The Halliwick Method (pmror.m) By Dr Fran Stanatand Joban Lambech
disobililiesfior wouldbe kno*n m rhe Europebeoon lo work w,A McMilon |o Aher his relurnhonr militoryduv in Hol|wictPhilosophy lFiguío rl Thisphi oppi rhe merhodwith therrclients. Thrr world wor [, JomesMcMillon l]913 - losophy@s bosedon Generolsystem loid Ée ÍoundorionÍor fieropeuricopplico- 1994)woseoger lo rerumeporl,c poiion in Thory {o pre-worhoLirtic opprooch lo llon. ThefieÍopeul,c opplicoton oÍthe Ten compêtiiiveswimmino. McMillon oLricllv monoqemqroÍoborl ond opeiorionolized Poinr Proorum wo5 de,eloDed in Bod reolizedrhor his odlimihd h s dbiir Ë wilhospects oÍ Íluidmechonics, neuropsy- Rosoz,S;izerlond ond collà rhe woter compeieH 5olhr;olive wos to helpyouth clology,psychology, pedosogy o"d sroup Specilic ExercisêSyslem or the Logic leornto eniovthe octiviv he so deorlv dynomi.s.The ÍesL,li wos o psychosen5ory Approoch to Exercisein lhe Woter l*"d. !" ïé beqon*oikinq wih laól ;obr leominssrrdr,esy collà rheHolli\"kl swimclubs. he r
Poges39.42 orè presênrêdby rhe Àquori<Íheropy & RehobInrrirure {AÍRt). Quesrioíi ó..onn6nrs doy hê dirêGredro ATRIor 45450 Cofioge Rów, Cholsêll,^ 4991ó; phone {90ó) 482-95@; íqx (9Oó)482.4388r ê-noil [email protected]êr ' ' AkwA )unê/ )Jt 2wl \ ,,t t The Halliwick Method cont.
Seond, fobiion dêvicesprcvide o folse ruchtocton os oqe. ohrii' ond/o, hrel oÍ restorotionbefore Éê stepsin mentolodop- seise ol securiryond overdependence. osrstoncerequlri. FinoÍ1y,M.Millon hod toiion hovebeen completed. For fiis rêo Flohtiondevicês slip, breok, be;me punc- o chectnq svitemÍo' tl,euse oÍoom* dnd 5on íudenls ore osigned to groups qnd turêd cdn inodverienilysuppod dn srolps È;r;orEd w,rho helpe;pro,tdins occordinglo lhen oquoticobililies. individuolfoce dow in Éê worêr o$iíonce, progresringio clenl ,ndepend- Fi'rolly, use oÍ froidion oids con hove o enceond crsiinq new sillolionstor inde negohveimpocr on psychoso 40 AKWA . )une/ )rV 2AOl The Halliwick Method cont. Èe pelvic oreo. The lnshuclorprovides lhe inshvciorinhoduces movemenl in lhe Íhe Halliwick Mêthad: WoteÍ Freêdan fol minrmolsuppor ond compleiesihe proces woterwi$ tuóuLenlgliding. The Íudênr, in lndividuak with Dhobilities Baak Ihis is ó cón- oÍ d,rengogemenlb/ e'entuo y lettinggo o supineposition, is possivelymoved pahênsive explonotion óí thê Hdlli||ick Method Once rhê siudentsore comlorlobe ond throughAe woterby Ae lnskuch)lwho oí swin instruction fot individrals wik disobili independentin the woter,they to ore oble producesturbulence under $e nudenb' ties. Papet $t5, Availobleon Co $15, lpdl móvêto b. dn.ê rêdórdnón shollder. Thisturbulence prod(s mow File/MS Wóá.MAC, prcgton sitê license hênt hiwórdihe iníru.lor Thèíudènt hust ovoiloble upan requdt). Aobn.e Restorqtion mointoino sri ond bolqncedbody position Available f@n: Aguo c Ca.s\hing Duringphose h\o, bo once resicrotion, (e.s., fie studentprcdlces no scu ins or Educotian Resoot.e Setvi.es, 7252 W. ifieswimmer lems lo conlrclrotoiion, Gogil- kickins).This step ollows Èe studentto Wobosh Avênuê, MilwoDkeê, W 53223 io],verticol, lolerol ond combinedlesrob kh *perience controlledmovement t{rough Aher Halliwick prcdrch ovoilable thrclgh poíurol contol and mosieru hrust. Sogiilolrotdlion is done in on uprighl positionbending Irom leftto righior hons- Iening weight. Verticolroloiion s!troonds lhelronsveBe oxis moving kom stondinglio Be.ket 8E Btóphysiólogi. A.peck of supineto slondingposilion Loierolroiotion Hydtotheópy, in Beckeí BE, Colê N lEds). oround the spine produceso horizontol Tbe next issue Canprchênsive Aq&tic The@py. Bostón, 3ó0" roll. Combinedroiorion, o combino- Bu tÍe I wo| |h-\e i nêno nn, | 9 97 on oÍfieveriicolond loterolrotolions in o ofAKWAuill Co J, Shepetd R Nêutó!ógicól horizonlolposillon, teoches fie conceplol continae the Rehobilj,ltion, A/inizing naturÍ pêíomance ","11",i "Í h",61. " Axíod, BuíeÍwa,th Heinenann, 1998, Finolly, the swimmer is loughi 60r Halliuich Metbod Crrninghon L tlolliwi.k Caócept,in Ruon buoyoncyis on upword thrustfiol hrings RG, Maítis DM, Colê AJ lEd..). Aquotic obiecrs ond people io rhe surfoce with tberapeutic Rehobilirotion.Philotlêlphio, Lippin.at, 1997. (McMilloncolled rhis lpfir!í or nenbl Horisan RA,Hilna M, BuktrcdeS. Laadlhg inversion).Ihe studenleorns io sobmerge application. ol the lower linb when wolking porriolly ond upon suÍocins, lsês one oÍ the roto innêBeà: inplicdtións ld clinicol p@ctice tion polierns lo ochieve o comÍorioble Physialhercpy, I 992 ; 78 : I ó+ I óó. LonbeckJ lEd). Neuophysiologi.ólbosis ?nÈ' lot oquotic thercpy: thaarcticol topics. fo.ilirorion Spakone, Constellote, | 99ó. Fo.ilibrion,which includessimple pro- Lonbe.k J . De tlolli||ick can epte,@hhther gresions movêmenh, ond basicswimmins opiê ih wólet en Nênmen wu gêhdntli.opten. is the Íino phose Ho iwickMethod. (ln oÍ KwíaaluigM NVOM. 1994 2: 5ï57. iheropeuiicl,êrms íocililoiion is iheobility hr MockinnonK. An e'otuotianal thebenelik initiolepurposeÍul movement.) Once turbu ol Hólliwick swimning on o chiltl with nild ledgliding k noslered,studenb ore ioughr spostic diplesio. APC.P. )aurnal 1997: simpleprosresions rhor enoble rndepend ent movêmênllhrough lhe woler Whie Mo in Íhe Halli|/ick Cancept. proqre$ionsmoy need b be clslomized J M.Milk" d.na,t trtg,".,tul nhEt\k,. Physiothènpy. | 98 | ó7: 288.29 1. Ior ioch srudentibosed on Íunctionoloblli i in ties,body composltionond symmetry)self McMillon J. Thê @le af Wotet Inhibirion propellins movemenisore usuolly some Rehobilibtian. fysiotercpeure. 1977; 45: 43- Inhibitionis the notion, pui Íorth by 4ó, 87-94, 23ó-244 "bolonce formoÍ scullinsond/or kickins. McMlllon,thot ls íillne$." lln Once comfortobe wiih independeni Moris DM. Aquatic Rehabilibtian of the theropeuticterms inhibllion is fie ohi ih/ ro movemeniin thewoier fie siudenlis reody Neutologically lnpaied Client, in Ruati RG, slopunwoiibd movemenl.) lt is dur;ngfiis lor moretrodiriono swimming movemenrs. Mótn DM, Cóle N lEds). Aquotic phosê lhol íudents procticemointoining While odo ,olionsmoy be ne.essoryii is Rehabilitation Philodêlphio, Lippincóí, 1997. posrurol bolonce ond conÍol. Siudênb the sool oÍ the Ho iwick prosromic p€ Nical K, SchnidtHahsbery M, McMillor J. o$ume o voíieryot posiiionsnond ng or pore studenislo swim in os noditionolo Bionechdnicol Ptin.iplês Applietl to the floo ng, wiih ihe níruchcrodd,is lu.bu Íoshion05 po$ible. whie iitle doro s Holliwi.k Cancêpt aí Teochins Swinnins to lence or loc le $imulotion designedio o'oilobe, here o.e on obundonceoÍclinl Phrically Handicopped lndividuok, in Iercds compromisethe studênis' obilit lo mqintoin col ohservoiionssuggesting thoi indi"iduols .1, Bedirgfield EW lEds.). Swinnirg lll o boloncedposition. Moíery is whenfie wiÈ disobiiiiesrouohr wifi $e Holliwick Conpóign,HumónKi nêtic s, 19 79 nudenrcon ochieveÍillne$ ' Merhod become independenrswimmere Reidconpian M. Hyd@lhercpy: Ptinciples Oncelhe studenl hos mostered íillnesí who uiilize trodilionolswimming strokes óhd Pío.ti.e Q'fad,BrtteNo í11êinendhn, ond con moinioinhorizonlol body positlon, (Lombsk,Shondo, Stonot). AKWA. )une/ )rV 2ao\ flfl - affY Ílldls Thellalliwicl Method= IncÍaleutic lrulication TH|s IsTHE SEcoNDPaFr OF aTwo PaRÍaRTrcLE. Bt,Dr Fran Stanat and Iohan Lanbeck lodc m0|lnci l0 H0fdro h tm [|a$r imnereedin the wrrer (weighdess),proprnr influencethe netacenter A body in watet filo í0{ohl lro0r ceplive inpul is compromnedand tone n has to nake the nccesary adjustmentsto 'làcrile The magicofthe Halliwick Method as .educed. inform*hn is enhanced causethe forcesofgravity and buoyan.y to a strategyfor teachiogswinming lies in the and an individual mav rely on primiive be equal and direcrl)- opposire óf each combination of facror (hyd'ody.a-i. reÍlexesto monitor and control movenent other, resuLtnrgin balance. Vhen these forcs, n*acner eflèas.ióertia abd prim; and po$ure. In Àe water, the primitile forccsare not equaland opposite,the body rive rerlexq)that enable*ud.nn t,' h-" t, reÍlexesare inertia patrns they can be wiil becomeunstable causing the body to conÍoi novemebt. This tefèrredrc as a urd o cau* novenrni'. Mdvillàn us.d continually strive ro reach balance. The psycho-senv,ry motor learoing prccess- rhese inertia patterns to e.hievr notion body uscsautomatic reacrionsto bálance Thn sane cónbida Jn offectors makesthe from a positn,n of *ability. INOTE: and stabilizeposture. In caseswhere los of Halliwick Mchorl an eflèaivetherapy tech- McMillan als, fountl rhat the eflect of balancecan nor be coord;natedwell, the nique. While mrny of rhesefactor have weighdesneson tonereducriorwas presenr body uses pattetns baed on primiÍive been widely discused in the literamre, tegrrdles of sarer temp.rarurc. He was ,eflexes'. Th*. reflexes coincide with 'thcrc McMiLlanconceptualized and exphinedthc ofren herrd saying is so such thing as inerria patrerdsand can block unwanted inpact ofseveralhydrodynanic torcesfron romrion and smbil;e posture. differentand nultiple framesofrcference. In order to undentand thc uscof incr McMillan usedvarious handling teh- McMilLu bdieved all of the lituaturc tia pattehs, it is inportànt to undcrsrard niques,rtubulence, water depth and tmtile on the thenpeutic benefits of buovàn.y, rheconcepr of thenetacerrer. Mcra(rrcris stimulation to disrupt the client'seqttilibri- especiallythe notion of weigh esnes. but r navai architectuni term used to describe un. Íhk disruption in equilibrium foic€s theorizedone addnional benefir: The reduc- the point aroundwhich the forcependulun the body to roll eusing individuals to "...tone tion in posturàltone. is influenced ofgravity and buoyancyrotate. Both forces continually acr ro balance rherí&lveb. 'Ihese bv proprióceptive input stimulated by are equally importrnt and influential with metrcnsic eÍïecrs acting in Éndeqr gravitationalforces. In other words,rone is snall changescausing imbalanc. The shrpe, with compronised proprioccptive ittirul function of weighC'. Vhen r penon is drnsity and symmetry of a body will also (brought about by TREATMENT ROTATIONAL STARTING ËxERCISE TREATIíENY HoDËtll"Ás oBJECTTVES(TO) PLANES (RP) POSTURE (SP) PATTERNS(XP) TECHNIQUES(TT) TREATMENT(Xtr) GWM() 2. ll1 Tll t. (,crc) PUe33042 e Dn*e[nd by[rG lqrrft ll|l]8Dyr ÍciaD hr{trrll onD. ficdimr 0r GonnflB n D! dlÍrclêdm [m ar |5150G0m00 mu, cl]r$!i, ll 19010; 0[! {900)182-9500! hx 19061482-1388, c{ l [email protected] VJ//í AKWA . Ausust/ Sêptêmb€r2001 t0 ltxt - alPI Íods require an individÍàl o reiy on primitive . reducepJn (-P) sn Í0 PGillo[t 6P) rcfldes rc moniror and conrol movement . rcducespadc;ry GSp) Siàrtingposirions are designed ro cause and/or ro relear! moveheDr. . increasenènÈl adaprabilityGMA). predeierninedbiomechmicál and hydrcdy -Ihe lrltuicl o$ t0uttic abbreviariomÍrrc usedÍ, dnelop Standingposirions are affectedby the Ilr!Í8llr Tld quc shor, srccin.t teatmerr plans. Once an wà1erdepth (wD) in which rhe cliert is At its mosr bàsi. level,thc rherapeuric a$e$menr has been cornplecd and rrear sranding. ceneràlly, clienrs sÉndirg in useof th€ Haliiwicl{ Merhod is the disrup- hent obicctives idenrificd, the rherapisr warcr àr T1l are neutràl {N}). Clienrs in tion of the netacentic fores causingan selecis rhc rpprcpriare rotarional plane, warcr àboveTll (N+) àre relarivelyDon individuàl b useprinitive reflexcsto leÍn Íe.ring posirión, exercisepàfterbs, rrear- weighr beàring, feel inceàsed efïec$ of o. rcleàrn posrural conrol, balànce and buoyàncy a.d menr rcchriques ind node of Íearmcnr. Leduced prop.ioceprive novernent. Thesedisruptions arc carefully irput. Balanceis diflicult and maintained INO'I Fl.:Fàcilitátion ofposrÍre ánd balancc asesscd,plánned ard execuredro àchiwe Nnh Íhe head and oursrretch€daÍms. As reacrionsis r verybroad obje.tive aDd appli the desired therapeuric eflèca. Halliwjck, o rhe water levd drops bclow Tl1 (N,), rhe " able ro nost ;ndividuàlswith neurologicrl an aquadctherapy rechnique, is a . . .clinical clienr erperiencesnrcreàsed wcighFbea!ing, impairrncnts.Cunrndy, therapistsusing the decisionnaking svsrcm' (Lambcck,2u00), reduced rffeas of buoyancy and nore Iogic Apprcach havc nÀrowed rhe |PBR which enàbl€sa rherapi$to choosebetween p!oprio.eptive iDpur. objecriveto indude $,ch inten$ assyrnme 10,000options ro producerhe desn d ouF A clasi. srarring posirion in $e try, disassóciat;on,ccnrnliza rn, reciprocrl "cul,e" .otue. The optionsare creÍed wirh conb; Hilliwick Method is rhe or siftins molion, ct.. (hmbeck, 2000)j. nationsof sir aspecrsof trcthenr plinnirg. positionar N+. The clienr basicJlyappears Theserpec* includc feàtmenr objectives, u if they are sirrins ar a able wirh arms rolalional plàne,smrring posirions,cxercise nohÍo[d PrlH||5 {[Pt slrerchedin frcn! on rhe table. Hips and pattems,trarmerr rcchniquesand mode of selecrionof rhc treÍ |(xarioml plane is knecsàre in 90' oíflcxion, back is srraight, treament. The aspecrsof reamrent crn bc bascdon the efeci of ihpairmenr dn the Íeerflar on the boÍon wirh feer and knees clicnts'body symmerrl logefi.r ànd aÍnrssrrerched our in fronr rhc Sagirtal rotario! enri.c length. The kneelingposnion is rhe stàrts1íirh rhc iidividual samcàs the'.ube exccprihe.lienr is resrirg fàcing rhe rhcràpist in a sitrins posirion (called ln the supineor backlying posirion, the cradlenr Halliwick or ar N+, rhe luhhar spiDeis in nrufal align- open saddlein wàtsuO). menr,hánds at the sidcor rpdt (depend- This posirior gives rhe ing on the anount of trunk srabilny), drentisr nàrimàl con- head ncuÍal or dishrly flexed. hips in trol to engagethe clienr neurral flerion with legs rogetherand lècr in sagirral rotlion. A client who is heniplegic lhc pron€ posirion or lronrJying position,ir N+, places màv herefir froh rhe rhelumbÀr end cer- vical spnre in àn exreDdedposiiion and is side-tl€xing activities ptuduced wirh sasiÍal t-rnbrh In thc obliqueposition, ar N+. rhebody Jabh kró;,s Hnllnnh rdÈtbn (sR) t0 à$isr is in neurralexrension, angling diagonally in wirh learning posru.e the ware. wirh the fèeron rhe boitón and righring rcactions when wirh the Íàcefloàdng ar rhe surface. ||utrctl otFcÍvc8fio) ;n thevcriicrl positio!. The purposeof the t.ogicApprcach to A clieDrwho hrs had a srroke(resuhiDg ÍrGniscPln0nt IXP) in henriplcgià) Excrcisein Èc \Xràteris ro cnáblean individ might bcgnr work in lrteral The cxcr.ise patrerns uscd in the (l.lu ual ro ihprove fun.donal abifties ob land. rodtn,n alons the lonsirudinàlaxis ro LogicalApproach ro Exe.cisenrdude syh- McMillan idenrifiedísen àr.is ktr obiec ficilitare posrureand balanccreactnns. meÍi.al, asymmeÍical, oos-larcral rnd rnd óàt an be cnhàn.edwirh the l-osic An individuJ sirh an crdopnxrhesis Approà.h ro È{crcis€ in rhc Wàter. lhc hip s,;rh mus.ular insmbiliryin rhe fiontal In symneffical,both sidesof thc body phne mighr work ;n kricrl nÍÍi,n (VlU àreperfo.mingar rhesàhe time. Vhenonly . rrcngrhcnweàk mullc groups Jlong dre (ànsve.seaxis ro rengthen weak one extrem;ryis pcrfoihing ir is ag.mmeÍi- G\íMC) nusclesroupsànd Èc nàrcposuie and bàl càl. C.osÍlareralparterns inrolve thc uppd . 'nd€aser.nge or norion GRM) cltrrtury oD oneside the low€.exÍcmity on . fdcilinre postuieand balàr.e A pcrsonwith scvcc spasricquadriple rhe opposire sidc perforhing an àcrivit),. rad;ons (FPBR) sia mighr work in combiDcdtuÈtm (CR) FnDIy, bilaterrl G.ne às s)'mmeÍical?)pat . ndease gcncràlph)'sical corditi{rn along the combinedaxis ro iedu.e spasdciry rcns àre eirher uppc or low€. qrremiries GGPC) and increascrange of moiion. perforning in unison. a0 AKWA. Ausu$/ Sêprêmber2OOl I flfl - ImPrmdF 'Íwo ||lat|trnt lch quc!m ncurologictechniques are also used speed,clnnge of radius md l*ers, length of The t gic Ápproach to Exercisein Warer in rhe Lgic Approach o Exercise in Yreter time, visual control dd posirion durins 'lhe us sevenÍeatnenr techniquesto disruptrhe first is spccilLcskin stimulationthat cm movemenr. The decisions reguding which netaenaic bJmce. The disruption fores produccvariousposmres, balance and move àspectsend intensities io employ arc bmcd d ;ndividual ro use inerria parrcrns ro docl ment. Lighr srrokesor tapping is ail that is on the ph*e of the progran in which rhe op posturál .onÍol, b3lan@ aód movenenr. needed. Since skin receptors adapt quickly, .lienr is pafti.ipáting.Eách phxe, poin|rrd \íhile each of thcse techniques will be dn- skin srimulàdón nust be usedvery lighdy element of the lngic ApproÀch to Exerciseltl clsed individu,lh on€ should utrdesrand with frcquentchanges in areason the bodl the wner will be aplained. 'lhe that each techniquc will prcduc nultiple secondncurologic reatnent rech Pre-inining. In order for the Logic results. For @mplq when a clienr is chal, niqueis rr.nsference.It is engagingtheclient Approach ro Exercise ir varer to be eÍIec- lenged to resein posure and brlance. thar in movcment first on the unaÍfected side of tive, a c.lient must have achioed the first five individuatwill perform isometric,isoknetic the body wirh an attcmpt to perform thc stcpsofrhc Halliwick Method plu the addi- 'Ihc and isoionic exercisesthat wiil aid in rhe drc alfcctcd sidc. tion oí sagittalrotation ontrol (ee Figure *rengthening of weak muscle groups. notion is thar rheclient willbe ablcto trany 6). A prerequisirefor rquatic therapy is Buoyd.)', ànd the ónomnanr weighde$- client confon (noral adjmtm€n, and ness,will mrurally causea redrction in independence(disengagemenr) in rhe spdriciry. Th€ reduction of spmiciry water Therapistsmust ssure rhat @upledwirh incre*ed novenent ànd clierrs qr roleratethe physiological qperi- sÍength will enablelhe clienrro respomero i-merion and hydrody ena greaterrange ofnodon. All ofthe nomic facrus, erhibit comfon with acrtuiriq and hydrodpamic forccs will water on rhe Íàceand in rhe eaa and ceate r favonhle environnedr fàr a demonstrarebreath cootrol. Onre+ leducrion in pa whlle the general clicnt hasachioed mentaladjustment purposeof e@h rrearnrentrrchnique and disengageneot, the therapist will be descril,ed.onè shouldons;der assiststhe client to muter cagittal, the broaderimpact on the client. veriical, lat€ral and combiqed rota' The firsr wo rrealmenr rech- rion. lhe client'smove to onc ofth. niques are graviry doninrnt ánd l.ogic Approach phue (inhibition, uprhrus dohinanr which involve íacilitation,dynamic) when ócy arè using graviryor buoyancyro àlter or rheLntu Patin,n able ro submerge,rise to the surface aid a clienls posrumlconÍol, balàncc and usea rotationalpatrern to achi*e a comÍorrablebrearhing position. The $ird and íounh rrcaÍncrt 110d00Í ltramrGítllfD Inhibition n posture on- techniquesare turbulen.e a*nted and luF lqb.!l!dsl. The tDal Àspecrof t{alliwick as an rrol. Throughourrhe ourse of the interven bulencereskred. ln dre assisredtechnique, a AKWA . Ausu* / Septembêr200