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Clinical Information on IMF Therapy®

Intention-driven Myofeedback

Influencing neuro-plasticity to improve arbitrary movement of paraplegic patients through training the perception of movement

O.C. fell off a telephone pole at the age of 10 and has been paraplegic (incomplete) since then. He came across IMF-Therapy 43 years later and used the MfT Z2 machine at home. Within 3 months he achieved a major breakthrough and can now raise himself from a lying to a sitting position, bend his hip and pull up his foot. He is even able to walk a few steps with the help of walking aids.

The focus of central-motor rehabilitation is neuro-physiologically based physiotherapy. It is limited when the psychological (cognitive) organisation of actions (Perfetti, C.) isn’t challenged sufficiently, for example concentration, imagining movement and perception of movement.

In Germany alone approximately 1.4 Million people are suffering chronically from the consequences of paraplegia, and the number is increasing. The consequences of lesions of the central nervous system affect the whole of the ideo-motor system with its neural structure (hardware) and processing (software).

Arbitrary movements can only be achieved once the neuro-motor system can once again make use of these structures, following relevant restructuring of the central nervous system. Incredibly, the brain is capable of restructuring throughout a person’s entire lifetime and this ability can be influenced.

Latest research has shown that it is not motoric but cognitive defaults which are the main cause of chronic disabilities in patients who have suffered neurological lesions (Hörnberg, V.). Particular investigation has shown that besides from motor dysfunctions, almost all patients in the chronic stage of the illness suffer from deficient “depth sensibility” (proprioceptive perception deficiency) of different severity. They are unable to differentiate the meaning of various peripheral stimulations, which is necessary for neuro-plastic modifications (Spitzner, M.).

The result of impaired information processing becomes obvious when the patient tries to actively carry out a movement with the paretic limb. The patient’s effort doesn’t lead to a physiological movement but instead establishes pathological patterns, which are enhanced with every new attempt. Eventually the patient gives up using the affected limb, which is the exact opposite to what rehabilitation tries to achieve (Taub, E.).

Therapists are therefore trying to find other ways of triggering movements. Despite dysfunctional perception this peripheral facilitation is based on the fact that “movement is driven by the sensory system. A therapeutic approach has to take this into account and has to feed the affected side with as much information as possible.” (Meier – Baumgartner). Because of the patient’s impaired proprioception a great number of the therapeutic movement stimulations can hardly be perceived, which means that afferent impulses cannot be converted into controlling impulses, which regulate movement.

Therapeutic movement stimulations therefore produces “raw”, unused, signals. This results in deficiencies in spatial orientation and spatial control of movements (Bietz, J.). The “sensory-motor” approach doesn’t go far enough, because physiotherapy (KG) pays too little attention to “the factors of psychological regulation, which cause, regulate and control purposeful movements” (Kircher, G.). The effectiveness of physiotherapy has not yet been proven (Hummelsheim, H.).

Based on these experiences the MDK and health insurance companies draw the wrong conclusions, as for example: “... successful rehabilitation of chronic patients cannot be expected.”

Latest research and the therapeutic results of the MfT Z2 machine have been able to clearly refute such misjudgements. With the help of PAIVIO the cybernetic approach could be overcome and has been taken in to account accordingly when the use of MfT Z2 was conceived. Since the cognitive turnaround the following applies:

  • The brain controls human behaviour
  • Learning causes many behavioural changes
  • We can modify our own neural system through learning experiences

The success of MfT Z2 is based on positive feedback following an imagined movement. Contrary to the “sensory-motor” approach the present concept claims that a purposeful imagined movement triggers a “feed forward mechanism”. The efferential activation prepares the sensory-motor system for receiving sensory information. This feed forward mechanism is the prerequisite for influencing the proprioceptive perception. Purposeful imagining causes two motor instructions:

  • The general efferent instruction to the muscular system
  • An associated central instruction, which prepares the sensory system to be ready to absorb information from peripheral receptors (Kuh, W.)

MfT Z2 ensures the availability of this proprioceptive feedback by detecting smallest changes in mental processes, which are then intensified and channelled back as stimulation impulses via two channels to the affected muscles. During the cause of the treatment repeated exposure to the feedback leads to improved perception. For example lifting the foot:

1. Active lifting of a foot.

The patient has some activity left in his ankle and is being asked to lift the foot. Result: He pulls and twists the foot outwards (supination). EMG activity in the m. tibialis anterior is too high, but it is reduced in the m. peroneous. Detailed examination of the proprioception illustrates the extent of the impairment of movement perception. Active exercise would increase the imbalance within this synergy.

2. Lifting a foot with MfT Z2

If the patient is asked to only imagine the movement, he or she triggers very weak muscle stimulation with the help of MfT Z2, and experiences a discreet, physiological feedback of the dorsiflection/pronation. The supination pattern diminishes after only a few sessions. EMG activity in the hypotone muscle radically increases with increased training, the synergetic imbalance diminishes. The perception and control of movement improves.

With the help of MfT Z2 weak innervation points within the muscle system can be located and balanced out.