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235
General Chapter

REMINDER

Myofunktional Exercise Collect ion

Application:	no illustration
This chapter gives a general description of a collective group of exercises. Their shared feature: In general REMINDER -exercises are applied with all subconscious problems (see also notes in the paragraph "Discussion"). In a critical condition the REMINDER should address and activate the conscious mind. This is what all exercises summed up below have in common, the vehicles, though, the aim should be reached with differ in the described way.
Contents:
The creation of a mentally prepared exceptional situation provokes a positive or negative feed-back stimulus; see annotations as mentioned above and further in FEED-BACK-EXERCISE.
Materials:
Exercise specific; means for tuning in a feed-back perception.
Procedure:
- Previous exercises: In the respective pre-exercises the patient gets informed about the aim to be gained after the physiological frame conditions are created for Sensitivity, Orientation, Mobility/Motility and Tonicity.
- Step-by-step-Description: The procedure is exercise specific. The methods are applied in a way (see remarks about positive and negative stimulation in paragraph “Discussion”) that during or before the occurrence of the malfunction the ingrained nonphysiological process gets stopped and immediately carried out in the correct way.
-Timing: In general these methods can only then be applied when the neuro-muscular system in the target area is capable of or put in a position to meet the requirements. So in advance the necessary exercises will have to be carried out (see Pre-exercise). In particular the REMINDER will become dispensable through the therapy success. The timing assessment depends on the respective exercise.

Characteristics:

Sensory function, Aesthesia, Tactile Kinaesthesia, Sensitation, Orientation, Feed-back, Reflex Control, Motivation (for self monitoring), Information, frequently Manipulation.

Remarks:

See “Pre-Exercise”

Discussion:

Under the Term REMINDER quite different methods are listed which all pursue the objective to bridge the gap between conscious and unconscious.
The consciousness of the patients will have to be directed towards a specific (muscle) action being either worth learning or avoiding.
This will be managed in a sensory, aesthetic or tactile kinaesthetic manner. The signals are feed-back stimuli which either, in the positive case, indicate a correct muscle action, in the negative case a misconduct and, thus, influence a muscle action indirectly.
An example for a positive REMINDER would be the PLATELET-HOLDER.
Here the contact between lips and platelet signalises the success of the action – loosing the contact would switch on the conscious and the action gets corrected via this Feed-back stimulus in a control loop.

The example for a negative REMINDER, then, the TEETHCLICKING. Here the contact of the masticatory surfaces against each other signalises the action avoidable, the teeth pressing. The action will be corrected by this Feed-back stimulus via control loop.

The third possibility is applied to consciously monitor a not consciously guidable action as a reflex circuit and possible detect faults.
An example for this would be the LIPS OPEN.
during a deglutition exercise like in the ,1-2-3’-EXERCISE. The keeping open of the lips during deglutition is nonphysiological, so this activity gains the conscious to be “switched on”. The concentration of the patient is directed on the further proceedings of this action. He will thus control the proceedings which he will not be able to influence directly but, depending on the prescription, have the possibility to make corrections through the exercise instruction.
The mentioned unconscious problems, named after the English term ‘Habit’ or the French ‘Tic (Nerveuse) have been dealt with explicitly in Volume I and II (Thiele, E.: Myofunktionelle Therapie in der Anwendung. Hüthig Heidelberg).
These neuro-muscular disorders have their reflection on the physical side. The latter the patient mostly is aware of. For the therapist now it is an important duty in regard to the motivation to point out the connection between the unaware disorder and the impairment the patient has become aware of.
To these REMINDERs are also counted the MNEMONICs which are dealt with in a special chapter. They meet the requirements to direct the unconscious to the action to be accomplished and serve as a temporary useful or indispensible aid and must supersede themselves in the course of treatment as they are nonphysiological in their nature – which just is what gives them their potency.

This fact might give cause for categorizing the feed-back stimuli into physiological and nonphysiological ones.
So the stimulus in the exercise PLATELET-HOLDER would be in fact required but undesirable – a MNEMONIC. The TEETHCLICKING again would in deed be physiological but in the special case of pressing a signal for an unwanted action.