3.1. Sensorimotor

8/6/2019 3.1. Sensorimotor

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History

Vidar Vindal, Gitle Kirkesola ,

Silvia Kollos[PT from Norway, Austria and Germany]

Hannspeter (Hape) Meier

Australian research group -

Hodges [1990]

S-E-T concept


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global and

local stabilizers

Muscle classification

Anatomic basics

. to control segments and joints

segment system


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back muscles [m. erector spinae]

abdominal muscles [different parts]

Global muscles [lumbar area]

Abb. Delavier 2006 Abb. Platzer 2005


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tonic contraction

optimal compression of joint

surfaces

feed-forward

Local stabilizers [lumbar area]

Properties and abilities


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Feed forward mechanism

Cresswell 1999, Hodges 1997 and 1999

Transversus abdominis contracts in all

quick movements of the trunk, upperextremities, and lower extremities,

before the muscles producing the

motion are activated.


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Moseley GL, Hodges PW, Gandevia SC :

Deep and superficial fibers of the lumbar multifidus

muscle are differently active during voluntary arm

movements.

Spine 2002;2:E29-E36

Feed forward - mechanism


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For 75%, the m. multifidus is the most

important muscle for stabilization of the

segment L4 - 5, during movement in theneutral zone!

Wilke 1995


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Local stabilizers first order [lumbar area]

diaphragm

m. transversus abdominis

mm. multifidi

pelvic floor

The collective of lumbar stabilization


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m. quadratus lumborum

[medial portions] m. psoas major [posterior portions]

m. latissimus dorsi

m. obliquus internus u.

externus abdominis

Local stabilizers second order

Abb. Prometheus, Schnke u.a., 2005


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Global muscles

back muscles [m. erector spinae]

abdominal muscles[m. rectus abdominis]

Abb. Delavier 2006 Abb. Platzer 2005


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globalglobal

musclesmuscles

locallocalstabilizersstabilizers

diaphragmdiaphragm

pelvicpelvicfloorfloor

LumbarLumbarstabilizationstabilization


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1] ..... muscles

2] ..... tendons

3] ..... joints

4] sensors for movementand acceleration

5] sensors for pain andinjuries

6] sensors of the skin

SensorsSensors ..

This stabilizing system depends on theperformance of the sensorimotoric system!

Meissner's corpuscles

Merkel cell

Pacini's corpuscles

Ruffini's corpuscles


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Labile und unstable training devices

SensorimotoricSensorimotoric trainingtraining

Abb. Hape Meier 2007


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high sensorimotoric activity based on .

fast, aggressive und unstable stimuli

Unstable training devices


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Unstable training devices


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Injury prevention and performance

development:

Hypertrophy and

synchronous activity of

the local stabilizers

coordinated interaction

SensorimotoricSensorimotoric trainingtraining


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..... reduced information from the sensori-

motoric system and

reduced local stabilization

reduced strength

shear forces

Chronic injuries or pain in the locomotorsystem means ....


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passive control

system

active control

systemnerval control

system

[Panjabi 1991]

Functional instability[motor control deficit]


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reduced sensorimotoricinformation ...

Paradoxical innervationRelieving posture: Muscles don`t get

enough information and correct incoming

information to be abel working or reacting

in an normal way!

..... from the

- muscle sensors- tendinous sensors

- liagemental sensors

- capsule and

- skin sensors

Emergency programm/ paradoxic innervation


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mainly takes the stabalizing control

tries to limit painful movement

hypertension

coordinated interaction is disordered

structural muscle shortening

Emergency programm/ paradoxic innervation

The global muscle system


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Summary

Without sensorimotoric activity no motoric!

Pain reduces the flow of information from the

sensors

Feed forward mechanism does not work at

peak level!

paradoxical innervation/relieving posture


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Methodological approach

Reactivation of neuromuscular response!


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The REHAPE concept

reduce pain

reduce tension

Increase metabolism in the global muscle system

sensorimotoric training



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REHAPE Sling Trainer

I. First, activate the local stabilizers.

II. Second, the global muscle system.


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Remember: methodological approach

high sensorimotoric activity based on . fast, aggressive und unstable stimuli with and on

unstable training devices and

pain free

open and closed kinetic chains


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Open and closed kinetic chains

Closed kinetic chain:

The distal end of the body segment is fixed,the proximal segment of the body moves.

For example: push up, squats

Open kinetic chain:

The proximal part of the body is fixed and thedistal end oft the body segment moves.

For example: bench press, leg extension


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injuries [pain]:

Reactivation of neuromuscular response!

Hypertrophy and

synchronous activity of the local stabilizers

coordinated interaction

SensorimotoricSensorimotoric trainingtraining afterafter


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SLINGTRAINING

Speaking about the shoulder

Erwin Reiterer


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Anatomic basis



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art. glenohumerale

art. subacromiale

art. acromioclaviculare

art. sternoclaviculare

art. scapulothoracale

Anatomic basis


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Scapula thoracal rhythm

Anatomic basis


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Scapula thoracal rhythm

University of Washington

Anatomic basis


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Coordinated interaction in the moment of

scapula thoracal moves

- concentric and

- excentric activity


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Local stabilizers: rotator cuff



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1] ..... muscles

2] ..... tendons

3] ..... joints

4] sensors for movementand acceleration

5] sensors for pain andinjuries

6] sensors of the skin

SensorsSensors ..

Scapula/arm moves and the stabilization dependson the performance of the sensorimotoric system!

Meissner's corpuscles

Merkel cell

Pacini's corpuscles

Ruffini's corpuscles


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I. Feed-forward

II. centering

III. control distance

Methodological approach for stabilzing

the shoulder



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The feed-forward-activity depends on the

performance of the sensorimotoric system!

I goal: Feed-forward

Training with and onunstable devices!


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II goal: centering [rotator cuff]



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10 mm

III goal: distance holder



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Impingement - injurie


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Chronic injuries or pain in the locomotor

system means ....


peak level!


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passive control

system

active control

systemnerval control

system

[Panjabi 1991]

Functional instability

[motor control deficit]


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reduced sensorimotoricinformation ...

..... from the

- muscle sensors- tendinous sensors

- liagmental sensors

- capsule and

- skin sensors

Emergency programm/ paradoxic Innervation

Paradoxical innervationRelieving posture: Muscles don`t get

enough information and correct incoming

information to be abel working or reacting

in an normal way!


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Scapula thoracal[relieving posture] Impingement - injury


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m. levator scapula m. pectoralis minor

scapula thoracal muscles don`t work together




system means ....


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system means ....


peak level!

scapula thoracal muscles dont`t work together


decentration caput humerus


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Gleno humeral

Ventral position of the caput humerus

Shear forces


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The REHAPE concept

reduce pain

reduce tension

increase metabolism in the global muscle system

sensorimotoric training



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REHAPE Sling Trainer

I. First, activate the local stabilizers.

II. Second, the global muscle system.


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Remember: methodological approach

fast, aggressive und unstable stimuli with and on

unstable training devices and

pain free

closed kinetic chains

muscles of the thoracic spine

scapula thoracal muscles

gleno humeral muscles

3.1. Sensorimotor

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