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INTRODUCTION

Approaches to intervention continually emerge as a result of the interface between theory and clinical problem solving. Creativity in intervention is the hallmark of the effective, dynamic clinician, who matches the client’s capabilities and needs to a management approach that will foster optimal quality of life and well-being. Although therapeutic intervention might include any combination of intervention approaches, therapeutic touch is one of a master therapist’s greatest gifts to a patient.

Cornerstone Concepts

  • □ Evolution of practice from theory

  • □ Historical roots viewed within the current perspective: reflex theory, hierarchical model, and dynamic systems approach

  • □ Approaches to intervention/frames of reference

  • □ Sensorimotor approaches: PNF, NDT, SI neuro-physiological approach, contributions from Brunnstrom

  • □ Task-oriented models: strategies used to perform functional tasks, age-related strategy changes, functional training approach (strategies to improve mobility, stability, controlled mobility, and skill)

  • □ Importance of person-centered functional goals

  • □ Integrated approach to intervention with patients with neurological dysfunction at any age

This text has presented first an overview of how the nervous system functions and how the systems that contribute to the production of human movement develop over the life span. The text further presented how movement control develops and changes over the life span and how motor learning is a dynamic process, giving human beings a unique ability to adapt to changing conditions, including not only normal age-related changes but also to the challenges presented by a neuropathological incident. This theoretical knowledge is essential for clinicians who are engaged in the very real and very dynamic business of helping to create a bridge between theoretical knowledge and available intervention options, as they engage in the practice of working with children and adults who are neurologically challenged.

Therapeutic approaches to intervention with individuals with neurological disorders have evolved over the past several decades since the birth of the professions of occupational therapy and physical therapy. These patient-centered rehabilitation professions of physical therapy and occupational therapy are dynamic, constantly building on an ever-growing body of neuroscience knowledge. Approaches to patient intervention or frames of reference naturally emerge and develop as the base of knowledge broadens. It is crucial that the treating clinician (therapist or therapist assistant) develop an ability to make sound clinical decisions in selecting from among these sometimes diverse approaches and interventions to offer the patient/client the best intervention approach possible. Furthermore, it is reasonable to expect that therapeutic approaches to intervention will continue to emerge, develop, and become refined. Critical thinking is a must for the contemporary clinician, who is charged with staying abreast of new knowledge and therefore innovative intervention opportunities, as they continually unfold.

Intervention approaches emerge as a result of the interface between theory and clinical problem solving. Therapists and assistants are encouraged to study the contributions from each approach and become eclectic in an approach to ...

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