Theoretical Principles of Rehabilitation of Motor Disorders. the Kozyavkin Method
Total Page:16
File Type:pdf, Size:1020Kb
Theoretical principles of rehabilitation of motor disorders. The Kozyavkin Method 47 Theoretical principles of rehabilitation of motor disorders. The Kozyavkin Method 2.1 Phases for establishing theories related to movement systems CP is a complex and multifaceted pathology caused by organic lesions in the nervous system. Owing to the fact that cerebral palsies are expressed clinically by various speech, movement and mental disorders, this pathology requires early diagnosis and early measures for further rehabilitation treatments. These measures should take into consideration how all the motor systems in the body are organized. The very first concepts related to motor mechanisms and structures were founded on principles of unconditional reflexes, that is, a movement was evaluated as a natural sequence of ordinary motor reflexes, whereas the reflex arch was considered as the basic element of the complex physiological process. I. M. Sechenov, founder of the theory related to reflex activities in the brain, Sechenov Ivan Mikhaylovich (1829- 1905) came to a brilliant conclusion in this field, Founder of the theory related and successively showed that all voluntary to reflex activities in the brain movements and mental processes are mere reflections of objective influence on humans, that is, they are essentially reflex movements. I.P. Pavlov developed I. M. Sechenov’s ideas and formulated the principles of reflex theory, namely, principles of determinism, structure, analysis and synthesis. Furthermore, he set up rules governing higher nervous activity in humans. Pavlov’s further studies on motor theory were built upon observing conditioned reflexes as the basis for improving movement activity. As I. M. Sechenov’s reflex theories and Pavlov Ivan Petrovich I. P. Pavlov’s studies on higher nervous (1849- 1936) activity were developed even further, Founder of the science dedicated to active neural activity they came to reveal a gap between the role played by the periphery and center. 48 Phases for establishing theories related to movement systems N. Y. Vvedenskiy, a Russian physiologist, displaced biocurrents in human muscles and was the first to listen to neural rhythmic excitability. Thus, he established the importance of frequent rhythmic stimuli in biosystem responses. At the turn of the XIX – XX centuries, studies on local nonfluctuating stimulation were quite unusual. N. Y. Vvedenskiy introduced the idea of “instability” or functional mobility. Nerves and muscles showed reduced excitability and tissue conductivity as a result of excessive stimulation. This led to the elaboration of the parabiosis theory, which stated that living organisms react universally to changing factors in the environment. Vvedenskiy compared parabiosis to an arrested wave of stimulation. It appeared that excitability may become localized and inhibitions may develop if stimuli exceed the instability level of tissues. In fact, inhibitions actually appear Vvedenskiy Nikolai Yevgenievich (1852–1922) as modifications of excitability. For the Russian physiologist, author of the first time, the question of the uniformity parabiosis theory of fundamental neural processes was raised, namely, stimulation and inhibition. By proving three-phase reactions of living organisms and the presence of parabiosis in microintervals, it became evident that three fundamental processes, namely, stimulation, inhibition and rest formed a single unit. As a result, the following features became clear: parabiotic inhibition and local nonfluctuating stimulation, inhibition in centers by single stimulation, the ability of weak stimuli to increase tissue readiness for further activity and so on. This greatly influenced the further comprehension of nervous system reactions to stimuli. N. Y. Vvedenskiy’s student, A. A. Ukhtomskiy developed fundamental studies related to the dominant principal (Latin: dominans – dominant) and established a connection between this new concept and N. Y. Vvedenskiy’s theory of parabiosis. A massive flow of impulses creates a hotbed for stimulating the brain; it then provokes inhibitions of autonomic and other body functions, which do not take part in the main (dominant) program regulating the body. Characteristic features of the dominants are: increased excitability in dominant centers, stabilized stimulation throughout time and possible stimulus summation. By revealing the dominant principal, Ukhtomskiy showed that the final results of reflex reactions in the human organism are not only determined by impulses traveling from receptors to effectors (in accordance to classical concepts about reflex arches); the actual results also depend on the functional condition of the nervous centers. The stimulation hotbed is viewed as the dominant principal; it inhibits all other reflexes as recurrent stimuli, and acts 49 Theoretical principles of rehabilitation of motor disorders. The Kozyavkin Method as a bridge system actively present in the human body and joining together all the nervous centers located in the CNS and the periphery. The dominant mechanism takes part in forming the central structure of any functional system which is still at the afferent synthesis stage. It was proved that the dominant is one of the fundamental mechanisms for cerebral activity. The dominant is activated in the organism when there is a motivating stimulation at a given moment. The Ukhtomskiy Alexey Alexeyevich (1875- 1942) mechanisms, which form the dominant, Russian physiologist, author of the are the ascending activating effects doctrine related to the dominant located in the hypothalamus and reticular principal formations. Both features selectively strengthen the stimulation level in the appropriate cells of the cerebral cortex. The descending effects in specific areas of the cerebral cortex selectively facilitate and extend stimuli through nuclei relays in the hypothalamus and reticular formations. In these conditions, any stimuli will provoke summation of all stimuli processes in concrete nervous centers and lead to the organization of a comprehensive activity program, which ensures optimal results for the organism Studies related to the dominant principle revealed a natural law that governed all the activities of the integral human organism. It was shown that the stimuli hotbed or any other system do not dominate in natural conditions. This would, in fact, enable the human body to adapt more readily to existing conditions. Later, this system was referred to as the functional system. Walter Bradford Cannon, an American physiologist conducted studies related to homeostasis, calling it an “autoregulation of physiological processes”. Homeostasis (Greek: homoios – similar + statos – standing still) refers to the relative dynamic constancy of the internal environment and Cannon Walter Bradford the stability of fundamental physiological (1871- 1945) body functions. Living cells constitute an American physiologist, founder of active and autoregulating system which the homeostasis theory is subjected to various environmental 50 Phases for establishing theories related to movement systems influences. Cells are capable of renewing themselves; this is one of their essential properties. A multicellular organism is a comprehensive system where cells have various functions. However, complex mechanisms of homeostasis enable the system to sustain a relatively dynamic stability. The corporative activity of numerous cells is one of the most surprising features in any living organism [Hagen G., 2001]1. For example, this may be observed in muscle coordination during any locomotor activity. At the beginning of the 20th century, Sherrington referred to these phenomena as muscle synergies. A child’s organism creates special conditions in order to sustain his internal environment. In fact, homeostasis in a child’s organism is ensured against the background of anabolic processes predominating over catabolic processes. This also constitutes one of the conditions for growth. This phenomenon also determines higher intensity of metabolic processes and greater tension in neuroendocrine systems of regulation, all of which distinguish a child’s organism from an adult’s. As a result, homeostatic disorders can be observed more often in children, especially when the homeostatic functions of the lungs, kidneys and gastrointestinal tract show definite signs of immaturity. The most significant modifications occur in fluid balance during the first year of a child’s life; the volume of extracellular fluid increases considerably and falls behind the overall increase in body weight. High levels of secretion and liver excretion of aldosterone have a direct influence on tissue hydration in newborns and infants. In children, this neuroendocrine control over homeostasis is combined with highly regulated acid-base balance in the saturation rate of blood with oxygen. This is explained by the comparative predominance of anaerobic glycolysis in the metabolism. Consequently, even moderate hypoxia in the fetus shows that lactic acid accumulates in the tissues. Furthermore, acidogenic functional immaturity in the kidneys creates preconditions for the development of “physiological” acidosis. In newborn infants, some particular features of homeostasis are often connected with disorders which border on the physiological and pathological. P. K. Anokhin’s studies related to systemogenesis and functional systems were an important landmark in explaining development mechanisms of neuropsychic Anokhin Piotr Kuzhmich functions in human