Arthrogenic muscle inhibition

[JuliPotter]

Dear Laurie,
I just reread your articles about arthrogenic muscle inhibition and I am wondering, what do you think about clicker training as a way to help treat AMI? Using the clicker to mark muscle contractions ,then the initiation of movement. I am wondering if this may help connect both the afferent and efferent neurons for the patient has to think about the movement. This adds a cortical component....

Were the studies suggesting that whole body vibration would be helpful as well for muscle activation?

I read this blog again because I have a geriatric patient who has L-S disease, spondylosis along with decreased flexibility and muscle atrophy along the lumbar spine, SIJ dysfunction and unilateral hip OA. There is muscle loss in all 4 limbs, the muscles are quite tense as well and occasionally she will knuckle on the left rear.

Thank you so much,
Juli

[lehughes]

Hey Juli,

Great questions and I am enjoying your thought processing.

So, the thought of clicker training is really interesting! I think you are likely on to something! It would be an alternate way to work "External focus of attention" and "neurocognitive training".
(PS for those reading this that don't know what we are talking about, here is a link to the blog that discusses this:
https://www.fourleg.com/Blog/394/Blog?b ... Inhibition )

Thank you for your brain power on this! Well done!

Okay... then to think of it as it pertains to your patient.
So the 'arthrogenic muscle inhibition' would apply to pain at a joint (i.e. the hip).
However, the lumbosacral issues would be causing more of a power outage. In which case, I'm not sure the cognitive / cortical aspects might not be make much of a difference if the messaging can't get through.

Oh, and I forgot to answer the part about the vibration. Yes, the research is showing that vibration does help with muscle activation. So, it can be useful for the neurogenic atrophy AND the arthrogenic muscle inhibition!

Thank you for your thoughts!

Cheers,

Laurie

[JuliPotter]

Laurie, Thank you so much! I truly love physiotherapy! I feel there is so much I still don't know and I try not to let this discourage me....I am just so grateful for you and Four Leg Rehab!!

I have also wondered about the benefit of clicker training, marking for muscle contractions, or any movement, for the IVDD dog. You mention that this might not help with L-S stenosis because the neural mechanism is not intact but I wonder if marking involuntary or reflexive movement could also be beneficial even if the nerves are not firing correctly....not sure how to explain it but I am thinking that it gives the patient cognitive control based on operant conditioning- any behavior that has been reinforced will be repeated!

I do have a few questions about equipment if you don't mind!
I am not trained in acupuncture but I have learned so much from Four Leg Rehab and your talks at the STAAR conference that I do tend to use acupressure quite a bit. For example, with the geriatric German Shephard, I do acupressure between the lumbar vertebrae. So I recently watched one of your training videos on conservative management of patellar luxation and you mentioned using the Tens Acupoint finder. I am just wondering how this works! Would using the Tens acupoint finder be more beneficial than using my finger? How does this differ from using IASTM? (you mention using IASTM to stimulate acupuncture points during your Gua Sha training video)? And how do you decide which Acupoint finder to purchase? They range in cost from $14-$150.00 online.

And....I recently purchased a vibration platform (was recommended for my son but I hope to use it at the clinic as well)! Yah! It's a Rumblex 4D Vibration Plate, but it is a bit confusing....this platform has 3 different movements, up and down, pulsation and lateral (side to side) and then you can combine the movements. So the information lists the Hz for each movement. The lateral or side to side movement only goes from 6.3 to 8.7 Hz but the pulsation ranges from 27-40 Hz. On your vibration platform training video, you mention that 20-35 Hz may be the best dose! do you know if this frequency is for the side to side movement or for the pulsations? I wonder if this varies by product? I wonder if you combine the side to side movement and the pulsation if you add the Hz together to determine the dose? When I looked at the Theraplate website, they say that the motion of their platform is circular but they do not mention the Hz used!
Thank you so much, Laurie!
Juli

[lehughes]

You could very well be onto something in regards to the clicker training and Neuro rehab. Why not? You won't know unless you try it. There is potential for sure!

Re: Acupuncture / pressure / acupoint stimulation...
Well, if we look at what happens, you can justify doing any type of stimulus to the acupoints. You could do a variety of types of stimulation. Needling can create a localized mini-inflammation that stimulates the body to respond. Poking, rubbing, creating an irritation could do the same. The Tens stimulus might have a different impact on the nervous system. Cupping or lifting the skin can have a different fascial impact.
Maybe throw the kitchen sink at it! A little of everything!
ooh, the point finders are a bit hit and miss with comfort. I have one that I bought back in the 90's. It's 80Hz and very comfortable. I have a cheapy one from Amazon that's 10Hz and it's a bit 'shocking'. So, honestly, it's a bit trial and error.

The vibration...
One study showed that it doesn't really matter if it's the up and down or the side to side. I think the pulsation is where you want to try to hit the 20 - 35 Hz.

Good luck! Have fun!

Cheers,
Laurie

[JuliPotter]

Thank you so much, Laurie!! You are the BEST!!
Juli

[JuliPotter]

Laurie, I wanted to share this with you for not only is this fascinating but this may provide some support for the use of clicker training to benefit the neurologic patient.
Here is a video about the use of the Feldenkrais method in helping an infant who was born with only 1/3 of her cerebellum. The story suggests that the body can teach the brain what it needs to know in order to heal!
https://www.youtube.com/watch?v=CNVw4ZISLMs

Here is the link for the Feldenkrais website - https://feldenkrais.com/about-the-feldenkrais-method/
The Feldenkrais method uses gentle movement to increase range of motion, improve flexibility, improve coordination and improve body awareness. I initially learned about this method from Alexandra Kurland, a horse trainer who uses these principles to improve balance and body awareness in horses.

Thank you so much for always inspiring me!
Merry Christmas to you and your family!
Juli

[lehughes]

Thank you! I will look into this!
I've heard of it, but never have taken any courses in Feldenkrais!
Merry Christmas to you as well!

Laurie