Physical modalities in the treatment of neurological dysfunction.

OBJECTIVE

This chapter presents modalities of physical therapy used in optimizing sensorimotor recovery from nervous system injury.

METHODS

A brief historical perspective, rationale, indications for application, and evidence of effectiveness of various physical treatment modalities is provided.

RESULTS

Many of the facilitatory and inhibitory techniques used in the past are no longer used, as they were based on an understanding of recovery after nervous system injury that is now outdated. There has been a paradigm shift in the management of people with neurological dysfunction. In particular there has been a reduction in focus on the positive features or the upper motor neuron syndrome, such as spasticity, and an increasing emphasis on active, task-related practice of functional tasks.

CONCLUSION

Physical therapy for people with neurological disorders has undergone a paradigm shift as a result of new knowledge about motor control, skill acquisition, and recovery of function after injury. Future research should address new applications of electrical stimulation and whole body vibration as well as the optimal dosage and timing of interventions.