• Kabat method
  • Perfect Method
  • Bobath method
  • Postural Rehabilitation Mézière
  • Vodder lymphatic drainage
  • Neuromuscular Taping
  • Pumping

METODO KABAT[1].

Indications: Kabat was born and developed in the context of neurorehabilitation, but his techniques are also highly suitable for orthopedic rehabilitation. The use of this method is optimal for strengthening and muscle stretching, for the increase in the width of the joint range, for the reduction of stiffness and spasticity, for coordination e balance.

The Kabat method was born in California in 1948 in the Kaiser Rehabilitation Center of Vallejo from the collaboration between the neurologist Herman Kabat and the physiotherapist Margaret Knott, to treat patients with neurological pathologies. Currently this method is widely used in Europe and the two Americas. The French call it the Kabat method, the Anglo-Saxon PNF or proprioceptive neuromuscular facilitation. In Italy a variant called RMP with Neurokinetic Facilitations-Concept is used Kabat by Giuseppe Monari where RMP stands for Progressive Modular Rebalancing .

Kabat believed that knowledge was essential acquired through basic research were used in the clinical practice. His method was the fruit of this approach by thought, so it was born right on basis of the integration of neurophysiological knowledge with practice clinic, of the neurological medical approach with the rehabilitative physiotherapy approach. These partnerships have led to the development of different techniques, than in their complex they make up the method. The use of these techniques is aimed at muscle strengthening, as the range increases articulate, to the reduction of stiffness and spasticity,  improvement of coordination e of balance.

Noel-Ducret suggests as the best synthetic definition of this method a sentence extrapolated from an article by Viel E.[2] : “Use of source information superficial (tactile) and of profound origin (joint position, stretching of tendons and muscles) for the excitation of the nervous system, than to his time ago act the…musculature ". Now let's go into more specifics to get a more concrete idea of ​​the method.

The physiotherapist administers stimuli to the patient precise, controlling intensity, duration, frequency and location depending on of the purpose, to facilitate the implementation of a specific motor act. These stimuli, called FACILITATIONS in jargon, provide information sensitive that help the central nervous system to plan and carry out movement at its best. For the CNS, the fundamental information for this purpose is what is called proprioception . It is about the ability to perceive the position of one's body in space even without support of the vista. The receptors that contribute to proprioception e which are called into question by the facilitation stimuli administered by the I am a physiotherapist:

  • The muscle receptors: the tendon organs of the Golgi which are found in the musculo-tendon joints and which are sensitive to the stretching of the tendons, both due to passive mobilization and muscle contraction. I fusi neuromuscular, sensitive to both static and dynamic muscle stretching.
  • The receptors articular, present in joint capsules or ligaments, that communicate the degree of angulation in which the different parts of the body are located between them at a certain time.
  • The skin receptors, sensitive to touch and any deformation of the skin.

These receptors are stimulated:

  • Directly from contact of the hands of the physiotherapist on the patient's skin
  • Through the coaptation (which means stimulating a joint in compression), extremely useful for inducing limb stability.
  • With the application of a resistance to movement (the position of the therapist's hands is crucial, in that constitutes a real guide to the direction of movement, that yes it will play in the opposite direction to that of the applied resistance). There resistance stimulates the recruitment of a greater number of motor units in the muscle.
  • With the administration of the stretch stimulus, which causes a short contraction muscle reflex. The physiotherapist simultaneously asks the patient to make a voluntary contraction in opposite direction to that of the stretch stimulus. This contraction will benefit from the initial reflex contraction (caused by the excitement of neuromuscular spindle due to stretching) which works as a facilitation.
  • With type stimulations auditory / cognitive-verbal ("Verbal command"). This is an indication summary of the way in which the patient must perform the exercise. The therapist first explains to the patient in exhaustive manner of the exercise. During the development it then uses specifics verbal commands, which indicate and stimulate a specific mode of execution: “HERE!”, "STRIP!”, "PUSH!”.
  • With stimulations visual (the patient must follow the movement that the limb performs with his eyes in the space).

The different techniques proposed by the Kabat method provide specific methods of intervention to be used from time to time depending on the problems that must be addressed: improve coordination, balance, stability, there resistance, muscle strength, the range of motion, reduce hypertonicity.

The neurophysiological principles on which these are based techniques are:

  • The law of the subsequent induction "by Sherrington. The contraction of a muscle is greater when preceded by a strong contraction of its antagonist, if the two contractions follow each other without time interval. We can like this improve, for example, a deficient flexor movement of a limb harnessing the strength of the opposite movement, or the extensory one.
  • The innervation reciprocal. There are inhibitory circuits at the medullary level that do so that, when a muscle (agonist) Yes contracts, his antagonist releases[3]. We can then achieve the relaxation of a muscle causing his antagonist to contract. The stronger the contraction will be of the antagonist, the greater the relaxation ! The mechanisms of inhibition they allow for a relaxation of spasticity and make it easier the execution of the act to the subject.
  • Irradiation: "THE strong muscles are used as starters to reinforce the action of weak muscles. (…) a muscle that encounters strong resistance radiates i his less vigorous brothers.[4]”
  • Stretching prolonged. “Stretching a spastic muscle continuously (but without brutality), a progressive decrease or elimination of the spasticity. The organs of the Golgi, stimulated by continued traction, produce inhibitory signals that, accumulating, They "depress" the tension muscular. Just applied the traction, i engine spindles (fast running) stimulate contraction; the Retention of traction allows the Golgi organs (slow running) to take over, and their inhibiting message overcomes the message facilitator who preceded him. [5]”.
  • The repetition of the movement. It has as a result, according to Pavlov, the formation of new ones central integrations[6] establish (corticalizzazione).
  • Spatial summation stimuli: the simultaneous activation of several excitatory synapses on one the same neuron leads to the achievement of the current threshold that allows the generation of an action potential by the neuron, and then the propagation of the stimulus. From the point of view of practical application this for us it means that giving more stimuli at the same time allows us to enhance the motor response by increasing the number of motor neurons involved. To this we must add that the intensity of the stimulus increases the muscle response, therefore also a modulation of this intensity falls among the tools available to us to refine the effectiveness of the exercises proposed.
  • Time summation stimuli: repeated stimulations increase the motor response.
  • Type of contraction. Isometric contractions,  concentric isotonic and eccentric isotonic: the first are contractions without moving the joint heads, the latter with approach and the last ones with removal of the articular heads. The first case occurs for example when we hold a heavy object lifted without moving it. The according to when we lift the shopping bag off the ground, the third when the we rest on the ground. These three types of contractions

In 1987 an Italian physiotherapist, Giuseppe Monari, after taking a PNF course in California, introduced the Kabat method in Italy.

The use of this method led him over the years to introduce their own elaborations which led to the realization of a much more complex approach and articulated compared to the original model, much to justify and make a change of name is needed to distinguish those that have become moles made two different modes of intervention, while respecting the initial formulations that refer to Kabat and his working group.

We will retrace the steps that led here to the current RMP-Elaboration of the Kabat Concept taking as a reference the story of this content evolution in the introduction to the edition of 2014 of “Progressive Modular Rebalancing, Elaboration of the Kabat concept[7]”In G. Monari.

Monari tells us of a first evolution that dates back to the years 1974-1980 in which the importance of biarticularity and monoarticularity was identified complex.

A biparticular muscle is a muscle that lies between its heads articular includes two joints and consequently its action can have effect on both. The rectus femoris, for example, can act as a flexor hip and / or as a knee extensor. Working in bi-articularity for the rectus femoris means acting on both joints and therefore divide his work on both of his ad items by percentage adapted according to the specific needs of the motor act you want carry out. Monari calls this way of working the muscle “function intelligent".

Having to divide its strength both upstream and downstream with respect to its length, the rectus femoris forces other muscles to come into it help to perform both functions in the best possible way, of hip flexion (asking for help from the psoas muscle) and knee extension (asking help to the vast muscles) and this involvement will also improve over time performance of the supporting muscles.

The biarticular work forces the rectum to vary its length greatly and in this way improves its own elasticity. If the rectum is exercised separately only as a flexor hip or only as a knee extensor is not forced to divide their work intelligently and this requires involvement cortical (cerebral) of lower quality level and determines a minor neuroplasticity effect. The difference in level of involvement cortical was demonstrated by transcranial color doppler functional. Also working only on one of its adverts it does not need any particular variations of length because the one it needs is obtained by stretching it level of the other listing. In the work in biarticularity the muscle starts from a maximum shortening to arrive at maximum elongation.

By complex monoarticularity we mean the fact that a Monoarticular muscle works simultaneously in all three of its functions: flexion-extension, abduction-adduction, rotations. In this way it will be able reach the state of maximal shortening. As well as the work in biarticularity, even the use of complex monoarticularity involves a greater cortical involvement and therefore greater neuroplasticity.

A second evolution of the method then took place between 1974 and the 1980, when the key to interpretation was identified in the postural passages of the trunk's recruitment capabilities in its four functions rotation, flexion, extension and inclinations. The postural steps become therefore a refined tool for evaluating the functions of the trunk, but at the same time they also constitute a basic platform on which structure the therapeutic exercises to be proposed to rehabilitate those components of the trunk that are deficient.

Between 1978 and the 1986 there was the introduction of pyramid progressions to specifically evaluate and intervene on problems of equilibrium which, as known,  is given by the ratio between the width of the support base and the height from the ground of the center of gravity of a body. Working on balance means proposing to the patient exercises set on a targeted variation of these two parameters that gradually allow the patient to reach a standing position (where the support base is minimal and the center of gravity at maximum height from the ground) having filled those gaps that made it impossible to achieve or that it they made it precarious. By pyramid progression we mean all of that progression of postural steps that allow us to move from position supine (maximum support base and minimum height of the center of gravity) to the location erect (or from the prone position, or from the lying position on the side). Evaluation of how the patient copes with these pyramid progressions it allows to intercept the moment in which deficiencies begin to appear e therefore to identify the level of exercises to propose and also allows you to evaluate if the patient is able to reach the standing position and the I walk. This work was fundamental because it allowed us to overcome a modus consolidated operandi that was to exercise the function directly lacking to improve it: if the patient walks badly let him walk e so exercising it will improve. These studies suggest the fact that it is probably more appropriate to identify the deficiencies upstream of the function deficient and rehabilitate them specifically in order to properly re-establish the function (for example the path).

The importance was subsequently highlighted muscle elasticity so that a muscle can exercise its best contractile power. A muscle that has undergone shortening is a muscle that has lost elasticity. The greater a muscle's ability to achieve maximum elongation and maximum shortening and the greater the its contractile capacity. Furthermore, a shortened muscle limits the action of his antagonist because it acts as a brake (when a muscle contracts his antagonist must relax and stretch). Muscle shortening would have also an effect on the sensitivity of the muscle spindles that would increase the excitability of the stretch reflex.

Hence the pivotal role that is attributed from the RMP to the achievement and to maintenance of physiological muscle lengths in all areas, but in particularly in that of neurological pathologies, since in these patients an alteration is found, which facilitates the establishment of pathological patterns and can adversely affect pain in the shoulder which can often be encountered in particular by the hemiplegic patient: “… The therapist first still to deal with the "muscle strengthening" must worry about the "lengths muscle "". Therefore, a method of evaluation of the "real" muscle lengths, which ensures effective control of the position of the joint heads during the evaluation preventing it create those escape routes of the system that we call "compensation".

These are the main innovations that come indicated in the writing of G. Monari to whom I refer here. They are not unique but I believe that they are sufficient to give an idea of ​​the theoretical basis of this method and its rehabilitation potential.

Perfect Method

Indications: neurological pathologies of the central and peripheral nervous system that lead to motor or sensory impairment and orthopedic pathologies. The use of this method is optimal for the rehabilitation of proprioception and tactile sensitivity (which are not only altered in neurological pathologies but also in those in the orthopedic field, in especially in the case of fractures and surgery), for the reduction e hypertonic control, of the irradiation and the abnormal reaction to stretching. The integrity of proprioception and the adequacy of muscle tone are fundamental prerequisites for carrying out fluid and functional movements.

Proprioception and movement

We have said that the Perfetti method is ideal for the recovery of proprioception and tactile sensitivity deficits. But what what is proprioception?

A healthy person knows perfectly well, without support of sight, the position of one's body within the perceived space and the relationship of its different parts to each other (trunk, head, meaning..). If I want to grab a glass I obviously have to see it, but I don't have to look at my hand to understand how it should move and how it should adapt the grip to the shape of the glass. This perception of the one's body is called proprioception. The design and the execution of fluid and functional gestures requires an integral proprioception, which instead results altered in multiple pathologies, is borne by the central nervous system (stroke, multiple sclerosis, Atassie, Parkinson's disease.) what a peripheral, but also in cases of fractures or interventions of joint prosthesis implants. The rehabilitative treatment of proprioception it is essential to obtain an appropriate recovery of the fluidity of the movement.

Patients with proprioceptive deficits try to spontaneously compensate for this deficiency using the view, which in mammals is an extremely informative channel "Overbearing" with respect to the other senses: they look at the hand to understand how they should move it towards the glass, they look at the foot to understand how they should move the step. In this way, however, they reduce their chances of retrieving proprioceptive information and therefore of a more physiological mobility.

One of the goals of the rehabilitator will therefore be to "Forcing" the patient to question the information coming from those bodily structures that are key to proprioception (muscles, tendons, joints, skin) which the healthy person benefits from in an "automatic" way, unaware. This can be done through a first phase based on stimulation and recovery of these sensory channels e, in the case of pathologies of the central nervous system, on the acquisition of voluntary control (cortical) followed by a second phase of recovery of the automatic control (subcortical) of the use of somatic information.

At the base of the Perfect method there are three degrees of exercises:

I ° exercises degree

“The first degree exercises have the purpose of allow the patient to achieve satisfactory control over reaction to stretching, the overcoming the deficit of sensitivity tactile e kinesthetic, as well as the recruitment of a greater number of motor units. They consist in the request of attention towards appropriate afferents, mostly kinesthetic e tactile, in order to arrive at the verification of adequate perceptual hypotheses proposed by the therapist through suitable aids[8].”.

While performing these exercises, the patient must inhibit any type of contraction voluntary and must limit itself to adapting the muscle tone of the limb in a way such as to allow the physiotherapist to guide the movement. “In some of these exercises, after showing the patient a series of pictures, her hand is guided, inhibiting any voluntary contraction, to follow the contours of the figures themselves with their eyes closed and then the patient to identify on which figure of the series has been guided the arm[9].”. To be able to do this correctly exercise the patient will need:

  • perform a visual analysis of the figures that the are shown.
  • transform the visual angles of the contours of the figures in kinesthetic angles or in an idea / hypothesis of the movement that his limb will have to make to follow the different outlines of the figures themselves (hypothesis perceptive).
  • make an analysis of the movements that the physiotherapist is making his limb perform (kinesthetic analysis), to make him follow the contours of the figures. This analysis of the movement is based solely on proprioceptive information.
  • Compare the kinesthetic analysis of movement perceived through proprioception with the idea / hypothesis of movement that he had created based on the vision of image outlines (check of the perceptual hypothesis).

2nd exercises degree

In these exercises, which aim at the irradiation control,  “The patient is asked to verify perceptual hypotheses that require recruitment of only a few motor units of a small number of muscles (..)[10]”. This type of exercise is essential to bring the patient to “control over radiated contractions determined by movement voluntarily performed[11].”. The patient to perform this correctly exercise will have to learn how to modulate muscle recruitment to perform a kinesthetic analysis by actively moving the limb in order to then be able to verify the perceptual hypotheses. In 1st degree exercises this movement was guided entirely by the physiotherapist. In the 2nd degree exercises actually the patient actively performs only part of the entire trajectory of the movement, which takes place anyway with the Facilitation of the therapist's manual guidance who must measure his own intervention by evaluating how much of the movement to actively let the patient based on the patient's ability to control irradiation. The therapist, as well as calibrating the facilitation, must also dose carefully the speed with which the movement is made, bearing in mind that one of the factors that trigger the irradiation is precisely the speed of the movements. All the first degree exercises can be transformed into second degree exercises degree.

Exercises of 3rd degree

They serve to help the patient carry out a process of generalization of the trajectories performed with first and second degree exercises  to allow him the possibility of executing as many trajectories as possible e in the most functional way possible “using the information coming from the outside and from one's own body only to regulate spatiality, temporality and intensity of movement, as does the healthy subject, when it should learn a new motor performance[12].”. It is possible to offer the patient this type of exercises only when he has come to control in an automated way (subcortical), through first and second degree exercises, irradiation and the reaction to stretching. The automatic control of these two parameters in fact allows the patient to focus exclusively on evaluation of any discrepancies between the required movement trajectory by the physiotherapist and the one he performed.

Control volunteer (cortical) and automatic control (subcortical).

In the exercises of 1st and 2nd we assist, as we have seen, to a transition from a voluntary control of irradiation (exercises of 1st) and the abnormal reaction to stretching (2nd exercises)  to an automatic control. Actually also the learning of new motor skills in physiological conditions takes place through a transition from a first phase that takes place through control volunteer (cortical) of the execution of the motor task to be learned to a second phase in which the control of the activity we carry out takes place in a manner "Automated" (subcortical). When we learn to drive the car we must pay attention in a controlled way to how to put the foot to to brake, to accelerate, how much force should we use to push the pedal, the direction in which to move the shift lever to change gears, to how far we have to turn the steering wheel and in what precise sequence we have to carry out all these single actions necessary to carry out the guide. And at the beginning it is very difficult and often the car switches off because we do not know how to adjust the clutch and accelerator. When we have finished the learning process all these actions are we run automatically without having to pay attention and we can chat with passengers while we think about the route to choose to get to the desired destination.

In rehabilitation, the relationship between information subjected to controlled analysis and the one subjected to automatic analysis is “Programmed by the rehabilitator, in such a way as to allow a progressive lengthening of the sequence sections that can be activated with a single information taking subjected to controlled type analysis[13].“. Later you can teach the patient a autonomously switch from automatic to controlled analysis during the exercise, using what Perfetti calls "attention signals". Yes it may deal, for example, with information indicating the appearance of irradiation. By way of example, the year is reported in sitting position in which the patient has to extend the knee to follow a line with the sole of the foot drawn on the ground. The detachment of the medial edge of the foot from the ground becomes here "Signal of attention" to switch to controlled analysis because precisely it is index of the onset of irradiation[14].

Request the execution of the entire sequence early of the step would involve a controlled analysis of a number of elements unmanageable. A well-structured preparatory work before being able to propose such a complex execution. Perfetti suggests a key in the planning of this rehabilitation work or the study of the ontogenesis of movement : “(..) identify structured recruitment complexes that are functionally used by the child in specific periods of maturation and that in periods just as accurate, in relation to cognitive evolution, are combined between them so as to allow increasingly complex operations[15].”.

The repetition coding or the stable and lasting acquisition of new skills.

As we have said elsewhere, neurorehabilitation yes proposes to induce lasting changes in the central nervous system, what in the jargon we call "corticalization". Perfect from this point of view, he speaks of “coding repetition[16]”. This consists in proposing repetition of the execution of a scheme, however, inserting "variations on the theme": have the patient follow the contour of radius semicircles with his eyes closed ascending / descending and ask to identify them. This approach, second Perfect, it allows the patient to identify and learn not so much “a move of the game ”but rather“ the rules of the game ”and make them your own (corticalizzarle).

In describing the three degrees of exercises of the method Perfect I have referred to the perceptual hypothesis several times. Now let's see more in depth of what it is treats.

The perceptual hypothesis and movement

Perfetti tells us that in front of "(..) to the need for fulfill a certain task the central nervous system is forced to pose certain perceptual hypotheses to be verified and formulate a series of interlinked operations capable of leading to the acquisition of information needed to validate or reject, through adequate comparisons, as assumed[17].”. To get to lift a bag from the ground ad example, we have to design, based on a series of perceptual hypotheses:

the approach movement to be made based on the distance, visually estimated (perceptual hypothesis), of the envelope handle from our hand,

the movement of the hand to make the grip on the base to the shape of the handle (perceptual hypothesis) and its orientation in the space (perceptual hypothesis).

the muscle strength to be used to lift it to the base to the estimate we make on the weight of the bag (perceptual hypothesis).

This project will be implemented through a series of operations linked together. If during the execution of the gesture it will emerge that the perceptual hypotheses are not perfectly fitting and that therefore the "Project" is not perfectly appropriate for the task to be performed, appropriate "adjustments" of the motor act will intervene during his the execution. This is possible thanks to a very refined system of feedback that allows the central nervous system to know in real time what happens at the peripheral level and therefore to compare in real time the "project", developed on the basis of a specific objective, with her execution.

The contraction of the muscle is only the last ring of a chain of events that include the modulation of attention with respect to a whole series of sensory afferents to the central nervous system, mainly tactile and proprioceptive information, and selection e memorization of those fundamental information linked to that precise context that must be compared with pre-existing schemes to elaborate the specific parameters of muscle contraction for that specific act motor. It is therefore essential from the beginning to bring the attention of the patient towards "(..) those structures that allow to program the characteristics of this recruitment towards a perceptual hypothesis[18]”. In this context, the first degree exercises, that in a traditional view would be classified as passive because not require voluntary muscle contraction, but only an adaptation of the muscle tone, they are actually active exercises because they are aimed at all of that sphere of "actions" that are upstream of the voluntary movement. The exercises of first degree require the patient to carry out a visual analysis of the shapes and to derive the "kinesthetic equivalents" or, for example, to transform angles identified with the view in "kinesthetic angles" that refer to the proprioceptive sensitivity deriving from the information coming from anatomical structures involved in movement (muscles, tendons, joints, cute). The patient thus makes a hypothesis of what he should feel / perceive in follow the contours of one figure rather than another. When the therapist will make him perceive the outline of the figures to identify them ad eyes closed then, he will have to compare his kinesthetic hypothesis (hypothesis perceptive) deduced from the visual analysis with what it will actually perceive. There awareness of the discrepancy between perceptual hypothesis and reality will improve his kinesthetic analysis skills.

Bobath

Mézière

Vodder lymphatic drainage

Indications. For a complete picture of the information relating to this method I refer to the official website of the Italian School of Lymphatic Drainage Vodder (http://www.linfodrenaggiovodder.it/metodo-originale-vodder). In this context I will consider only the indications relating to those pathologies of interest rehabilitation in which this method can be used in association with physiotherapy to help reduce some related symptoms.

  • Affected pathologies of the circulatory system: venous insufficiency, interrupting his lameness, circulatory disorders affecting the microcirculation
  • Pathologies in the field orthopedic: joint and muscle trauma, sprains, tendon injuries, ligamentous, outcomes of fractures, endoprosthesis interventions, syndrome Sudek algodystrophy, whiplash, arthrosis, discopathies, lombosciatalgie, cervicalgie, impingement syndrome affecting the scapula-humeral joint
  • Pathologies in the field neurological such as facial paresis and multiple sclerosis
  • Pathologies in the rheumatology field

The Vodder method was devised by Emil Vodder and his wife Estrid Vodder, both Danish, and presented and introduced by them officially for the first time in Paris in 1936.

This method involves the use of spiral movements or circular lenses with alternating pressure that oscillates between zero and 40 Torr and that has an action on the skin and subcutis. This pressure alternation stimulates i mechanoreceptors of superficial lymphatic vessels by increasing their motility intrinsic they are endowed with, but these pressure swings have also a "sucking" effect that favors the displacement of lymph from the interstitial fluid to the lymphatic vessels. According to studies conducted by Vodder Schule treatment with the Vodder method does not only have a lymphatic drainage effect, which favors the drainage of liquids and waste substances from the tissues to the lymphatic system improving metabolic exchanges, but it also has other important effects:

  • Sympatholytic. Vodder lymphatic drainage in fact decreases the level of activity of the system sympathetic nervous (SNS). The SNS is part of the so-called vegetative nervous system also autonomic nervous system (SNA) because it is not subject to ours voluntary control. The SNS is also called the fight or flight system because it typically activates to respond to "fight or flight" situation, when it is necessary to react promptly to a danger and face it or get away from it in time. Without entering the specific to the topic, from this last definition we can already anyway deduce that the activation of the SNS must have activating and non-activating effects calming. Among these effects we find theincrease heart rate and major changes at the system level circulatory which differ according to the different body districts, release of cortisol into the circulation (said also the stress hormone), increase muscle tone.
  • Painkiller. The activation of the skin receptors given by the massage inhibits, at the level of spinal cord, the transmission of pain signals to the nervous system central.
  • Immunologico. This effect has not yet had a scientific demonstration to date but, second the statements of the Vodder Schule, is an improvement in the patients' immune defenses was found treaties that have proved to be less delicate.
  • Reduction of muscle tone. It therefore has a beneficial action on contractures (date also by the analgesic effect and by the drainage of metabolic substances of muscle waste including lactic acid).

Taping NeuroMuscular

Indications: post-surgical orthopedic rehabilitation, neurorehabilitation of pathologies a load of the central and peripheral nervous system

The method of NeuroMuscular Taping (NMT Concept) “.. uses decompression and compression stimuli to obtain beneficial effects on musculoskeletal systems, vascular, lymphatic and neurological, aiming clinical and rehabilitative purposes. With the application of ribbons, folds are formed skin during body movement that facilitate lymphatic drainage, promote blood vascularization, reduce pain, improve the muscle-joint range of motion and posture. (…) The taping NeuroMuscular is a non-invasive and non-pharmacological technique, than through the application of an adhesive and elastic tape with particular characteristics mechanoelastic offers a mechanical stimulation capable of creating space in the fabrics; promote cell metabolism, activate the natural abilities of body healing and normalization of neuromuscular proprioception[19].”.

Pumping

It is a technique of the Bienfait method. The pompage it is a movement that the therapist performs on different parts of the body for to bring a body segment from a state of tension to a state of relaxation alternating them with a regular rhythm. In the application of the technique we must consider three times: the tension, the maintenance of tension and relaxation. By varying the pace and tension you can get different effects. Slow pompages, for example, are useful for contractures because they induce muscle relaxation, for the treatment of muscle-fibrous retractions but also for the joints (Bienfait suggests a systematic use in treatment of osteoarthritis)  why ne reduce stiffness which limits the physiological movement. The pompages also have a beneficial effect on the level both blood and lymphatic circulatory system. Promote the supply of oxygen e nourishment to the tissues and the elimination of waste products that in jargon we call it catabolites and they have a powerful analgesic effect.

[1]Noel-Ducret F. Metodo in Kabat. Proprioceptive neuromuscular facilitation. Encycl Med Chir (Scientific and Medical Editions Elsevier SAS Paris), Medicine Rehabilitation, 26-060-C-10,2001, 18 p.

E. A lot of. The kabat method. Facilitation proprioceptive neuromuscular. Publisher Marrapese. 1997.

G. Monari. Modular rebalancing Progressive. Elaboration of the Kabat concept. Edi-ermes, 2004.

[2]Much E.. Use of proprioceptive neuromuscular techniques for reeducation and education of the sporting gesture. Switzerland Zeits Sport Medb 1985; 3:00-104

[3]

[4]E. A lot of. The Kabat method. Facilitation proprioceptive neuromuscular. Publisher Marrapese. Roma. 1997

[5]E. A lot of. The Kabat method. Facilitation proprioceptive neuromuscular. Publisher Marrapese. Roma. 1997. Pag. 113

[6]place

[7]G. Monari. Modular rebalancing Progressive. Elaboration of the Kabat concept. Edi-ermes. 2013

[8]Pag 101

[9]Pag 70

[10]Pag 75

[11]Pag. 102

[12]Pag 104

[13]Pag 57

[14]Pag 58

[15]Puccini P. Perfect C. System development functional of the manipulation (structural analysis) SIMFER 12, Summaries, 1981

[16]Pag 62

[17]Pag 44

[18]Pag 69

[19]David Blow…