Sean Gibbon’s Blog
I decided to start this blog after recent course feedback. On the course we discussed some of the issues in the physiotherapy profession, the complexity of pain, research gaps, ideas, clinical reasoning, clinical top tips and case studies. So this blog was born to share this. It is my opinion that chronic pain is not simple and that most people will do better with an individualized approach rather than simple strengthening. I look forward to sharing some case studies to highlight the use of Motor Behavior Therapy, and the newer testing and rehab strategies not everyone is familiar with (e.g., primitive reflex inhibition, postural reflex facilitation & cranial nerve treatment). My research ideas have largely come from problem solving with clients and continue to evolve. I’m sure it will evolve to include other musings!
The model has advanced quite a bit over the years into “Motor Behavior Therapy” (MBT). This is a clinical reasoning framework for the personalized management of musculoskeletal pain. The key themes are:
- Mechanisms
- Causation
- Individualization
- Barriers
Making Sense of Complexity
A Rehab Direction for All Patients
Motor Behavior Therapy is allows the therapist to assess the dominant mechanisms contributing to an individuals’ presentation and use clinical reasoning to prioritize starting points and problem solving. The MBT framework has identified key barriers for progression which can be used for stratification or sub-classification.
Motor Behavior Therapy allows the therapist to integrate their current knowledge and apply it within this framework, while adding new core skills to improve patient treatment.
Latest Posts
Scapular winging: “weakness” of serratus anterior or the lack of development of prone rolling related reflexes?
Understanding causation goes hand in hand with "mechanisms" in Motor Behavior Therapy. Scapular winging is a common finding in shoulder related symptoms (and neck too!). This is believed to be involved [...]
Hip adduction: “Weak” Gluteals or the presence of Primitive reflexes?
Understanding causation goes hand in hand with "mechanisms" in Motor Behavior Therapy. Hip adduction is considered one common movement pattern that may increase tissue loading in some areas of the lower [...]
Orthopaedic versus Neurological Clinical Reasoning in Musculoskeletal Pain
Experienced clinicians who have done neurological rotations as students and during early training have observed similarities between neurological approaches and orthopaedic approaches. This is beyond improving movement and function. Neurological dysregulation [...]
Implications of “Adult-Minor Neurological Dysfunction” in Musculoskeletal Pain
Like many aspects of patient presentations, it is best to view neurological soft signs and other neurological factors (e.g., motor imagery ability, proprioception, tactility - two point discrimination) on a 'spectrum'. [...]