Neurodynamic, Balance, and sensory training + Flashcards
Do no assess neurodynamics if peripheral conductions signs are present? do you treat?
Yes assess
No treat
Contraindications to neurodynamic techniques
- undiagnosed condition
- conditioning worsening
- severe irritably
- presence of hard neurological signs
Prone knee bend tests which spinal segments
L2-L4
SLR tests which spinal segments
L4/5-S2
Progressing neurodynamic treatment
think sliders (both ends are moving) then go to tensioners (one side is not moving)
- start movement at remote area and indirect Rx (tx interface)
- then move proximal area with or without mobilization of interface
- go further into resistance, don’t provoke pain (just moderate stretch)
- add repetitions
how do you progress balance/proprioceptive training
- start double leg support to single leg support
- eyes opened and eyes closed
- on flat ground and on solid ground
- increase levers
- perturbations: whole body movement, expected and anticipatory
What is included in sensory training
Desensitization, protective education, sensory integration
Desensitization Rx?
- lots of education on how pain becomes chronic and how you get allodynia or hyper/hypo-algesia
- talk to interprofessional team about medications (pharmacist)
- appropriate exercises that increase stimulus but not too rapidly or to cause more damage
- mirror therapy very good (CRPS, amputations)
- compression/support?
- start with soft fabrics, move to more rough fabrics to get sense to change of sensation, contrast baths
What is stereogenesis Rx
they need to watch, connect sensory and motor and make it salient for the individual
Special considerations for sensory training with amputee
if amputation (see section), educate on areas where they may get injured, how to change/modify movements or their set up
