I have this ongoing discussion with my clients what is more significant for their rehab. Let’s put it in simple example. Is it more important that someone can stand or take steps? I know the function, action is most desirable for my clients. They usually read it as progress, the improvement. However, for me, as a physio I view the whole picture to assess its quality. How stable you hold when you move your leg? Is your posture correct or do you appear to be comfortable when moving?
What are the stages of control?
I can formulate three main stages of control: sensory connection, stability and dynamic control. All of them will influence how well you can perform your task. Each of them has its significance and will be contributing to improvement of your execution.
First of all – the sensory connection
Detecting the sensation coming from the body part and its position can support your participation in the task. As they say, if you feel it, you can probably move it. When such communication is affected by an illness or trauma, therapists work to restore the ongoing sensory conversations occurring in your body. We use brushing, tapping, compression, hot and cold compresses and occasionally even electrical stimulation. All of it to evoke the nerves carrying on the messages to the brain and building ‘bridges’ over affected areas to stimulate recovery.
Second – the stable foundations
It is ability to hold the body part in an expected position against the gravity. It requires good sensory connection and muscle activation. You need to have a good ability to tighten muscles and hold the tension. It improves with practise and could be challenging at first. It is easier with one body part and it gets harder when you try to stabilise another one at the same time. Great example would be this image from my recent session, when spinal cord patient was training holding single leg in Crook lying. Ongoing practise allowed her to build the consistency and then we approached to holding two legs in the same position.
Single leg Crook lying 
Double leg Crook lying
The action time
Once you achieve ability to hold position – the movement is the next one. It is ability to move your body part in the desirable direction. It could be very small movements, but it is massive achievement. You need to feel your body, stabilise it and then make it move as you wish. Simple, but often quite hard. It gets easier with practise.
Whatever it is the handshake or your first steps, it is your stride to wellness.
