Integration Of Panat Into The Rehabilitation Process - PANat Urias Johnstone User Manual

Integration of PANat into the rehabilitation process

Integrating PANat into the rehabilitation process will incorporate patient centered goals
and use task specific strategies to minimize compensatory movements that occur during
functional activity. This is achieved by maintaining muscle flexibility and extensibility,
strengthening weak muscles, stimulating muscle activity in a functional context and
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increasing sensory stimulation .
The aim of training is to promote the quality and quantity of activities with the
hemiparetic limbs, in uni- /bi-lateral and bimanual movements whilst preventing
detrimental compensatory strategies. The choice of activity in the training session is
based on the impairments that constrain the patient from performing or completing a
task.
Exercises are performed with an increasing number of repetitions within a well
structured and mostly closed environment. Variability is introduced into the training plan
by changing the complexity of each task, altering the speed and/or the support surface,
adjusting the lever effect with air splints or other therapy tools and introducing cognitive
elements: e.g. dual tasking.
The appropriate choice and use of air splints and therapy tools may be used to reduce
the complexity of multi-joint movements by limiting the ´degree of freedom of
[20]
movement´ of the joint during a specific activity. They promote selective motor
control of the affected limb in a meaningful task and provide opportunities for repetition
and high intensity training in either individual or group sessions. Finding a balance
between ´hands-on´ and ´hands-off´ practice or self-directed training can improve the
patient's ability to problem-solve.
The patient's goal and performance must be re-evaluated regularly and the therapeutic
interventions modified to ensure they maximise their rehabilitation potential.
Air splints and other therapy tools can be used in all phases of rehabilitation from the
acute stage to that of long term management. The emphasis within the training
programme will vary from prevention and treatment of adaptive changes to mobilization
and recruitment of muscle activity.
Sensory-motor deficits respond slowly to change, but the task and the setting can be
structured in a learning environment to stimulate muscle groups needed to accomplish
the planned activity.
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© Rights reserved PANat 2009, revised 02/2015, version 2017