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Understanding the Cerebellum and developing our clinical practice...

Reflections after teaching an Ataxia Workshop.


So good to be back teaching not just the Introductory modules but workshops

with a more specific focus, and this weekend’s Ataxia workshop was a real

pleasure to teach. An experienced group, who were very glad to get back to

thinking about their own development, lots of great questions and discussion,

and a very familiar venue at Manchester Neurotherapy Centre, who always

provide an ideal client for the clinical workshop.


‘Sad neuro geek’ as I am, I had to 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 ‘Best Friend’!

The workshop included a lecture to update participants on more recent

literature, evolving their understanding of:

  • The wider variety of cerebellar roles, including sensory acquisition and consequent movement control

  • 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 ‘recipes’ so I took two main themes into the

practical’s: ‘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, considering 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, so that we 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!


If you would like to update and develop your clinical skills, relating

theory to practice, have a look at our courses on the BBTA website and

sign up to a Themed Workshop! www.bbta.org.uk


Sue Armstrong, Advanced Bobath Tutor, BBTA

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