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    Neuro-Coordination Umair PT

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    Fatima Sehar
    Neuromuscular coordination involves controlling centers in the sensory, central nervous, and motor systems. Abnormalities can cause ataxia, which is loss of voluntary coordination of muscle movements. Treatment includes Frenkel's exercises, which use repetition and attention to movement to improve coordination through alternative nervous pathways and strengthened muscles. The exercises start simply in lying or sitting and progress to more complex movements like walking sideways or reaching to improve balance and coordination.

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    Neuro-Coordination Umair PT

    Uploaded by

    Fatima Sehar
    113 views20 pages
    Neuromuscular coordination involves controlling centers in the sensory, central nervous, and motor systems. Abnormalities can cause ataxia, which is loss of voluntary coordination of muscle movements. Treatment includes Frenkel's exercises, which use repetition and attention to movement to improve coordination through alternative nervous pathways and strengthened muscles. The exercises start simply in lying or sitting and progress to more complex movements like walking sideways or reaching to improve balance and coordination.

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    neuro-coordination Umair PT

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    Neuromuscular coordination involves controlling centers in the sensory, central nervous, and motor systems. Abnormalities can cause ataxia, which is loss of voluntary coordination of muscle movements. Treatment includes Frenkel's exercises, which use repetition and attention to movement to improve coordination through alternative nervous pathways and strengthened muscles. The exercises start simply in lying or sitting and progress to more complex movements like walking sideways or reaching to improve balance and coordination.

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    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    113 views20 pages

    Neuro-Coordination Umair PT

    Uploaded by

    Fatima Sehar
    Neuromuscular coordination involves controlling centers in the sensory, central nervous, and motor systems. Abnormalities can cause ataxia, which is loss of voluntary coordination of muscle movements. Treatment includes Frenkel's exercises, which use repetition and attention to movement to improve coordination through alternative nervous pathways and strengthened muscles. The exercises start simply in lying or sitting and progress to more complex movements like walking sideways or reaching to improve balance and coordination.

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    © All Rights Reserved
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    Download as pptx, pdf, or txt
    of 20

    Neuromuscular

    coordination
    Saima Abdul Aziz
    BSPT, MSPT
    IPM&R, DUHS
    Objectives.
    • At the end of this lecture, the students will be able to learn
    about:

    • Neuromuscular coordination and its main controlling centers

    • Briefly describe the effects of sensory, CNS and motor


    coordination abnormalities.

    • Treatment of ataxia with Frenkel’s exercises


    Re-education

    • The use of alternative nervous pathways

    • The condition of the muscles


    Principles of re-education
    • Weakness or flaccidity of a particular muscle group:
     To correct the imbalance by emphasis on the activity of weak
    muscle
     To restore the normal integrated action of muscle in the
    performance of patterns of functional movement.

    • Spasticity of muscle:
     To promote relaxation
     To stimulate effort
     To give confidence in the ability to move and to train rhythm
    Cerebellar ataxia
    • Loss of coordinating impulses.

    • Hypotonic muscles

    • Postural fixation is disturbed

    • Balance is difficult

    • Movements are irregular, swaying and inaccurate


    Aim of treatment
    • To restore stability of the trunk
    • Proximal joints to provide a stable background for movement
    • When the muscular weakness is severe, strengthening methods
    must be used first but the main emphasis in treatment is to
    holding (isometric exercises)
    Loss of kinaesthetic sense
    • Information as to the whereabouts of the body in space
    • The position of the joints
    • Tension in muscle

    • Lesions causes:
     Hypotonicity of the muscle
     Incoordinated movement
    Identification of Fall Risk Factors
    • Risk factors for falls are divided into two categories:

    • Intrinsic Risk Factors


    Dizziness, weakness, gait abnormalities, poor balance, confusion,
    poor coordination, ROM, cognitive impairment

    • Extrinsic Risk Factors


    Floor surface, poor lighting, cluttered furniture, obstacles, non-level
    surface, poor shoes
    Falls are a result of loss of
    postural control.
    Normal Postural Control (Balance)
    • Balance requires keeping the “Center of Mass”
    (COM) over the “Base of Support” (BOS) during
    static and dynamic situations.
    • Neural components of postural control:
    • Sensory processes
    visual, vestibular, somatosensory
    • Central processing
    a higher-level integrative process
    • Effector component
    • sometimes referred to as the neuromuscular component
    • postural alignment, ROM, muscle force, power & endurance
    Normal Postural Control

    Adaptive postural control requires modifying sensory and


    motor systems to changing tasks and environmental
    demands.
    Tabes Dorsalis
    • Degeneration of the dorsal roots of the spinal nerves and
    posterior columns of the spinal cord

    • Gastric crisis with severe pain and vomiting is most common

    • Pain, urination problems, paresthesias, ataxia, diplopia, vertigo,


    deafness
    Tabes Dorsalis
    • Signs: Reduced lower cord reflexes, Romberg sign, sensory
    loss, atonic bladder, Charcot’s joints, optic atrophy

    • Personality changes, memory loss, apathy, megalomania,


    delusions, dementia (Garcia von Lin syndrome)
    Frenkel’s exercises
    • Definition :
    a series of gradual progressive exercises designed to increase
    coordination
    Aim :
    Establishing control of movement by use of any part of sensory
    mechanism which remain intact as sight & hearing to
    compensate for the loss of kinethetic sensation.
    • a-concentration of attention
    • b-precision
    • c-Repetition
    Technique

     The patient is positioned and suitably clothed so that he can see the
    limbs throughout.

     A concise explanation and demonstration of exercise is given before


    movement is attempted, to give patient a clear mental picture of it.

     The patient must give his full attention to the performance of


    exercise to make movement smooth and accurate.

     The speed of movement is dictated by physiotherapist by means of


    rthymic counting, movement of her hand or the use of suitable music.
    The range of movement is indicated by making the spot on
    which the foot and hand is to be placed.

     The exercise is repeated many times until it is perfect and


    easy. It is then discarded and a more difficult one is substituted.

     All these exercises are very tiring at first, frequent rest periods
    must be allowed. The patient retains little of no ability to
    recognize fatigue, but it is usually indicated by a deterioration
    in the quality of movement, or by a rise in pulse rate.
    Frenkel’s exercises cont
    • I-lying ---------
    • flexion-extension
    • Abduction – adduction
    • Each movement will be performed unilaterally fast then slow
    then interrupted by hold
    • bilateral performance simultaneusely then alternatively
    Frenkel’s exercises cont
    • Sitting :
    • 1-Slide heel to reach a mark on the floor
    • 2-change standing and sit again
    • Standing :
    • 1-transfer weight from foot to foot
    • 2- walking side ways
    • 3-placing foot on specific marks
    Frenkel’s exercises cont
    • For arms :
    • Sitting with arm supported on a table and placing hand at
    specific mark
    • Try to reach an object
    • Picking up objects
    • Put the hand in a ring or hole
    THANK YOU

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