Rehab of Primitive Reflexes Influencing Movement & Motor Behavior: Helping people move better!

 We are doing a Primitive Reflex Inhibition course in Calgary, Alberta, Canada on Nov 25-27, 2022 (half day Friday afternoon). Get in touch for more information: SMARTERehab@gmail.com

It is too simple - if you have a problem with movement - go back to when you learned how to move!

Primitive reflexes techniques are gentle and easy to use strategies you can take right away into your clinic to start influencing numerous aspects of motor behavior (see below).

Course Description

Movement is a foundation of physiotherapy rehabilitation. A sub group of patients have very poor coordination and this can interfere with traditional rehab (e.g., eloquently termed "motor morons" in Canada). Other patients just seem to have tightness in muscles that does not go way. While others have little movement with too much joint protection. This can be due to retained primitive reflexes.

Primitive reflexes are brain stem-mediated, complex automatic movement patterns that commence in utero. If PR are present they will influence normal motor control and can interfere with normal rehabilitation.

There are numerous causes of PR being present in neurologically intact adults (e.g., atypical birth history or developmental milestones especially walking and crawling; concussion). Numerous conditions are known to have retained primitive reflexes (e.g., ADHD, Developmental Coordination Disorder, dyslexia, addictions, scoliosis, DM, chronic LBP, chronic WAD, post concussion syndrome, chronic shoulder pain, stroke, TBI).

The treatment of primitive reflexes can be used clinically in different ways to :

• reduce individual muscle tone in chronically short muscles (e.g., hamstrings, gastrocnemius)
• increase range of motion (e.g., upper cervical flexion, glenohumeral joint medial rotation)
• improve general coordination (e.g., clumsiness, proprioception, postural stability)
• target specific problems (e.g., toe walkers, some torticollis)
• facilitate pelvic floor rehab (e.g., pelvic floor asymmetry)
• improve motor imagery (e.g., midline and musculoskeletal body image deficits)
• normalize muscle tone (e.g., stroke)

During this course we will cover the assessment and rehabilitation of primitive reflexes in detail. Strategies for treatment in the clinic and home exercise will be covered.  Specific examples will be used to show how primitive reflex inhibition can immediately improve movement and motor behavior.

The course material has other uses for neurology, concussion, pediatrics and in helping regular clients learn exercises more quickly.

There are no pre-requisites for this course

Interested in hosting a course? Get in touch: SMARTERehab@gmail.com

Testimonials

"This course is a game changer. Sean continues to push physiotherapists to think beyond the standard orthopedic model, incorporating neurological, neuro-developmental, functional medicine and original research into a model that answers so many questions regarding each patient's unique pain experience. His midline and musculoskeletal body image work is revolutionary" "Finally, I have a way to treat motor morons"  Brent Lewis Physiotherapist, Moncton NB, Canada

 “I can't recommend Sean Gibbons and Smarterehab courses enough. I have found the sub-classification system to be easy to use and revolutionary in removing a lot of the guesswork in my patient management. The courses have been transformative in my practice in that it has wide applicability across a spectrum of conditions that would normally constitute ‘difficult’ patients. I can't recommend these courses highly enough! Chris Barber MCSP BSc (Hons). Musculoskeletal & Sports Physiotherapist, Director: Advanced Physiotherapy Centres Ltd.

"As a clinic owner and have seen a trend in Canadian physiotherapy towards spinal manipulation and needling techniques. While these techniques are valuable, the transformative learning that takes place in a SMARTERehab course is the direction I am dedicated to bringing our profession. As Physiotherapists, if we wish to distinguish ourselves from chiropractors, massage therapists, athletic therapists, osteopaths etc., we need to move away from technique based therapy. Sean is masterful at explaining the complex relationship between Central Sensitization, Central Pain, Sensori-Motor Function and how it relates to Motor Control dysfunction and pain. No other approach I have seen, heard of, or even read about does such a complete job of integrating neurological rehabilitation techniques and treatment. I now have junior therapists who are able to reason their way through the most complex of chronic pain cases and can formulate treatment plans that are effective and get results. Most importantly they can explain to these patients the nature of their problem in a way that they can understand. It is so rewarding to see patients, empowered with this knowledge, resolve problems that have sometimes existed for decades. Equally as rewarding is watching a junior Physio quickly solve by identifying the underlying movement dysfunction and easily explaining its cause. Thank you for what you have done and continue to do for our Profession". Dave Holmes. Owner and Physiotherapist at Tower Physiotherapy & Sports Medicine

"If you find yourself stuck and frustrated with chronic, generalized, weird pain patients who don't respond to usual treatments, this is what this course is all about. Sean's courses are truly unique and bring practical, guidelines that are untouched by other institutions". Jean-Michel Cormier, Physiotherapist Max Health Institute, Shediac, NB, Canada

"The courses that I have taken with Sean have completely changed my pelvic floor practice and the way I practice as a physical therapist! Sean's courses are a must in order to help a variety of clientele and especially those who do not respond to conventional treatments! He has researched and developed new techniques that are essential for pelvic floor therapists". Erica Lafontant, pht, B. Sc, M.Sc.A Rééducation périnéale et (Pelvic Floor Physiotherapist). Action Physio. Ville Mont-Royal, QC,

"I have attended this course in the past and it has had a profound effect on my practice and so made a great impact on my patients outcomes. Lots to learn , makes sense and is easily applied in practise, sing up and you will not be disappointed." Pam Bagot MSc HCPC MCSP. Paediatric and Adult Neurological Physiotherapist - PamThePhysio.com

Facilitator

Sean Gibbons graduated from Manchester University in 1995. He has been rehabilitating motor control, movement patterns and chronic pain his whole career. He a clinician who does part time research. His research has been on who will respond to motor control exercise; the influence of cognitive deficits and learning difficulties; body imagery as a pain mechanism, cranial nerve injury in concussion, WAD and viral infections; and the influences of low grade systemic inflammation in musculoskeletal pain. His research fosters the use of Personalized Rehabilitation with the addition of further sub-classification categories and causation for each subgroup. He has presented his research at national and international conferences and has several journal publications and book chapters on related topics. He is an Assistant Clinical Professor (Adjunct) at McMaster's Advanced Orthopaedic Musculoskeletal / Manipulative Physiotherapy Specialization and previously lectured at Manchester Metropolitan University's Masters in Advanced Physiotherapy program.

Journal References

Gibbons SGT 2011 Neurocognitive and sensorimotor deficits represent an important sub-classification for musculoskeletal disorders – Central Nervous System Coordination. Journal of the Icelandic Physical Therapy Association. 38 (1): 10-12

Parfrey K, Gibbons SGT, Drinkwater EJ, Behm DG 2014 Head and limb position influence superficial EMG of abdominals during an abdominal hollowing exercise. BMC Musculoskeletal Disorders. 15:52. DOI: 10.1186/1471-2474-15-52

Abstract References

Gibbons SGT 2011 Neurocognitive and sensorimotor deficits represent an important sub-group for whiplash associated disorders. Fifth International Whiplash Trauma Congress. Aug 24-28; Lund, Sweden. J Rehabil Med 2011; Suppl 50: 23

Gibbons SGT 2009 Cognitive learning and sensorimotor function provide a protective effect from disability in low back pain. Manual Therapy. 14 (S1): S30

Gibbons SGT 2009 Neurological soft signs are present more often and to a greater extent in adults with chronic low back pain with cognitive learning deficits. Manual Therapy. 14 (S1): S20

Gibbons SGT 2008 Retraining of asymmetry in recruitment of transversus abdominis. Orthopaedic Division Review. March/April: 29-34

Primitive Reflex Related Posts

https://smarterehab.blogspot.com/2020/02/lets-be-clear-neurological-soft-signs.html

https://smarterehab.blogspot.com/2019/12/wy-should-all-physiotherapists-be.html

https://smarterehab.blogspot.com/2016/11/why-does-replicating-primitive-reflex.html

https://smarterehab.blogspot.com/2019/09/if-you-can-do-muscle-energy-technique.html

https://smarterehab.blogspot.com/2016/11/symmetrical-tonic-neck-reflex-new-look.html

https://smarterehab.blogspot.com/2016/11/is-functional-hallux-limitis-sign-of.html

https://smarterehab.blogspot.com/2016/11/is-idiopathic-toe-walking-caused-by.html

 https://www.linkedin.com/pulse/primitive-reflex-inhibition-improves-body-image-two-point-gibbons

https://www.linkedin.com/pulse/understanding-movement-why-does-replicating-reflex-inhibit-gibbons

 

 

Primitive Reflexes Influencing Movement & Motor Control - How to Help Patients Move Better

Course Description

Movement is a foundation of physiotherapy rehabilitation. A sub group of patients have very poor coordination and this interferes with traditional rehab (e.g. eloquently termed "motor morons" in Canada). Other patients just seem to have tightness in muscles that does not go way. This is frequently due to a retained primitive reflexes.

Primitive reflex inhibition are very gentle and easy to use strategies that can be applied right away in the clinic.

Primitive reflexes (PR) are brain stem-mediated, complex automatic movement patterns that commence in utero.  If PR are present they will influence normal motor control and can interfere with normal rehabilitation. 

There are numerous causes of PR being present in neurologically intact adults (e.g. atypical birth history or developmental milestones - especially walking and crawling; concussion). Numerous conditions are known to have retained primitive reflexes (e.g. ADHD, Developmental Coordination Disorder, dyslexia, addictions, scoliosis, DM, chronic LBP, chronic WAD, post concussion syndrome, chronic shoulder pain, stroke, head injury).

The treatment of primitive reflexes can be used clinically in different ways to :

 ·         reduce individual muscle tone in chronically short muscles (e.g. hamstrings, gastrocnemius)

 ·         increase range of motion (e.g. upper cervical flexion, glenohumeral joint medial rotation)

 ·         improve general coordination (e.g. clumsiness, proprioception, postural stability)

 ·         target specific problems (e.g. toe walkers, some torticollis)

 ·         facilitate pelvic floor rehab (e.g. pelvic floor asymmetry)

 ·         improve motor imagery (e.g. midline and musculoskeletal body image deficits)

·         normalize muscle tone (e.g. stroke)

During this two day course we will cover the assessment and rehabilitation of PR in detail. Strategies for treatment in the clinic and home exercise will be covered.  Specific examples will be used to show how primitive reflex inhibition can immediately improve movement and motor control. This course all practical apart from a brief introduction and summary.

The course material has other uses for neurology, concussion, pediatrics and in helping regular clients learn exercises more quickly.

There are no pre-requisites for this course

If you are interested in hosting or taking a course please feel free to email. stabilityphysio@gmail.com

"Overly Complicated Treatments" Are Not Overly Complicated When Sub-classified for Neurocognitive and Sensory Motor Function

 I keep hearing on social media about "overly complicated treatments". I also keep hearing most of the same people promoting "simple" interventions and "keeping it simple". 

I would like to make a few points.

• Most of the same neurocognitive skill sets that are required to truly benefit from pain neuroscience education and treatments to reduce fear are the same as those for motor skill learning (e.g. attention, working memory). Why aren't these called "overly complicated"?
  
• When you subgroup people for neurocognitive function, suddenly there are no overly complicated treatments. Sure there is a small challenge and this is useful for neuroplasticity. 
• Pain is not simple. A simple intervention will most often provide basic results. This means either small treatment effects, or it will not alter the trajectory of the presentation. Musculoskeletal pain can present with a wide variety of Motor, Sensory, Behavioral, Psychological, Soft Neurological, Neuro-Immune-Sympathetic-Endocrine dysfunction.
  

There are many reasons for reduced neurocognitive function e.g.

• neurodevelopmental disorders
• learning difficulties
• neuro-inflammation / low grade inflammation
• endocrine dysregulation
• autonomic dysregulation
  
• post concussion syndrome
• atypical birth history
• major surgery as an infant
  

Education level is not very useful. There are too many false positives and negatives. It is not uncommon to see patients with higher education who have problems learning. This can also happen in the physiotherapy profession.

A patient who presents with low back pain could also have a wide variety of other relevant presentations

• developmental coordination disorder (with habitual use of end range spinal movements and poor sensory motor function)
  
• asthma
• irritable bowel syndrome
• sensory hypersensitivity 
• high blood pressure
• chronic sinusitis
  

Will a simple strengthening intervention sort this person out? No, but neither will a motor control based intervention. 

Simple doesn't have to mean strengthening. Neurological based interventions such as primitive reflex inhibition or postural reflex facilitation are also simple. These can be combined with basic neuromuscular interventions.

References

https://www.researchgate.net/publication/262912623_Neurocognitive_and_sensorimotor_deficits_represent_an_important_sub-classification_for_musculoskeletal_disorders_-_Central_Nervous_System_Coordination

https://www.researchgate.net/publication/339363667_O27_The_development_initial_reliability_and_construct_validity_of_the_motor_control_abilities_questionnaire

The Complexity of Musculoskeletal Pain Cannot be Addressed by Strengthening

Chronic low back is complex. It is associated with a variety of Behavioral Factors, Motor Changes, Sensorimotor Changes, Altered Body Image, Brain Changes; Neurocognitive Deficits, Co-morbidities, and NICE (Neuro-immune, Cardiometabilic, Endocrine) changes.

The central nervous system must simultaneously regulate spinal control, continence and respiratory function. There are also complex interactions with educational level, socioeconomic status, ACE (Adverse Childhood Experiences- without specific behavioral manifestations), atypical birth histories and early life development. 

There are also huge variability in motor skill learning ability, neural efficiency, brain competition, and probably a lesser extent, exercise induced analgesia,

Add this to the influences of previous injuries (asymptomatic), and neurodevelopmental disorders (e.g. ADHD, DCD). 

Plus the unknown influences of cross modal plasticity, synesthesia, atypical handedness and bifocals/trifocals.

Then we have the individuality of beliefs, readiness to change, lifestyle factors, therapeutic relationship and loading factors. 

Lets not forget the non-modifiable factors (e.g. age, gender, ethnicity, genetics, anthropometrics). 

The only way to address chronic low back pain is through individualized approaches. A multi-dimensional sub-classification model can guide this. 

There are many of the above combinations of presentations that simply do not respond to isolated strengthening, get worse with isolated strengthening or have minimal improvement. There is likely a subgroup that does respond to isolated strengthening, but there are no strong predictor variables. 

So simply "getting strong" is wrong (sometimes, or has minimal benefit). Certainly it should not be a focus of rehab. Sure, it can come later if required. 

Undergraduate degree; Physiotherapy degree; maybe a post graduate degree; countless hours of continuing education. Physiotherapists aren't personal trainers.

We have so much more to offer and can do better than just strengthening.

 

 

n stem reflexes

Is one screening tool enough to identify the diverse spectrum of behavioral factors that may influence a poor outcome in musculoskeletal pain?

Reference as:
Gibbons SGT (2019) Is one screening tool enough to identify the diverse spectrum of behavioral factors that may influence a poor outcome in musculoskeletal pain? Proceedings of: The 10th Interdisciplinary World Congress on Low Back Pain. October 28-31, 2019; Antwerp, Brussels

General Comment: A battery of ultra brief screens may be a way forward for screening the diverse array of behavioral presentations that present in chronic musculoskeletal pain. Current screens have limited diagnostic accuracy. This project was a feasibility study.

Introduction
Behavioral factors are known to predict a poor outcome from acute low back pain (LBP) and are associated with chronic LBP. The psychiatric and pain literature note many behavioral conditions that are associated with chronic pain. There are behavioral conditions that are not commonly recommended in screening since they are often co-morbid with other conditions that are screened. This screening approach has potential problems. First, the screening of only one behavioral condition will lower the accuracy of the screening since other relevant conditions may be missed. Second, it is not well understood how outcome is affected if multiple behavioral conditions are present. Third, the treatment for one behavioral condition is different from combinations of behavioral conditions.

Purpose/Aim
The purpose of this paper was to identify the percentage of patents that score above the cut off point on a battery of behavioral screening tools.

Materials and Methods
A clinical audit was performed on 485 patient charts: 223 LBP (85 acute/138 chronic); 118 whiplash associated disorders (WAD) (37 acute/ 81 chronic); 63 neck pain (11 acute/ 52 chronic); 81 peripheral regions. The following behavioral factors were assessed using a battery of previously validated short questionnaires with cut off points. Category 1 included: anxiety (2 items); kinesiophobia (1 item); catastrophication / recovery expectation (1 item); ); stress (2 items); post traumatic stress disorder (4 items). Category 2 included: depression (2 items); hopelessness (1 item). Category 3 included: self esteem (1 item); body appreciation (2 items). Category 4 included personality disorders (8 items). Category 5 included social factors (2 items). A category was considered positive if any one score for any condition was recorded above the suggested cut off score. Descriptive statistics were used. Standard practice was to assess outcome with a 7 point Global Rating of Change scale; Numerical Rating Scale for pain, function with the Patient Specific Functional Scale and a disability questionnaire related to the body region: Roland Morris Disability Questionnaire; Neck Disability Index.

Results
The questionnaire took under 10 minutes to complete. Missing values were under 2%. A poor outcome was considered not improving beyond the minimal clinically important change (MCIC) on any domain using evidence based interventions. A poor outcome was found in 68% (1 category positive; n=12); 82% (2 categories positive; n=17); 92% (3 categories positive; n=26); 100% (4 categories positive; n=23).

Conclusion(s)
This clinical audit suggests that a variety of behavioral factors present with musculoskeletal pain. As well, scores above the recommended cut off point suggested cut off values for multiple categories of behavioral factors may be more predictive of outcome than 1. There is a clear need to understand how the interaction of psychiatric conditions in different categories influences the response to different therapies. Using multiple short questionnaires appears to be feasible. Further research is needed to test the reliability of the items used as a whole and to control for subejct's co-treatments and exposures in a larger sample.

Keywords
Low back pain, whiplash associated disorders, psychosocial factors, outcome, screening, Sub-classification

Transversus and Multifidus rehab does help a subgroup of low back pain. The case is not closed!

This type of rehabilitation is heavily criticized. There are numerous reasons for this such as the non functional nature of the exercises and the results of results of systemic reviews. 

I have over a dozen systematic reviews and or meta-analysis in my personal library. In general the results say that these specific motor control stability exercises (SMCSE) are better than no / minimal intervention, but not better than other active interventions. 

I have done one systematic review as part of the course work for my PhD (see reference below) and I have updated it for my thesis. 

 https://www.researchgate.net/publication/339362910_Specific_Motor_Control_Exercise_for_Lumbo-pelvic_Pain_of_Articular_Origin_A_Systematic_Review

First, there is evidence  to support these exercises when a subgroup of non specific low back is used (when there is evidence of articular related low back pain). I guess this could be argued that it isn't actually "non-specific low back pain", but that's a separate discussion. Only one of all these systematic reviews did actually bother to separately look at "more specific" low back pain. 

Second, there are actually conflicting results in these reviews. This is when short term outcomes are compared, and when meta-analyses are considered.

Thirdly, there is considerable difficulty in analyzing these studies and putting them into groups (e.g. specific exercise on its own or + other intervention (active and or passive, and or education). Comparison groups are quite variable (active intervention, passive intervention, education, combinations of  etc). This highlights the problem of the lack of a standard therapy for research use.

The "pundits" will state that the supporters of SMCSE will cry about "the exercises weren't done right". Is this an issue? Well, when I lectured to a group of MSc students on the UK (who were all meant to be very experienced), only one actually knew how to palpate a contraction of an exercise biased for transversus abdominus. This is actually worse than normal when I give lectures. In general, between 40% - 50% of clinicians do not know how to do this. Some of these people are physiotherapy specialists and a few even teach continuing education courses. There are a lot of professional issues here of course. As echoed in the literature, it takes a high degree of skill by the therapist to know how to properly implement SMCSE.

I have no idea of course how this equates to the exercises used in clinical trials. Certainly the instructions used in many seem suspect. This highlights the need for standardized instructions and reporting in exercises used in clinical trials. 

There is also a considerable body of evidence to support the rationale for the use of SMCSE which tends to be forgotten and misrepresented. Too often, some of the early research is quoted and misrepresented.

Let's not forget, there are of course numerous agendas, biases and other issues related to this topic. So no, the case is not closed. In fact, with the current evidence SMCSE are not guilty and in fact play a role in the rehabilitation of articular related low back pain. 

We know who to use the exercises with and we have preliminary evidence to predict who will respond.

Rule in:

• Articular related low back pain
• Good motor skill learning (assessed with the Motor Control Abilities Questionnaire)https://www.researchgate.net/publication/339363667_O27_The_development_initial_reliability_and_construct_validity_of_the_motor_control_abilities_questionnaire?_

Rule out:

• Behavioral Factors
• Non mechanical pain
• Chronic Low Grade Systemic Inflammation https://www.researchgate.net/publication/339127713_Are_co-morbid_medical_symptoms_associated_with_poor_response_to_sub-classification_based_management_of_chronic_low_back_pain_A_retrospective_case-control_study

So we need a clinical trial with articular related low back pain due to similar causes and compared to an exercise intervention that does not cognitively alter or control movement.

If You Rehabilitate Movement You Should Know About Primitive Reflexes

Primitive Reflexes influencing Motor Control & Motor Skill Learning. Come Learn! 

It's so logical why isn't it part of mainstream rehab?

If someone isn't moving well, rehab the strategies in which they learned how to originally move.

Primitive reflexes are essentially what guides infantile movements. They are very easy to rehab. Just low effort resistance in the correct patterns of the reflex.

What do we know about primitive reflexes for musculoskeletal pain?

• Having PR interferes with normal motor control and coordination
• Having PR interferes with learning motor control exercise or normal movement
• PR inhibition helps normal motor control and movement
• PR inhibition helps postural stability and balance
• PR inhibition helps neurocognitive function
• PR inhibition helps body image
• PR are stimulated by a sensory stimulus. Most are vestibular related and some are tactile

This course is suitable for orthopaedic, paediatric, neurological, pelvic floor and vestibular physiotherapists

Course Description

Some questions beg answers

How do you rehab someone with poor coordination?

Why does the brain move the body in a harmful way?

Why do some people never regain full ROM?

This course will answer these questions & more!

Primitive reflexes (PR) are brain stem-mediated, complex automatic movement patterns that commence in utero.  If PR persist beyond their average lifespan they may begin to interfere with normal movement, motor control and brain development. They present in a variety of conditions relevant to you such as MSK pain, concussion, atypical handedness / birth, early-late walking.

The presence of PR will influence motor control and can interfere with normal rehabilitation. 

During this two day course we will cover the assessment and rehabilitation of primitive reflexes in detail.  Strategies for treatment in the clinic and home exercise will be discussed. You will be able to immediately improve movement and motor control in your patients.

Specific examples of what PR can be used to improve highly common clinical problems including:

• Grasp reflex for shoulder upper limb coordination and glenohumeral medial rotation ROM

• Babinski and Foot Tendon Guard for lower limb & gait coordination, and dorsiflexion ROM

• Asymmetrical Tonic Neck & Abdominal Reflexes for abdominal hollowing, & trunk coordination

• Landau for hamstrings and trunk tone

The traditional view that PR are inhibited by normal movement is limited. The cognitive replication, rather than reproduction of PR inhibits them. PR are highly effective at rehabilitating normal movement, and neurocognitive function. 

Course Objectives:

The participant will be equipped to:

• Use primitive reflexes to rehab patients with very poor coordination & motor skill  learning

• Understand the role of primitive reflexes in pain, cognitive function and motor control.

•  Assess and rehabilitate primitive reflexes in children and adults

• Implement a home exercise program for primitive reflex inhibition

• Use primitive reflex inhibition strategies to improve movement & motor control 

Testimonial

"This course is a game changer. Sean continues to push physiotherapists to think beyond the standard orthopedic model, incorporating neurological, neuro-developmental, functional medicine and original research into a model that answers so many questions regarding each patient's unique pain experience. His midline and musculoskeletal body image work is revolutionary"

"Finally, I have a way to treat motor morons"

Chris Barber Physiotherapist

"Finally, I have a way to treat motor morons"

"Movement changes so quickly - and maintains"

Chris Barber Physiotherapist

What will you get from this course that you may not already have?

A rehab option for "Motor Morons". Neurodevelopmental rehab works for these patients

Improve Muscle Tone & Motor Control

Learn how to use PR to reduce tone and muscle tightness, improve movement and coordination.

Stop Wasting Time: quickly rule out the people who have poor motor skill learning

Understand the role of Primitive Reflexes in pain, cognitive function and motor control.  This is also important for neurological rehab.

Concussion

Find out how to help rehab concussion with primitive reflexes

Pediatrics, Neuro, Vestibular, Pelvic Floor Physios

The same primitive reflex inhibition techniques can be used very effectively with these groups 

Regardless of how much knowledge you have you will benefit from knowing:

• Screening who has poor motor skill learning

• Strategies to rehab motor morons

• Which Postural and primitive reflexes to immediately change movement patterns and performance on  specific motor control exercise

Want to Learn?

Ottawa, Canada: March 6-8, 2020: Primitive Reflex & Motor Skill Learning

Barcelona, Spain: March 20-22, 2020: Primitive Reflex & Motor Skill Learning

Toronto, Canada: May 2-3: Body Image, Motor Skill Learning & Primitive Reflexes for Pelvic Health 

Warsaw, Poland: May 8-10: Primitive Reflexes

Warsaw, Poland: May 11-13: Body Image, Motor Skill Learning & Advanced Primitive Reflexes

Harrogate, UK: May 16-17: Body Image, Motor Skill Learning & Advanced Primitive Reflexes

Montreal, Canada: June 5-7: Body Image, Motor Skill Learning & Advanced Primitive Reflexes for Pelvic Health 

Milan, Italy: June 19-21: Advanced Concussion & Body Image

For more information email: stabilityphysio@gmail.com

visit: www.smarterehab.org

Primitive Reflex Related Posts

https://smarterehab.blogspot.com/2020/02/lets-be-clear-neurological-soft-signs.html

https://smarterehab.blogspot.com/2019/12/wy-should-all-physiotherapists-be.html

https://smarterehab.blogspot.com/2016/11/why-does-replicating-primitive-reflex.html

https://smarterehab.blogspot.com/2019/09/if-you-can-do-muscle-energy-technique.html

https://smarterehab.blogspot.com/2016/11/symmetrical-tonic-neck-reflex-new-look.html

https://smarterehab.blogspot.com/2016/11/is-functional-hallux-limitis-sign-of.html

https://smarterehab.blogspot.com/2016/11/is-idiopathic-toe-walking-caused-by.html

Testimonials

“I can't recommend Sean Gibbons and Smarterehab courses enough. I have found the sub-classification system to be easy to use and revolutionary in removing a lot of the guesswork in my patient management. The courses have been transformative in my practice in that it has wide applicability across a spectrum of conditions that would normally constitute ‘difficult’ patients. I can't recommend these courses highly enough! Chris Barber MCSP BSc (Hons) Musculoskeletal & Sports Physiotherapist, Director: Advanced Physiotherapy Centres Ltd.
As a clinic owner and have seen a trend in Canadian physiotherapy towards spinal manipulation and needling techniques. While these techniques are valuable, the transformative learning that takes place in a SmarteRehab course is the direction I am dedicated to bringing our profession. As Physiotherapists, if we wish to distinguish ourselves from chiropractors, massage therapists, athletic therapists, osteopaths etc., we need to move away from technique based therapy. Sean is masterful at explaining the complex relationship between Central Sensitization, Central Pain, Sensori-Motor Function and how it relates to Motor Control dysfunction and pain. No other approach I have seen, heard of, or even read about does such a complete job of integrating neurological rehabilitation techniques and treatment. I now have junior therapists who are able to reason their way through the most complex of chronic pain cases and can formulate treatment plans that are effective and get results. Most importantly they can explain to these patients the nature of their problem in a way that they can understand. It is so rewarding to see patients, empowered with this knowledge, resolve problems that have sometimes existed for decades. Equally as rewarding is watching a junior Physio quickly solve by identifying the underlying movement dysfunction and easily explaining it’s cause. Thank you for what you have done and continue to do for our Profession. Dave Holmes Owner and Physiotherapist at Tower Physiotherapy & Sports Medicine
If you find yourself stuck and frustrated with chronic, generalized, weird pain patients who don't respond to usual treatments, this is what this course is all about. Sean's courses are truly unique and bring practical, guidelines that are untouched by other institutions. Places are limited. Jean-Michel Cormier, Physiotherapist Max Health Institute, Shediac, NB, Canada
The courses that I have taken with Sean have completely changed my pelvic floor practice and the way I practice as a physical therapist! Sean's courses are a must in order to help a variety of clientele and especially those who do not respond to conventional treatments! He has researched and developed new techniques that are essential for pelvic floor therapists. Erica Lafontant, pht, B. Sc, M.Sc.A Rééducation périnéale et . Action Physio. Ville Mont-Royal, QC,

Sean Gibbons graduated from Manchester University in 1995. He has been rehabilitating movement patterns and chronic pain his whole career. His PhD was on the development of a prescriptive clinical prediction rule for specific motor control exercises in low back pain. Key new sub-classifications were identified: Neurological Factors, which are related to extremely poor movement and motor skill learning; Body Image & Body Image Pain; and Chronic Low Grade Systemic Inflammation which is the cause of most chronic disease. His current work aims to further validate the screening tools and understand the underlying causes of each subgroup. The importance of individual factors such as the therapeutic relationship and patient beliefs are also considered. His dissection and research into psoas major, gluteus maximus and other muscles has led to the development of new rehabilitation options. He has presented his research at national and international conferences and has several journal publications and book chapters on related topics. He is an Assistant Clinical Professor (Adjunct) at McMaster's Advanced Orthopaedic Musculoskeletal / Manipulative Physiotherapy Specialization and lectures at Manchester Metropolitan University's Masters in Advanced Physiotherapy program.