Isometrics for performance

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It can be quite a challenge to decrease pain at the level of the patellar tendon. Eccentric exercises have been proposed yet they can be painful. Read more

Pain and posture

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If you sit back and read most of what is coming out of the literature, it seems that there is no link between posture and pain. Then again, some (1) have demonstrated that there is at least a correlation between pain and posture. These same authors were also able to show a correlation between a postural asymmetry and medication consumption as well as the necessity to stop daily activities. Read more

Balance and ADHD

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What has already been reported is that balance function is worse in ADHD children than in their normal peers. The studied reviewed here (https://www.ncbi.nlm.nih.gov/pubmed/28238393) was designed to asses the effects of balance exercises on the cognitive performance of children with both ADHD and vestibular impairment.

33 children suffering from severe vestibular impairment were randomly assigned to two groups that were matched for age. Some of the children concerned performed balance, gait and eye movement exercises. The other group of children did not. It was twice a week, for 12 weeks that the chosen children performed the selected exercises.

Specific cognitive tests such as choice reaction time (CRT) and spatial working memory (SWM) were utilized to test for cognitive abilities for both groups.

As far as the CRT test goes, the children who performed the exercises performed significantly better than the children that did not.

Generally speaking, this study illustrates that vestibular rehabilitation can improve cognition.

When looking at the brain pathways involved, it can make sense to think that when the body is lacking balance, it can be harder to recruit brain areas specialized in tasks that relate to cognition. In essence, the body’s number one concern is survival. To secure body stability is primary.

To be… to walk

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Locomotion is one of the most thoroughly studied behaviors in the animal kingdom. It is Mahler, a psychoanalyst that has stated that the onset of voluntary locomotion represents the “psychological birth” of infants.

The acquisition of crawling (typically the first locomotor skill) dramatically changes the relation between the infant and the environment. It is from this point on that the infant can find challenges and problems to solve. The infant can explore the environment and operate at will (Gibson, 1988).

Exploration thus provides new perspectives and it creates novel experiences that can drive changes in a family of different psychological phenomena.

So how is fear management and gait development possibly related?

Experience with locomotion seems to be a factor in the onset of weariness of heights.

Mothers notice two interesting phenomena related to drop offs.

First, there is a period after the onset of crawling when their infants would plunge over the edge of a bed, off the top of a changing table, or even off the top of a staircase if she were not extremely vigilant.

Second, within 2 to 4 weeks of crawling onset, infants will avoid drop offs. These maternal reports are highly consistent (Campos et al., 1978).

Although perception of self-movement has traditionally been relegated to information from the vestibular and the somatosensory systems, visual proprioception is so powerful that a standing 13-month-old infant will fall down when exposed to optic flow in a moving room (Lee and Aronson, 1974).

Visual proprioception is a powerful source of information for postural stability and instability.

When the infant moves voluntarily, the head and eyes consistently point straight ahead (Higgins et al., 1996). As this takes place, when the infant navigates the world, it becomes important to segregate information about environmental features from information about self-movement so as to steer an appropriate course and maintain postural stability.

How we have learned to walk seems to be at the core of how we developed, as a whole. It is by learning locomotion that we have had to face challenges and mange fear. Could it be that, if we did not crawl and walk on all four, we could be less equipped to face the challenges of the day?

Motricity and neuropsychiatry

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The goal of the study reviewed here was investigate how motor function and perception relate to measures of ADHD (Attention-Deficit/Hyperactivity Disorder), ASD (Autism Spectrum Disorder) and CD (Conduct Disorder).

Children with ASD and ADHD have been shown to have high rates of motor and perception difficulties in controlled studies.

Before ADHD ever was ADHD, in the 1980’s, Gillberg and Gillberg (1) introduced the concept of Deficits in Attention, Motor Control and Perception (DAMP) to describe the coexistence/co morbidity of ADHD and motor and/or perception problems, later often subsumed under the label of Developmental Coordination Disorder (DCD).

It is several Swedish studies that have shown that about half of all children with ADHD also meet the criteria for DCD and that these children have poorer outcomes than those with either ADHD without DCD.

CD is very common among children with ADHD (2) and not uncommon among children with ASD (3).

In the context of the Child and Adolescent Twin Study in Sweden (CATSS), ADHD, ASD and CD caseness was associated with much higher rates of DCD and Perception disorder caseness. CD caseness in itself was not associated with DCD or Perception problems.

Children born prematurely have been shown to have a higher frequency of motor delays and motor difficulties than children born full term.

Omitting prematurely born children from the analysis strengthens that association between perceptual problems and ASD caseness. This shows that strong correlations between caseness for ADHD and ASD.

This study is probably the largest study ever performed on the relationship between symptoms relating to commonly diagnosed problems in child and adolescent psychiatry – ADHD, ASD, and CD – and motor control and perception problems – commonly encountered but often not separately diagnosed, either as DCD or under any other label.

Cerebellar function is of importance for motor function and seems to be of importance in ASD as well as in ADHD (4) (5).

Considering that the major source of input to the cerebellum arises from the muscle spindles of postural muscles, could it be that it’s time to make links between posture, motor performance and learning/behavioural challenges?

1) Gillberg IC, Gillberg C. Children with deficits in attention, motor control and perception (DAMP): need for specialist treatment. Acta Paediatr Scand. 1988;77:450–451. doi: 10.1111/j.1651-2227.1988.tb10678.x.

2) Spencer TJ, Biederman J, Mick E. Attention-deficit/hyperactivity disorder: diagnosis, lifespan, comorbidities, and neurobiology. Ambul Pediatr. 2007;7(Suppl 1):73–81.

3) Anckarsäter H, Larson T, Hansson SL, Carlström E, Ståhlberg O, Gillberg CI, Råstam M, Gillberg C, Lichtenstein P. Child neurodevelopmental and behavioural problems are intercorrelated and dimensionally distributed in the general population. Open Psychiatr J. 2008;2:5–11. doi: 10.2174/1874354400802010005.

4) Rogers TD, McKimm E, Dickson PE, Goldowitz D, Blaha CD, Mittleman G. Is autism a disease of the cerebellum? An integration of clinical and pre-clinical research. Front Syst Neurosci. 2013;7:15. e-pub ahead of print.

5) Fatemi SH, Aldinger KA, Ashwood P, Bauman ML, Blaha CD, Blatt GJ, Chauhan A, Chauhan V, Dager SR, Dickson PE, Estes AM, Goldowitz D, Heck DH, Kemper TL, King BH, Martin LA, Millen KJ, Mittleman G, Mosconi MW, Persico AM, Sweeney JA, Webb SJ, Welsh JP, Schneider M, von Gontard A. Consensus paper: pathological role of the cerebellum in autism. Cerebellum. 2012;11:777–807. doi: 10.1007/s12311-012-0355-9.

 

 

Lordosis and degeneration

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Even if there is evidence that not all individuals with degenerative joint disease (DJD) suffer, one can safely admit that DJD is associated with chronic low back pain. Read more

Forward head posture and vitality

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Forward head posture (FHP) has been a hot topic in the field of physical therapy and performance training. According to most practitioners that base their work on the evidence, it seems that it would not matter so much how forward the head can be on anyone’s shoulders in terms of pain or function. Read more

Dyslexia: what is possible

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In France, we account for 2 dyslexic children per class. Dyslexia is a difficulty with regards to the alphabet, reading, writing and spelling, despite an intelligence that is average or superior to average and regardless of teaching methods and a positive influence on a socio-cultural level. If some believe it is of genetic origin and hereditary, others think we can fix it.

Read more

Of Stress and Balance

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Could it be that if you weren’t so keen on cartwheels as a kid, you could have a propensity to be feeling stressed out as an adult? It could be difficult to stipulate this for sure but there are some interesting links between our balance (vestibular) system and the stress response.

To start off, there is evidence from animal studies indicates that vestibular symptoms are effective in activating the stress response, and that the acute stress response is important in promoting changes in how both the vestibular system and the cerebellum function as a unit.

In the context of vestibular lesions, for example, evidence from animal studies has demonstrated neural pathways linking the vestibular nuclei with the limbic system including the hypothalamus and that stress responses evoked by vestibular symptoms promote synaptic and neuronal plasticity in the vestibular system.

Dagilas et al. (2005) investigated the stress response evoked by vestibular stimulation in healthy volunteers by measuring serum cortisol levels at the point of maximal nystagmus while undergoing caloric stimulation (vestibular stimulation). Cortisol levels were actually found to be significantly elevated above resting levels.

In a preceding detailed study, Kohl demonstrated that cross-angular rotatory vestibular stimulation potently stimulated ACTH, noradrenaline, and adrenaline secretion, in a pattern consistent with a vestibular-evoked stress response.

Human imaging and behavioral studies suggest the hippocampus may be an important center for vestibular compensation. Increased physical activity has been shown in animals to affect brain morphology by promoting neurogenesis of the hippocampus and vestibular exercises and the promotion of physical activity in general may have similar effects in humans.

There are a few neuroanatomical reasons why these realities can be observed. In particular, the nucleus tractus solitarii have extensive relationships with the vestibular nuclei both via direct projections and indirectly through the parabrachial nucleus, which provides a major input into the limbic system.

Balance is an interesting concept to begin with and it only gets better when you read the word and see all of its meanings. It can be even more exciting to actually have a profound effect on how an individual gains balance in order to improve their quality of life. That’s what the combination of Posturology and Functional Neurology is all about!

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3406321/

Of kyphosis, anxiety, depression and aggression

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Many believe that there is a connection between the body and the mind. Some set out to study to what extent that could be the case. Researchers Moslehi, Saiiari and Marashiyan have done just that. With the use of a specific anxiety questionnaire, the Beck Depression Inventory (BDI) as well as the Eysenck Aggression Inventory (EAI), they looked for associations with kyphosis abnormalities. Read more