Movement Behavior Analysis & Functional Neuromuscular Rehab series

Course Overview

Musculoskeletal pain can be related to a variety of factors including trauma or overuse, but frequently it is an insidious, recurrent and an ongoing problem for many people. This is often related to their movement patterns and neuromuscular control.

The underlying hypothesis of movement as a link to musculoskeletal symptoms is that the way the central nervous system coordinates movement can influence tissue loading. In normal function we need the ability to vary postures and movement patterns, or kinetic chain sequence, in order to avoid tissue overload. It is normal and necessary to use our end range movements, however it is abnormal to continuously use the same movement pattern or end range movement. If the ability to vary the kinetic chain and control movement is lost, tissue load can be exceeded, tissue repair can become compromised and pathology may result.  Articular-related symptoms and control are frequently concurrent with altered movement patterns and can contribute to ongoing symptoms. These are also influenced by biomechanical loading and exposures to risk factors.

Why is the central nervous system moving the body in a way that is potentially harmful?

This question should be answered or many people will not progress or quickly plateau. We review the functional causes of altered movement and motor behavior.

How does it fit in? – Movement as a Clinical Reasoning Tool

Targeting movement and motor behavior will allow you to be much more effective with whatever skills you already have! Treatment and progression will also be faster. These are discussed and numerous examples demonstrated during the practical sessions.

Is this for everyone? – Of course not!

This is what a Sub-classification is for. Motor behavior issues represent a subgroup of patients and are not the priority for everyone. The purpose of the sub-classification model is to show you how to identify who will respond to this type of therapy. Some people do not have the ability to learn motor control based exercises. Others can learn, but won’t respond. Some do not have a mechanical pain mechanism. While others have neuro-immune-sympathetic dysregulation (Gibbons 2016, 2019).

This series of courses will provide participants with skills in assessing movement and sub-classifying  movement pattern and motor control deficits that will relate to the functional movements that provoke the patient’s symptoms.  Rehabilitation strategies will provide a logical and functional based starting point with directions for progression. A universal clinical problem solving model is given to iron out real-life difficulties. 

Courses

 

·       Lumbar Spine

·       Cervical Spine

·       Shoulder Girdle

·       Forearm and Hand

·       Thoracic Spine

·       Sacro-iliac Joint

·       Hip and Lower Limb

·       Temporo-mandibular Joint

Courses can be taken individually or tailored pending your specific requirements

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 2009 The development, initial reliability and construct validity of the motor control abilities questionnaire. Manual Therapy. 14 (S1): S22

Gibbons SGT 2017 What are the functional mechanisms of altered movement patterns during trunk flexion tasks? The need for further sub-classification: A systematic review. Musculoskeletal Science and Practice. 28: e16-17. DOI:https://doi.org/10.1016/j.math.2016.10.043

https://www.mskscienceandpractice.com/article/S1356-689X(16)30791-3/abstract

Gibbons SGT 2016 Preliminary development of items to identify a neuro-immune-autonomic-endocrine involvement in complex pain presentations. Manual Therapy 25: e109-e110

https://www.mskscienceandpractice.com/article/S1356-689X(16)30221-1/fulltext

Lehtola V, Luomajoki H, Leinonen V, Gibbons SGT, Airaksinen O 2016 Sub-classification based specific movement control exercises are superior to general exercise in sub-acute low back pain when both are combined with manual therapy: A randomized controlled trial. BMC Musculoskeletal Disorders . 17:135. DOI: 10.1186/s12891-016-0986-y https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-016-0986-y

Gibbons SGT 2019 Are co-morbid medical symptoms associated with poor response to sub-classification based management of chronic low back pain? A retrospective case-control study. Proceedings of: The 10th Interdisciplinary World Congress on Low Back Pain. October 28-31, 2019; Antwerp, Brussels

Gibbons SGT 2019 Preliminary development of a clinical prediction rule for specific motor control exercise in adults with chronic low back pain,. Proceedings of: The 10th Interdisciplinary World Congress on Low Back Pain. October 28-31, 2019; Antwerp, Brussels

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