0002ae

General chapter

BASIC RULES

OF AN

ACTION COURES

Myofunktional Exercise  Collection

Application:

ZOOM

This chapter does not describe a special exercise but the diverse possibilities to assemble exercises to form a therapy concept.

This organisation concept should be applied throughout the complete therapy including the recall. For definition: TIMING characterises the “Chronological Coordination” and as this term is a bit lengthy, TIMING stands for the whole matter.

Its particulars are outlined in the adjoining illustration and in the chapter TIMING.

Generally terms as Sequence or Frequency which belong to the phrase TIMING are used to describe how the exercises should be practiced as through these details the training effect can be effectively  influenced and intensified.

Contents:

Through the arrangement within the course of one training session as well as in the total therapy course an exercise can be given quite different effective powers. Furthermore it can be set up through a pre-exercise, counterpointed by another exercise or reinforced by a supplementary exercise.

Its continuance or the number of repetitions is adjusted to the progress of therapy – at first introduced slowly, with respect to the development employed  intensively concentrating on certain main points or scaled back, later on abolished, replaced by a more advanced one or recommended for a long-term continuation. Certain exercises (the most effective application) are especially suitable to be incorporated besides the sessions prescribed into the individual daily routine.

Materials:

Exercise specific.

Procedure:

- Previous exercises:

As such would serve exercises which quasi serve as the fundament for the actual exercise. Seen in the long term it would be those exercises which put the target area in a state required for the actual exercise. In the short term that would, for example, be easing, stretching or sensory exercises which are directing the attention of the patient on the target area or the claimed muscle action.

-Starting Position:

Predominantly an appropriate   unstrained stand-by position  (BASIC-POSITION) and positioning of the upper body, neck, head, mandible, tongue and extrinsic orofacial musculature should be desirable. This should as well be the position the patient will reassume normally between the exercises.

- Step-by-step-Description:

The step sequence in the timing represents the arrangement concerning time, quantity, frequency and succession of the exercises in the training session.

The training session fundamentally consists of several training phases which are separated against each other by breaks, the rest phases. A training session lasting one hour may indeed be stated long-standing.

The Training Phase starts with the beginning of the execution of one exercise on from the starting position.

As well a pre-exercise may, practiced within the session, represent a consistent phase in itself. The term ‘pre-exercise’ as well refers to contents having been dealt with in precedent sessions.

A Training Phase may well be taken up by one single continuous exercise. This might well be a less demanding endurance exercise as, foe example, o Hold-exercise in the kind of RING LOCKER. It would be difficult to determine a length of time for one Phase as it, again, depends on the stamina and resilience of the special patient. As an average it may be termed as lasting about five to fifteen minutes.

Normally a Phase will be composed of several exercises which will be performed one after the other according to the therapy plan.  As mentioned previously the composition of such an arrangement requires a diligent planning (concept) by the therapist.

This then will result in the compilation of a specific Training Series.

The Series normally consists of a chain of Sequences. Where should the exercise Sequence be positioned within the Series? Is it suitable for the start, should it be stressed through this positioning?

As well a Series can be built up by linking up several execution of the same exercise with short breaks (“back to the starting position and immediate repetition”).

While the mentioned stationary phase, the break, will have a duration of some minutes and is serving as a regeneration an interruption is only marking the end of a Training Sequence.

The Training Sequence is representing the actual exercise. It may occupy about one minute and is followed by an interruption leading over to the next Sequence.

At this point the before mentioned crucially significant arrangement is taking effect:

If the Series will be dominated by one exercise several Sequences of it will be linked together.

In a static exercise as, for example, the Hold- or Stretching Exercise off from the starting position the desired position is taken up; after counting to (perhaps) twenty there is a return to the starting position. In the immediately following second Sequence again the practicing position is taken up, counted until twenty and gone back to the starting position. This will be repeated as often as the prescription specifies. Thus the Series may include three, five or ten repetitions of the sequence.

A variation would be to build up the Series out of several Sequences of one and the same exercise carried out in a different practicing mode. The above mentioned (static) mode was characterised by holding the training position while counting. In contrast taking up the position, immediate return to the start, immediate taking in the position, immediate return etc.  might be required whereas every action is counted.

In this case nit the length of holding the position but the changing serves as the counting measure with five, ten or twenty counts.

The practicing mode prescribes the beat, the Sequence is ‘tacted’. As, in this case, the speed is the determinant a frequency per time unit is resulting, about once per second or the like. Carried out in such way are kinetic in contrary to the above mentioned static ones.

As practical example we might look at the ,O’-EXERCISE.

The static application is prescribed with taking up the ,O’-position and holding it while counting to ten.

For the purpose of kinetic practicing the ,O’-position is gained for a moment and returned to the start – action – start and so forth.

If, now, the same exercise is linked up by Sequences for a Series with the two above described execution modes alternating this is a CHANGING EXERCISE. To build up an ALTERNATIVE EXERCISE different exercises are linked together as the ,O’-EXERCISE changing with the contra-acting WIDE GRIN.

A kinetic Series would in that case show the follow-up

-1. Sequence: Ten times ,O’ to and fro

-2. Sequence: Ten times WIDE GRIN to and fro

-3. Sequence: Ten times ,O’ to and fro.

This makes a Series of two alternating Move-exercises.

As a static Series would be formed if the above cited exercises would be prescribed now in the static (Hold-) mode as an ALTERNATIVE EXERCISE.

A third way to vary would be the change from a static to a kinetic exercise.

This will result in a broad range of variation within one Series.

A choice should be led by the consideration which objective the chosen arrangement should meet. It is a matter of fact that through there TIMING the exercises will achieve quite different effects.

An especially effective but complicated way of changing is gained if this change takes place within one Sequence. Here the sequence is put together from movements (for example contra-acting like above) which are carried out in a certain beat resulting in a Frequency like (for example) ,O’ > WIDE GRIN > ,O’ > WIDE GRIN and so on, in intervals of one second, about ten times repetition, then end of the Sequence.

This carry-out would be beneficial for improving Mobility, Motility, Coordination and Concentration.

-Timing: The timing individually depends on the concentrativeness and exercise capacity of the patient.

Within the discussion of the ‘Timing in the Exercise Arrangement’ finally the sensible arrangement in an Increase-Series or –Chain  should be pointed out:

First of all it is obvious to raise the Sequence running time (count to ten, twenty…) or the Frequency rate (ten times, twenty times).

As well exercises may be strung together requiring a more and more strong or differentiated muscle action (see particulars in the chapter INCREASE-ARRANGEMENT).

Characteristics:

All criteria, depending upon the individual arrangement.

Remarks:

Maximum precision enables maximum therapy success.

Extremely useful the timing will be for establishing the exercise succession. This applies as well for the single session respectively Training Phase as for the total therapy course. Furthermore the Timing is of quite some importance in the course of  escort motivation (see: Thiele, E.: Myofunktionelle Therapie in der Anwendung, Heidelberg 1992, Hüthig Buch Verlag, ISBN 3830401841, Band 2. ) as well as the didactic setup of a session which may be outlined as follows:

SESSION COURSE

1. control the exercise learnt,

2. study the new exercise,

3. schedule the training plan for the time till next 

   session.

It should be advised against accomplishing the therapy “off hand “ without Timing, so to speak conceptless. Though required through the therapeutic and cost schedule but less reasonable it seems to appoint the total number of all sessions from the therapy start. Frequently will arise a changed, new situation which has to be regarded by the therapy.

How important a correct time scheduling really is shows a further aspect of Timing:

Of crucial importance for the therapeutic success is the practicing besides the office sessions.

If the patient is burdened with tasks which are asking too much of the patient it might be the inducement for a general negative attitude a so for the failure of the treatment. (Not the MFT is inapt but – in such cases – the effecting.)

A child in the preschool age can indeed be encouraged to keep three times a day or even more often the allotted practicing time, especially if a caring relative is lending support.

If it might seem obvious that besides the training sessions there will no help be available for the child (in many cases this lack might even have been the cause for the problem) the therapist should place the focal point on the common training sessions.

For schoolkids the observance of the allotted practicing training times in the morning, at noon and in the evening seems to be unrealistic as the morning start for school generally happens under pressure of time.

For adults the precisely prescribed daily schedule mostly ends in frustration as “the daily routine business simply leaves no time”.

Subjectively however the patient gets into an additional stress situation caused by the therapist which, then, may lead to a give-up. (Frequently stress even may have been the cause for the establishing of the dysfunction).

Adult patients do need decision freedom and continuity motivation  (Thiele, E.: Myofunktionelle Therapie in der Anwendung, Heidelberg 1992, Hüthig Buch Verlag, ISBN 3830401841 Band 2.).

This requires exercises which can be integrated into the daily routine without greater problems:

WORDEXERCISES during the newspaper reading, RING LOCKER while watching TV, exercises during the drive, at the work station, alongside the morning freshen up, at dinner.

Such an integration of the MFT into the daily routine should be due for all patients at least during the final phase of therapy and the follow-up; instead of the former awkward dyshabits now valuable exercises will have to get habits.

Such specific personal attributions, reconciliations and adaptations for exercises and practicing times in the training course are long-standing practice in the tutoring for uprating in sports medicine.

The tasks in MFT effectively are similar except for the athletes try to get beyond their physiological frame while MFT is anxious to establish, fill in and reinforce it.

In either cases, though, the personal contribution is the basic.

Discussion:

See remarks above.