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FEEDBACK IN PHYSICAL REHABILITATION
New Generation in Rehabilitation FEEDBACK IN PHYSICAL REHABILITATION Dr. Avraham Cohen Chief Clinical Officer MediTouch Ltd.
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1 2 3 4 INTRODUCTION MOTOR LEARNING BIOFEEDBACK CLINICAL APPLICATIONS
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OPTIMAL REHABILITATION
Introduction OPTIMAL REHABILITATION REHAB. METHOD REHAB. AIM ? SENSORIMOTOR IMPROVEMENT FUNCTIONAL ABILITIES
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Motor learning MOTOR LEARNING IN REHABLITATION
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NEUROMUSCULAR / MUSCULOSKELETAL INJURIES SENSORIMOTOR IMPAIRMENTS
Motor learning DISABILITY NEUROMUSCULAR / MUSCULOSKELETAL INJURIES SENSORIMOTOR IMPAIRMENTS DISABILITIES
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FUNCTIONAL ACTIVITIES
Motor learning DISABILITY BODY FUNCTION FUNCTIONAL ACTIVITIES SOCIAL PARTICIPATION
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Motor learning APPROACHES FUNCTIONAL PRACTICE IMPAIRMENT IMPROVEMENT
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Motor learning APPROACHES IMPAIRMENT PRACTICE FUNCTIONAL IMPROVEMENT
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Motor learning CLINICAL REASONING DIAGNOSIS PHASE MOVEMENT ABILITY
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BRAIN PLASTICITY BRAIN'S ABILITY TO CHANGE
Motor learning BRAIN PLASTICITY BRAIN'S ABILITY TO CHANGE PHYSICALLY, CHEMICALLY AND FUNCTIONALLY THROUGHOUT LIFE.
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MOVEMENT INSTRUCTIONS
Motor learning MOVEMENT INSTRUCTIONS MOTOR CORTEX RECEIVES INSTRUCTION AND FEEDBACK INPUT FROM VISUAL AND AUDITORY CORTEX
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MOTOR CORTEX RESPONSIBLE TO PLAN, CONTROL AND EXECUTE
Motor learning MOTOR CORTEX RESPONSIBLE TO PLAN, CONTROL AND EXECUTE VOLUNTARY MOVEMENTS
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MOVEMENT INSTRUCTIONS
Motor learning MOVEMENT INSTRUCTIONS VISUAL INPUT IS RESPONSIBLE FOR SELF OBJECTIVE UNDERSTANDING OF MOVEMENT
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MOVEMENT INSTRUCTIONS
Motor learning MOVEMENT INSTRUCTIONS AUDITORY INPUT IS RESPONSIBLE FOR SELF SUBJECTIVE UNDERSTANDING OF MOVEMENT
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MOVEMENT INSTRUCTIONS
Motor learning MOVEMENT INSTRUCTIONS OPTIMAL VOLUNTARY MOVEMENTS ARE EXECUTED BY OBJECTIVE AND SUBJECTIVE INPUTS AUDITORY VISUAL
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SPATIAL ORIENTATION VISUAL SYSTEM VESTIBULAR SYSTEM
Motor learning SPATIAL ORIENTATION VISUAL SYSTEM VESTIBULAR SYSTEM PERIPHERAL SENSATION PERIPHERAL MECHANOCEPTORS
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PERIPHERAL MECHANOCEPTORS
Motor learning PERIPHERAL MECHANOCEPTORS MUSCLE SPINDLE TENDON GOLGI LIGAMENT ARTICULAR RECEPTORS SKIN RECEPTORS
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PERIPHERAL SENSATION DEEP SENSATION CUTANEOUS SENSATION
Motor learning PERIPHERAL SENSATION DEEP SENSATION PROPERIOCEPTION - JOINT POSITION INFORMATION KINESTHESIA - JOINT MOVEMENT INFORMATION JOINT RESISTANCE - FORCE GENERATED WITHIN A JOINT CUTANEOUS SENSATION TEMPERATURE PAIN PRESSURE
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Motor learning SPATIAL ORIENTATION SPATIAL ORIENTATION HELPS TO MAXIMIZE BODY FUNCTION
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PERIPHERAL SENSATION PROPRIOCEPTION JOINT POSITION INFORMATION
Motor learning PERIPHERAL SENSATION PROPRIOCEPTION JOINT POSITION INFORMATION KINESTHESIA JOINT MOVEMENT INFORMATION
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Motor learning PERIPHERAL SENSATION PERIPHERAL SENSATION HELPS TO MINIMIZE BODY DAMAGE
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POSITIVE BRAIN REORGANIZATION
Motor learning POSITIVE BRAIN REORGANIZATION OPTIMAL BRAIN ORGANIZATION MOVEMENT USING AMPLIFICATION OF WEAK AND REDUCTION OF DOMINANT INPUT MOTOR CORTEX VISUAL CORTEX AUDITORY CORTEX PERIPHERAL SENSATION
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REHABILITATION METHODS
Motor learning REHABILITATION METHODS IOT TOT OBJECTIVE EVALUATION OPEN KINETIC CHAIN HIGH RESOLUTION SUBJECTIVE EVALUATION CLOSED KINETIC CHAIN HIGH COORDINATION IOT – Impairment Oriented Training TOT – Task Oriented Training
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PRACTICE TYPE BLOCKED A SERIES OF IDENTICAL PRACTICE RANDOM
Motor learning PRACTICE TYPE BLOCKED A SERIES OF IDENTICAL PRACTICE RANDOM A SERIES OF DIFFERENT PRACTICE DISTRIBUTED MORE REST TIME THAN PRACTICE TIME MASSED MORE PRACTICE TIME THAN REST TIME
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PRACTICE METHOD LOCAL DEEP SENSATION LOW MUSCLE STRENGTH
Motor learning PRACTICE METHOD LOCAL DEEP SENSATION OPEN KINETIC CHAIN KINESTHESIA PROPRIOCEPTION JOINT RESISTANCE LOW MUSCLE STRENGTH LIMITED MUSCLE RECRUITMENT LOW BALANCE ABILITY NO GROUND REACTION FORCE
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PRACTICE METHOD MULTI DEEP SENSATION HIGH MUSCLE STRENGTH
Motor learning PRACTICE METHOD MULTI DEEP SENSATION CLOSED KINETIC CHAIN KINESTHESIA PROPRIOCEPTION JOINT RESISTANCE HIGH MUSCLE STRENGTH MULTI MUSCLE RECRUITMENT GRF HIGH BALANCE ABILITY WITH GROUND REACTION FORCE
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PRACTICE METHOD FOR MOBILITY OPEN CHAIN SHOULD BE USED FOR STABILITY
Motor learning PRACTICE METHOD FOR MOBILITY OPEN CHAIN SHOULD BE USED FOR STABILITY STATIC CLOSED CHAIN SHOULD BE USED FOR CONTROLLED MOBILITY DYNAMIC CLOSED CHAIN SHOULD BE USED
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Motor learning IMPAIRMENT FOCUS SELECTIVE PRACTICE LEADS TO PREVENT COMPENSATORY MOVEMENT DEVELOPMENT
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DIFFICULTY LEVEL CUSTOMIZATION
Motor learning DIFFICULTY LEVEL CUSTOMIZATION TASK DIFFICULTY LEVEL CUSTOMIZED TO PATIENT PHYSICAL ABILITY
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Motor learning INTENSIVE PRACTICE INTENSIVE REPETITION OF CUSTOMIZED TASK ARE REQUIRED FOR MOTOR LEANING AND PHYSICAL REHABILITATION
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Motor learning REACTION TIME TIME PREDICTION AND TASK INSTRUCTION AFFECT ON REACTION TIME
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Biofeedback
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KNOWLEDGE OF RESULT (KR)
Biofeedback KNOWLEDGE OF RESULT (KR) KR IS THE INFORMATION ABOUT THE PERFORMANCE OUTCOME DEFINITION FEEDBACK WITH LESS SENSORIMOTOR INVOLVEMENT IN THE CORRECT MOVEMENT PERFORMANCE DESCRIPTION
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KNOWLEDGE OF RESULT (KR)
Biofeedback KNOWLEDGE OF RESULT (KR) ADVANTAGES KR USED BY PATIENTS WITH BROAD SPECTRUM OF MOVEMENT ABILITIES KR CAN CAUSE COMPENSATORY MOVEMENT DEVELOPMENT DISADVANTAGES
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KNOWLEDGE OF PERFORMANCE (KP)
Biofeedback KNOWLEDGE OF PERFORMANCE (KP) KP IS THE INFORMATION ABOUT THE QUALITY OF PERFORMANCE DEFINITION DESCRIPTION FEEDBACK WITH MORE SENSORIMOTOR INVOLVEMENT IN THE CORRECT MOVEMENT PERFORMANCE
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KNOWLEDGE OF PERFORMANCE (KP)
Biofeedback KNOWLEDGE OF PERFORMANCE (KP) ADVANTAGES USED IN BROAD SPECTRUM OF MOVEMENT ABILITIES PROVIDES CONTINUING AND TERMINAL FEEDBACK PROVIDES PROFESSIONAL TRAINING PREVENTS COMPENSATORY MOVEMENT DEVELOPMENT
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FEEDBACK TYPES INTERNAL EXTERNAL PERIPHERAL REAL SENSATION AUGMENTED
Biofeedback FEEDBACK TYPES INTERNAL EXTERNAL AUDITION VISION PERIPHERAL SENSATION REAL AUGMENTED
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REHABILITATION PERIOD
Biofeedback FEEDBACK ACCURACY PRECISE FEEDBACK COMPARED TO GENERAL ENCOURAGEMENT PATIENT ABILITY REHABILITATION PERIOD
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Biofeedback FEEDBACK DOSAGE FEEDBACK INTENSITY NEEDS TO INCREASE AS IMPAIRMENT SEVERITY INCREASES FEEDBACK INTENSITY IMPAIRMENT SEVERITY
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TASK INTRINSIC FEEDBACK
Biofeedback TASK INTRINSIC FEEDBACK PROVIDES VISION, AUDITION AND SENSATION INFORMATION
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FADED FEEDBACK FEEDBACK SHOULD BE PROVIDED IN DEVIATION LIMIT
Biofeedback FADED FEEDBACK FEEDBACK SHOULD BE PROVIDED IN DEVIATION LIMIT FEEDBACK AREA DEVIATION AREA CORRECT AREA
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Biofeedback REAL TIME FEEDBACK PROVIDES IMMEDIATE INFORMATION, SHORT TERM MEMORY NOT REQUIRED
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TERMINAL FEEDBACK DEFINITION TERMINAL KR TERMINAL KP
Biofeedback TERMINAL FEEDBACK DEFINITION KR AND KP INFORMATION THAT IS PROVIDED AFTER MOVEMENT PERFORMANCE TERMINAL KR INFORMATION PROVIDED AFTER PERFORMANCE ON HOW TO IMPROVE MOVEMENT TERMINAL KP A COMBINATION OF INFORMATION AND INSTRUCTION PROVIDED AFTER PERFORMANCE ON HOW TO IMPROVE MOVEMENT
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NON MEASURABLE DEVICES
Biofeedback EXTERNAL FEEDBACK EXTERNAL DEVICES PROVIDE INFORMATION DURING TASK PERFORMANCE NON MEASURABLE DEVICES MEASURABLE DEVICES AUGMENTED FEEDBACK REAL FEEDBACK
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REPETITIVE PERFORMANCE
Biofeedback CHALLENGE EFFECT BEFORE CHALLENGE CHALLENGING TASK INCREASE MOTIVATION AFTER CHALLENGE REPETITIVE PERFORMANCE BETTER OUTCOME
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PERFORMANCE CONTINUATION PERFORMANCE CORRECTION
Biofeedback MOTION FEEDBACK LEADS TO SELF OBJECTIVE UNDERSTANDING OF PERFORMANCE POSITIVE FEEDBACK NEGATIVE FEEDBACK PERFORMANCE CONTINUATION PERFORMANCE CORRECTION
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Clinical applications
1. 2. 3.
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INSTRUCTION DETAILED JOINT/S MOVEMENT INSTRUCTIONS CAN BE CUSTOMIZED
Clinical applications INSTRUCTION DETAILED JOINT/S MOVEMENT INSTRUCTIONS CAN BE CUSTOMIZED EXT. EXT. HOLD FLX. FLX. HOLD
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Clinical applications
TIME LINE FEEDBACK CONCOMITANT FEEDBACK IS PROVIDED ON PAST AND PRESENT PERFORMANCE PAST PRESENT FUTURE
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Clinical applications
FADED FEEDBACK DEVIATION LIMIT CAN BE CUSTOMIZED
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Clinical applications
POSITIVE FEEDBACK NO EXTRA AUDITORY / VISUAL FEEDBACK IS PROVIDED WHEN IN DEVIATION LIMIT
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Clinical applications
NEGATIVE FEEDBACK EXTRA AUDITORY / VISUAL FEEDBACK IS PROVIDED WHEN OUT OF DEVIATION LIMIT
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QUANTITATIVE FEEDBACK
Clinical applications QUANTITATIVE FEEDBACK QUANTITATIVE INFORMATION IS PROVIDED DURING AND AT THE END OF THE TASK
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Clinical applications
QUALITATIVE FEEDBACK QUALITATIVE INFORMATION IS PROVIDED DURING PERFORMANCE
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INTENSIVE TASK THE TASK CAN BE REPEATED FOR INTENSIVE PRACTICE
Clinical applications INTENSIVE TASK THE TASK CAN BE REPEATED FOR INTENSIVE PRACTICE CYCLE 1 CYCLE 2
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SUMMERY SUCCESSFUL FUNCTIONAL RECOVERY Clinical applications
Motivation Intensive practice Functional practice Motor learning Difficulty levels Repetitive practice Real feedback SUCCESSFUL FUNCTIONAL RECOVERY
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meditouch.co.il
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