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Episode 3: Unravelling Postural Adaptations: why don't we fall over when we reach for something?

Unravelling the Neurophysiological Systems Behind Efficient Reach, Grasp, release and Manipulation – Why don’t we fall over as we reach out to pick up a bottle of water?

The Role of Postural Adaptations in Voluntary Movements

BBTA Tutors: Clare Fraser and Debbie Strang

At the Advanced Bobath Course at Walkergate Park in Newcastle the therapists gained an understanding of the intricate relationship between posture and voluntary movements and how this is crucial for effective patient treatment. Systems control theory, and notably the work of Latash, provides valuable insight into the role of anticipatory and compensatory postural adaptations in functional tasks such as reaching to pick up a bottle of water.


On the course we explored these concepts and their relevance to neurological recovery, and to movement performance, particularly in relation to the Bobath Concept. This deeper understanding of postural control in rehabilitation had a direct impact on the successful objective results we saw with the patients treated that week. Here is a brief summary of APA science to get your neurophysiology interest peaked!


Anticipatory Postural Adaptations (APAs):

APAs refer to pre-programmed adjustments in muscle activity that occur before a voluntary movement. They serve to stabilize the body and prepare it for the upcoming task. In any functional reaching task, such as picking up a bottle of water, APAs play a crucial role in maintaining postural stability to support the reaching movement.


Early Anticipatory Postural Adaptations:

Early APAs involve preparatory muscle activity over large groups of muscles, that occur prior to the initiation of the primary voluntary movement. These adaptations help to establish a stable base by activating appropriate muscles, such as those in the trunk and lower limbs, to counteract the destabilizing forces induced by the reaching action.


Anticipatory Synergistic Adaptations:

Anticipatory synergistic adaptations involve the coordinated activation of muscles in a synergistic or patterned manner, relevant to the planned movement direction, to maintain postural stability during the movement. These adaptations ensure that the necessary postural adjustments are made while executing the reaching task, facilitating efficient and controlled movement.


Compensatory Postural Adaptations:

Compensatory postural adaptations come into play when the initial postural adjustments are inadequate or disrupted, for example if something unexpected and unplanned happens, such as the bottle of water is slippery or heavier than expected. They serve to restore or maintain postural stability by making adjustments during or after the movement. These adaptations are critical in preventing falls or loss of balance during reaching tasks.


The therapists on our Advanced Bobath Course knew that the Bobath Concept places a strong emphasis on the trunk's role in functional movement. The concept acknowledges the integral connection between postural control and voluntary movements. By addressing the control and alignment of the trunk, the course participants at Walkergate Park enhanced the efficiency and effectiveness of reaching tasks in the patients that they treated on the course.

By the end of 5 treatment sessions we had significantly improved patient objective functional outcomes – and subjective ones: There was one gentleman who was able to reach his arm around his wife and hug her with his weaker arm, for the first time since his stroke. His posture and movement were greatly improved through the application of the systems control theory into rehabilitation practice.

The Bobath Concept's focus on facilitating optimal postural alignment and control in the trunk and core, aligns with the principles of anticipatory and compensatory postural adaptations. By optimizing trunk stability and alignment, therapists can promote better integration of APAs, during reaching tasks.

Understanding the role of postural adaptations in voluntary movements, as viewed through the lens of systems control theory and Latash's work, is essential for therapists involved in neurological rehabilitation. The concepts of anticipatory and compensatory postural adaptations elucidate the intricate relationship between posture and movement.


When combined with the principles of the Bobath Concept, therapists can effectively address postural control and trunk stability, ultimately facilitating functional recovery in individuals with neurological conditions. By embracing the neurophysiology and its application to practice the therapists on our recent course provided more comprehensive and targeted interventions, maximizing the potential for improved motor function and overall quality of life in their patient’s recovery. Well done everyone!


If you would like to develop your clinical practice through the application of up to date systems control neurophysiology science, to move your patients on in their rehabilitation, have a look at the BBTA website for more information: www.bbta.org.uk


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