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Desired PRI Clinical Application for Integrated Gait Progression Activities: Facilitating Right Brachial Inhale and Left Brachial Exhale During Left Stance.

Josh Olinick emailed this document titled “Desired PRI Clinical Application for Integrated Gait Progression Activities: Facilitating Right Brachial Inhale and Left Brachial Exhale During Left Stance”. Ron and I had a chance to go through this with Josh, and we love what he has put together. Ron is looking forward to discussing this document further at the Advanced Integration course in December!

Foreword from Josh:

I should start with the disclaimer that this was not my idea.  I was talking with James Anderson a few years back and he suggested that I try taking the article he wrote on left AIC inhibition/ delay and modify for the brachial chains.  I took a quick stab at it then, but wasn’t really happy with what I had come up with.  At that time, I was over loaded by opening a new clinic and couldn’t commit the time needed, but the idea kept running around in my head.  I had some time this year to write it out.  I think what makes the Myokin content more easily understandable is that a human is either in right stance or left stance, and they are either in a Left AIC pattern or a Right AIC pattern (without compensations like a PEC).  But the brachial chains seemed more complicated to me because they were more directly related to phase of respiration.  Bramble and Carrier showed that humans differ from other animals in that they can take up to 6 steps per breath while running.  This suggests that respiratory influence on the AIC and stance phase is more easily overridden than in the brachial chain.  So rather than focusing on individual chain inhibitory musculature like James did in his article, I decided to take a step back and consider what a patient in a right brachial chain pattern needs during Left stance in a Right AIC pattern.  Well, the easy answer that is taught in the Postural Respiration course is “Right Trunk Rotation”.  The thing I kept running into though is that position of the trunk is dynamic during stance phase and that respiratory phase is independent of that.  The more complete answer I came to is that in early left stance the right trunk needs to be more open (sooner) to reduce “listing” onto the left LE, thus the right chest wall needs to have a more inhaled state.  Whereas in late left stance, the left trunk needs to remain closed (longer) to allow a right heel contact without premature compression of the Right rib cage (i.e. keeping the left rib cage exhaled longer).  This idea is similar to James’ work on inhibition and delay in that the patient needs to get their left ZOA sooner (while the right upper trunk is rotated to the left) and keep it longer (while the right upper trunk is rotating towards the right – regardless of phase of breathing).  Hopefully this can help others in activity choice during different phases of their patients plan of care!

Read the article HERE.

Posted June 16, 2017 at 6:13PM

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