Neurological Teaching Centre

“Even Patients with CNS Lesions have Joints!” What role do joints play in the motor programme and therefore in the treatment of the neurological patient? It is known that the CNS is only interested in reaching a goal but we have to consider the proprioceptive input, the CNS is dependent on. The vestibulospinal tract and spino-cerebellar tracts can show us that the information from the Joint mechanoreceptors is important. Joints are the stable reference partner and therefore the orientation for the muscle. It is not the Osteokinematic but it is the Athrokinematic that gives the muscle the orientation. The muscle activity therefore depends on the position and mobility of the joints. When we treat we should remember that under all structures the skeleton with all its joints is the weight-bearing pillar we have to move. Our patients show us different pictures of pathological tonus. The hypotonic patients show very often the joints are in a wrong position taken out of the neutral alignment. At the same time hypertonic patients joints may be stiff and decentralised with a loss of sliding during a movement. The research can show us that a joint that is not stable or stiff will influence the activity of the muscle. Known as AMI (athrogenic muscle inhibition). Heidi Sinz is a German tutor who is both a Senior tutor teaching courses internationally in Manual Therapy and an Advanced tutor in the International Bobath Instructors Training Association (IBITA). She has developed a course where she helps therapists in the Neurological field make clinical links with the Musculoskeletal field and vice versa.