decades. Equally as rewarding is watching a junior Physio quickly solve by identifying the underlying movement dysfunction and easily explaining its cause. Thank you for what you have done and continue to do for our Profession".
Dave Holmes
Owner and Physiotherapist at Tower Physiotherapy & Sports Medicine

"If you find yourself stuck and frustrated with chronic, generalized, weird pain patients who don't respond to usual treatments, this is what this course is all about. Sean's courses are truly unique and bring practical, guidelines that are untouched by other institutions".
Jean-Michel Cormier, Physiotherapist Max Health Institute, Shediac, NB, Canada

"The courses that I have taken with Sean have completely changed my pelvic floor practice and the way I practice as a physical therapist! Sean's courses are a must in order to help a variety of clientele and especially those who do not respond to conventional treatments! He has researched and developed new techniques that are essential for pelvic floor therapists".
Erica Lafontant, pht, B. Sc, M.Sc.A Rééducation périnéale et (Pelvic Floor Physiotherapist)
Action Physio. Ville Mont-Royal, QC,

"I have attended this course in the past and it has had a profound effect on my practice and so made a great impact on my patients outcomes. Lots to learn , makes sense and is easily applied in practise, sing up and you will not be disappointed."
Pam Bagot MSc HCPC MCSP
Paediatric and Adult Neurological Physiotherapist - PamThePhysio.com

Facilitator
Sean Gibbons graduated from Manchester University in 1995. He has been rehabilitating motor control, movement patterns and chronic pain his whole career.

He a clinician who does part time research. His research has been on who will respond to motor control exercise; the influence of cognitive deficits and learning difficulties; body imagery as a pain mechanism, cranial nerve injury in concussion, WAD and viral infections; and the influences of low grade systemic inflammation in musculoskeletal pain. His research fosters the use of Personalized Rehabilitation with the addition of further sub-classification categories and causation for each subgroup.

He has presented his research at national and international conferences and has several journal publications and book chapters on related topics. He is an Assistant Clinical Professor (Adjunct) at McMaster's Advanced Orthopaedic Musculoskeletal / Manipulative Physiotherapy Specialization and previously lectured at Manchester Metropolitan University's Masters in Advanced Physiotherapy program.

Journal References

Gibbons SGT 2011 Neurocognitive and sensorimotor deficits represent an important sub-classification for musculoskeletal disorders – Central Nervous System Coordination. Journal of the Icelandic Physical Therapy Association. 38 (1): 10-12

Parfrey K, Gibbons SGT, Drinkwater EJ, Behm DG 2014 Head and limb position influence superficial EMG of abdominals during an abdominal hollowing exercise. BMC Musculoskeletal Disorders. 15:52. DOI: 10.1186/1471-2474-15-52

Abstract References
Gibbons SGT 2011 Neurocognitive and sensorimotor deficits represent an important sub-group for whiplash associated disorders. Fifth International Whiplash Trauma Congress. Aug 24-28; Lund, Sweden. J Rehabil Med 2011; Suppl 50: 23

Gibbons SGT 2009 Cognitive learning and sensorimotor function provide a protective effect from disability in low back pain. Manual Therapy. 14 (S1): S30

Gibbons SGT 2009 Neurological soft signs are present more often and to a greater extent in adults with chronic low back pain with cognitive learning deficits. Manual Therapy. 14 (S1): S20

Gibbons SGT 2008 Retraining of asymmetry in recruitment of transversus abdominis. Orthopaedic Division Review. March/April: 29-34

Primitive Reflex Related Posts

https://smarterehab.blogspot.com/2020/02/lets-be-clear-neurological-soft-signs.html

https://smarterehab.blogspot.com/2019/12/wy-should-all-physiotherapists-be.html

https://smarterehab.blogspot.com/2016/11/why-does-replicating-primitive-reflex.html

https://smarterehab.blogspot.com/2019/09/if-you-can-do-muscle-energy-technique.html

https://smarterehab.blogspot.com/2016/11/symmetrical-tonic-neck-reflex-new-look.html

https://smarterehab.blogspot.com/2016/11/is-functional-hallux-limitis-sign-of.html

https://smarterehab.blogspot.com/2016/11/is-idiopathic-toe-walking-caused-by.html

https://www.linkedin.com/pulse/primitive-reflex-inhibition-improves-body-image-two-point-gibbons

https://www.linkedin.com/pulse/understanding-movement-why-does-replicating-reflex-inhibit-gibbons

Course Description
Motor imagery is used in motor skill based interventions. Motor imagery ability is deficient in a wide range of pain and non pain subgroups. Reduced motor imagery influences motor skill learning ability and pain. It usually manifests as poor coordination.

This course has two main focuses
(1) Motor imagery as it relates to the assessment and rehab of motor control based interventions
(2) Motor imagery as a pain mechanism

The brain needs to know what is happening in the body. It gets this information from sensory feedback and forming complex maps. When this information is deficient the brain will change motor behavior to help get this information. When it is absent, significantly inaccurate or cannot be processed, musculoskeletal symptoms can result. It is now clear that our virtual brain and body imagery are involved in pain states. In some cases they can be a primary cause of the pain state!
Body Imagery Pain is introduced as it represents a non mechanical pain state that is not addressed in the definition of nociplastic pain or central sensitization.

On this course we go through an easy to use clinical assessment of motor imagery and targeted rehabilitations strategies. These include primitive reflex inhibition, postural reflex facilitation, midline rehab and specific sensory motor rehab.
Clinical examples will be shown as to how the rehabilitation is targeted towards facilitating improved pelvic health.

Course Objectives: The participant will be able to:
• Take a subjective history related to motor imagery and Body Imagery Pain
• Identify patients with poor motor imagery
• Use primitive reflex inhibition strategies to improve motor imagery and pelvic health rehab
• Subgroup Body Imagery Pain using a clinical reasoning process