This week’s ataxia workshop was a real pleasure to teach; an experienced group, who were very keen to develop their understanding of the cerebellum, gain new ideas and skills for progressing treatment in this complex clinical picture. We had lots of great questions and discussion, in a great course venue who always provide an ideal client for the clinical workshop.
Sad neuro geek as I am I confess the cerebellum (complex though it is) is my favourite part of the nervous system, I think because it is such a key target of our sensorimotor interventions – It is increasingly understood to be heavily involved in ‘sensory acquisition’, (Therien 2015) and since therapists are ideally placed to create interventions which provide, update or enrich sensory input in its widest sense I think of it as a therapist’s ‘Brains Best Friend’!
The workshop included a lecture to update participants on more recent literature and evolving understanding of
the wider variety of cerebellar roles, including sensory acquisition and consequent movement control, and improving movement performance as far as we can with individuals
postural control: APA’s, CPA’s and clinical relevance
integration of systems control in posture and movement
body schema and it’s ENORMOUS importance for perception and movement
functional ‘zones’ of the cerebellum and clinical consequences…
Treating Ataxic clients can be daunting for all of us, so I wanted to re-enforce key principles rather than give simplistic ‘recipes’ so I took two main themes into the practical: ‘sensory acquisition’ and integration of posture and movement.
The ‘sensory acquisition’ theme allowed us to really focus in on the many ways therapists manipulate or enrich sensory input during therapy – taking afferent input in its widest sense, whether working up against gravity, improving alignment or loading, using handling to give a better ‘reference point’ of stability or movement, change sequence/ timing/specificity of active movement, use of the environment…
The integration of posture and movement theme allowed us to explore ways of using available voluntary movement to create more specific APA activity to improve control, and to consider the ‘3D’ kinetic chain. The participants were able to understand and create their own ‘progressions’ in treatment, crucial for the CNS and specifically the cerebellum, as we need to keep treatment evolving and therefore ‘interesting’. Some very creative solutions were found to maintain stability, while allowing movement, linking to function, and ultimately to let the client actively explore their own movement and hopefully even have fun doing so….
The course finished with a clinical workshop, designed to put the course content into a clinical scenario, and we are always SO grateful that clients come in and take such an enthusiastic part in our courses – they really do bring them to life!
Go the neuro geekery!
Sue Armstrong, Advanced Bobath Tutor
If you would like to join a Problem-Solving Workshop, focusing on a specific topic, to develop your clinical skills and neurophysiology understanding, please look at the BBTA website for courses coming up: www.bbta.org.uk.
Comments