Main Stages in the Development of Kinesitherapy (Lecture)

Abstract

The authors present their own views on the development of therapeutic gymnastics methods for the rehabilitation of motor neurological disorders. The long and ambiguous process of physical therapy evolution from the use of passive movements to modern kinesitherapy based on the laws of neurophysiology is described. It took more than half a century for the elementary passive gymnastics,originally used in the treatment of motor neurological disorders, to become modern kinesitherapy. The gradual accumulation of clinical experience and scientific knowledge made it possible to first introduce empirically found methods of excitation of some paretic muscles into rehabilitation practice, and then supply them with methods of including individual parts of the body in the motor activity due to the forced contraction of adjacent surviving muscle groups. The Soviet physiologists had developed functional systems doctrine and the concept of voluntary movements multilevel organization based on inborn and acquired motor programs. This investigation helped to understand that the skillful use of preserved motor abilities is the key to successful reconstruction of the basic functions, as well as every day and working skills (reflexes, synkinesis, mechanical coordination and reactive forces). In this case, the process of voluntary movement development is always associated with the patient’s volitional inhibition ability. So, it possible to counton impaired functions compensation in a reduced form long before the complete mobilization of all components of the movement. In chronological order, a critical review of several well-known kinesitherapy techniques is given (sisters Kenny, G. Kabat, S. Brunnström,spouses Bobat, etc.).