Lecture
Session 2A
11.00-13.00 |
Introduction to Neurodynamic Stabilisation
Dynamic Neuromuscular Stabilization (DNS) is a new rehabilitation strategy based upon the principles of developmental kinesiology and neurophysiological aspects of the maturing postural-locomotor system. The maturation of the post-partum central nervous system (CNS) and muscle function is related to anatomical maturation (morphological development). Postural activity occurs automatically in the course of maturation of the CNS via coordinated activity of muscles. Postural ontogenesis defines ideal posture from a developmental perspective whereby optimal muscle coordination is ideal for joint loading, hence defines ideal motor stereotypes. The process is genetically determined and comes into play automatically in the course of CNS maturation. At the age of 4.5 months, stabilization of the spine, pelvis and chest in the sagittal plane is completed. Completion of basic sagittal stabilization is followed by development of extremity movement patterns (i.e. supporting and stepping forward /grasping functions) coupled with trunk rotation. As such, the quality of torso stabilization is essential for any phasic (dynamic) movement since each movement is preceded with the stabilization of body segments to provide balance, efficient coordination and stability to its participating elements. DNS diagnosis is based on comparing the patient’s stabilizing pattern with the stabilization developmental pattern of a healthy baby. The treatment approach emphasizes the training of these ideal patterns as defined by developmental kinesiology. The brain must be properly stimulated and conditioned to automatically activate optimal movement patterns that are necessary for the co-activation of the stabilizers. The ultimate strategy is to teach the brain to maintain central control and stability of the movement restored during the therapy. This can be achieved by activation of the stabilizers when placing the patient in the primal developmental positions.
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Workshop 4b
Session 3A/4A
14.30-18.00 |
Spinal Stability Workshop b. Neurodynamic Stability
Etiology of back pain should be investigated not only from an anatomical and biomechanical standpoint, evaluating influence of external forces acting on the spine, but should also include evaluation of the internal forces induced by the patient’s own musculature. Activation of the stabilizing muscles is automatic and subconscious, preceding every purposeful(or dynamic) movement. The integrated stabilizing system of the spine consists of well balanced activity between deep neck flexors and spinal extensors in the cervical and upper thoracic region. Stability of the lower thoracic and lumbar region is dependent on the proportional activity between the diaphragm, pelvic floor, all the sections of the abdominal wall and spinal extensors. Under pathological conditions, insufficient postural function of the diaphragm, abnormal recruitment and timing between diaphragmatic and abdominal muscles activity, abnormal initial chest position and hyperactivity of the superficial spinal extensors can be observed. Kolar’s approach to Dynamic Neuromuscular Stabilization (DNS) explains the importance of the above muscular interactions and their proper recruitment for dynamic stability of the spine and utilizes a series of systematic dynamic tests. DNS is a complex approach, encompassing principles of developmental kinesiology during the 1st year of human life, defining posture, breathing stereotype and functional joint centration from a “neurodevelopmental” paradigm. The treatment approach is based on reflex locomotion principles and ontogenetic postural locomotor patterns. The primary goal of this treatment approach is to optimize distribution of internal forces of the muscles acting on each segment of the spine and/or any other joint.
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