Bobat Core Stability Stroke | Anatomical Terms Of Motion | Human Leg

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Core stability for patient stroke
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  Postural control as the basic treatment of the neurological patient    Page  1 IBITA INTERNATIONAL BOBATH INSTRUCTORS TRAINING ASSOCIATION POSTURAL CONTROL AS THE BASIC TREATMENT OF THE   NEUROLOGICAL PATIENT  Teachers: F.C.S.P. Mary Lynch Ellerington Monica Morelli Monia Alessi Mariano Lopez   Student: Elisa Menegon Brescia, September 2013  Postural control as the basic treatment of the neurological patient    Page  2 TABLE OF CONTENTS Introduction p. 3 Theory p. 4 Case report p. 7 Clinical reasoning p. 10 Rehabilitation treatment p. 11 Conclusions p. 20 Bibliography p. 21  Postural control as the basic treatment of the neurological patient    Page  3 INTRODUCTION Due to the injury, the hemiplegic patient loses the use of a body part and consequently the body schema changes. It changes because a body part is used more, because of a loss of sensitive information from the affected side and the decrease in APAs (anticipatory postural adjustments) activities from the less affected side. Because of the loss of the ipsilateral way of the reticulo-spinal system, the loss of the stability on the less affected side, the loss of voluntary movements from the affected side, the voluntary movements of the less affected side are made by the trunk, which is weak also in the less affected side. Moreover in the less affected side there are n’t any normal movements and therefore the patient should be placed in a framework of tetraparesis. The sensory information plays a fundamental role for postural control. Horak says that postural control is a complex  motor skill that results from the interaction of multiple sensory-motor processes. Sensory information must be incorporated in the body schema, which is responsible for postural orientation. The postural orientation is the basis of postural stability. The goal of treatment is to optimize the function by improving postural control and selective movement through facilitation. It’s important to align the components in joint and muscles, to pay attention to the alterations in neural and non-neural structures, to increase core stability, to enable APAs: the core stability controls the trunk and the head, during the activity of the limbs. You can search ground reaction forces and single leg stance. The single leg stance incorporates the setting of the scapula, essential for reaching.  Postural control as the basic treatment of the neurological patient    Page  4 THEORY The descending pathways for motor control from the reticular formation finish at medial parts of the gray matter of the spinal cord, where they influence interneurons, that coordinate the axial and proximal limb muscles. Postural control involves an anticipatory mechanism, i.e. the “pre - programmed” answers that come before the limb starts moving. For example, when a subject is invited to use their arm to pull a handle, immediately after hearing an acoustic stimulus, the activity of the biceps muscle begins 200 ms after the sound. However, the contraction of the biceps is accompanied by a significant increase of the activity of the gastrocnemius (and other muscles not monitored): the contraction of the gastrocnemius muscle precedes the contraction of the biceps muscle.
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