Methods

More is Possible, 25.03.2024

Introduction

Spinal cord injuries (SCI) and paralysis can significantly impact an individual's quality of life and motor function. In the quest for effective rehabilitation, Activity-based Therapy (ABT) has emerged as a promising approach. ABT is designed to promote neuromuscular recovery, enhance neuroplasticity, reduce secondary complications, and ultimately improve the quality of life for those facing these challenges.

Program Objectives of ABT

Promote Neuromuscular Recovery

ABT targets the affected areas of the body to promote neuromuscular recovery. It does so through various components, but one crucial element is "Closed Chain Exercises." These exercises place the muscles in a weight-bearing position, stimulating neural pathways and facilitating the reorganization of the nervous system. This approach helps in closing the loop of signals between the brain and lower extremities, creating controlled movements.

Increase Neuroplasticity

Neuroplasticity, the brain's ability to adapt and rewire itself, is a key focus of ABT. Through repetitive movements and activities, ABT fosters the reorganization of motor patterns. A technique known as "Manual Sensorimotor Stimulation (MSS)" involves manual manipulation of affected body parts, engaging clients in visualizing movements, and assisting or resisting. This repetitive stimulation contributes to neuroplasticity, a cornerstone in regaining lost function.

Reduce Secondary Complications

Individuals with SCI are prone to secondary complications like osteoporosis due to reduced stress on bones. Incorporating "Loadbearing" into ABT is essential to combat this. Loadbearing not only maintains bone health but also stabilizes joints and provides sensory and motor function feedback. Standing more frequently helps improve circulation and minimizes the chances of osteopenia and osteoporosis.

Improve Quality of Life

ABT plays a significant role in enhancing the quality of life by increasing sensory and motor function. The core of this method lies in "Trunk/Core Strengthening." A strong core is fundamental for postural stability and everyday function. Improved core strength results in better stability, posture, and the ability to propel oneself, whether in a wheelchair or while walking.

Components of the ABT Program

Closed Chain Exercises

Closed chain exercises are integral to ABT, as they simulate weight-bearing positions. By applying pressure to the feet with the hands, ABT creates controlled movement, which serves as a vital neural stimulant and allows for the training of postural stabilizers and the neuromuscular system.

Manual Sensorimotor Stimulation (MSS)

MSS involves the manual manipulation of affected body parts, promoting repetitive movements and visualization. This technique fosters the reorganization of motor patterns and facilitates improved sensory and motor function.

Developmental Position Activities (DPA)

DPA employs a range of postural positions, from lying prone to standing, which challenges the musculoskeletal structure and stimulates the nervous system uniquely. These positions serve as a foundation for other exercises and movements in ABT.

Loadbearing

Loadbearing, an essential component of ABT, is crucial for bone health, joint stability, and providing sensory feedback. It helps individuals adapt to vertical positions, thereby improving circulation and minimizing the risk of osteopenia and osteoporosis.

Trunk/Core Strengthening

Strong core muscles, a focus in ABT, are essential for postural stability, affecting stability, and overall function. A robust core provides a solid foundation for connecting with the rest of the body.

Balance Training

ABT places a significant emphasis on balance training. Whether in seated or standing positions, improved balance enhances functional recovery by allowing individuals to focus on better movements.

Gait and Pre-Gait Patterning

ABT addresses the complexity of walking by working on gait patterns in both static and dynamic positions. This approach aims to restore mobility and functional independence.

Extremity Strengthening

Optimizing the strength and function of existing neuromuscular connections is pivotal in ABT. This component benefits activities of daily living and often serves as a catalyst for regaining function elsewhere.

Conclusion

Activity-based Therapy (ABT) has emerged as a comprehensive and holistic approach to spinal cord injury rehabilitation. By targeting neuromuscular recovery, enhancing neuroplasticity, reducing secondary complications, and improving the quality of life, ABT offers hope to individuals affected by SCI and paralysis. Its diverse program components provide a multifaceted strategy for addressing the complex challenges posed by these conditions. As research in this field continues to advance, ABT stands as a promising pathway towards improved functional recovery and overall well-being for those living with spinal cord injuries.

Useful links 

This video features Eric Harness, a pioneer in Activity-Based Therapy since the 1990s. He explains the history and purpose of Activity-Based Therapy.

https://youtu.be/ALSLdUz0H_I?si=UFXd4MOyEcCaKbg5