Motor Control.
Motor control is fancy terminology for basically saying that you can control your muscles' contractions and when they happen. Having the control to perform a muscular contraction is critical especially during something like standing and walking. In the patient with neuromotor control, the brain signals the muscles to contract, they do as they are told, and send a signal back to the brain of how strong and when the contraction occurred. This improves later contractions to make them more accurate. Now, imagine the patient whose brain and muscles are not able to signal each other. Now the muscle is not able to contract appropriately and the brain is not getting an accurate signal for how to improve the next contraction. Fortunately, through treatment such as electrical and controlled contractions, brain reorganization can help to improve motor control.
Functional Electrical Stimulation (FES)
Electrical stimulation is very helpful at creating contractions - so long as there is an electrical signal still traveling through the nerve you mean to stimulate. Functional electrical stimulation is more specific in that it sends a signal to activate the muscle at a specific time during a functional activity. For instance, during ambulation for a patient with foot drop, FES can fire the dorsiflexors and plantarflexors to normalize gait pattern. Studies have shown long-term improvement in dorsiflexion strength, decreasing plantarflexion spasticity, and lower extremity motor function with use of FES. |
Neuromuscular Electrical Stimulation (NMES)
While NMES can be used for retraining of muscles, it can also be used to reduce pain. In fact, one study found that NMES applied to a contracted wrist had a significant decrease in pain up to 36 weeks. Most studies focus on the effect of NMES on motor control improvements as well as spasticity reduction. It has been shown that applying NMES to the supraspinatus and deltoid, muscular control can reduce shoulder subluxations. |
Isometric Contractions
Isometric contractions are controlled contractions. To perform this contraction, you simply maintain the contraction for a specified period of time against a steady resistance. This type of contraction can help the patient focus on the movement itself and the muscles that need to be contracted. There are various types of isometric contractions that can also be useful in stabilizing a weakened but active muscle. |
Mental Imagery
No doubt the mind is our most powerful weapon. It can make or break your performance of a task. It can help you control or exacerbate your pain. It can help you recover or leave you further debilitated. The practice of mental imagery is an extremely powerful tool for most patients in that it can stimulate muscle activation and control pain. Though the jury may still be out on the effectiveness of this technique, a possible placebo effect cannot be questioned. |