MANIPULATION EXERCISE

Myofunktional Exercise  Collect ion

Application:

no illustration

This chapter gives a general description of a collective group of exercises and details which are sharing the here described facts. 

MANIPULATION EXERCISES is like what a spotter in gymnastics does when helping the sportsman during his training, an aid, a spotter’s aid. Here it is used to help the target musculature with an external handling to fill in its physiological movement frame which, through its disorder, it is bursting or misses insufficiently  by non-fulfilment.

Contents:

Manipulation is an aid. Mostly it is executed by the therapist (spotter) during a training session (hetero manipulation). But it, as well, can be taught the patient as a “self-made” action (self manipulation) with which he is acting without foreign aid or, in a wider sense, is helped by some means or matters (instrumental manipulation).

Manipulation, Thus, can be executed manually or instrumentally. It can help in the therapy starting state mentally or at motor skills to gain the target envisaged and later on – mainly by the use of feedback stimuli – to keep up to the level. In the course of therapy it should better make itself dispensable.

Materials:

‘Spotting’ for a movement with the hands, with every items carried, held, self or strange guided for training purposes as well, as equipment or utensils (about this also see notes in “Discussion”).

Procedure:

- Previous exercises: In a certain sense MANIPULATION EXERCISES are pre-exercises by themselves. A pre-exercise to a manipulation could be seen in the preparation of a sensitive patient to tolerate the touch, the item, the external influence.

-Starting position/ Step-by-step-Description:

 A defined starting position will mostly be required to place the manipulation in a correct way. It will be learned by the patient quite as the step sequence and is respectively exercise specific.

-Timing: Exercise specific, positioning in the starting phase of an exercise. Towards the end of the training phase within the general course the manipulation should get replaced by Sensitation and Orientation.

Characteristics:

Manipulation

Remarks:

In principle manipulation may be seen as nonphysiological – it is not planned in the physiological movement sequence. This is, why, as said, it should be abandoned as early as possible.

There surely are exercises which might be abandoned out of the reasons mentioned. Some, as the cited TAP-TAP through which with a manual guidance of the mandible – and only by this – a relaxation (RELAXATION EXERCISES) of the Adductors will be maintained and the resulting relaxed feeling mediated to the patient is scarcely replaceable.

Moreover the motivating effect should not be underrated. Many manipulations are lending the exercise a note of playfulness as, for example, the fun and enthusiasm of young patients with the exercise ‘TUG-OF-WAR’.

It is the demand to weigh the disadvantage of the non-functionality in the exercise against the advantages in therapy success.

When classifying exercises with aiding matters or handlings the manipulation has to be distinguished against the pseudo-manipulation. For the latter equally  matters or materials is used purposefully in the exercise which, however, is also of use in the physiological function ( as, for example, the sucking tablet):

Discussion:

MANIPULATION EXERCISES are in the original sense rather physiotherapeutic then functiontherapeutic, no functional exercises, for the therapy of muscle functions, though, not dispensable. A good, purely functional exercise is much more reasonable and to be given preference in choice.

To this the following example:

With the exercises TOUCH-THE-BUTTON

 and  ,1-2-3’-EXERCISE the initial phase of the deglutition reflex is to be habituated.

While the Elastic doubtlessly interferes with the ‘normal’ physiology of the oral cavity the adjusting of the patient to the BUTTON, the Incisal Papilla, is physiological and lies within the physiological frame, if it, then, succeeds without the monitoring through the Elastic, without the error feedback through the shifting from its correct position /posture for the tongue tip.

In the appendix a list summarises all exercises which are executed connected with manipulation in any way.

Instructions:

LIST OF EXERCISES

(exercise  / manipulation)