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Functional Manual Reaction
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Functional Manual Reaction - November 18, 2005 3:44:00 PM
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FunctionbyDesign
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I recently attended a Gary Gray seminar and learned a new form of manual therapy. It's all upright and the therapist "barely" comes in contact with the patient, just facilitates the motion in which the patient is already going (building on the clients successes) The thought process sounds similar to some of Barrett's ideas(my perception) that I've read on RehabEdge.
I was wondering if anyone is familiar with both Gary Gray and Barrett's philosophy.
How are they similar?
How much are they really different?
I would love to hear Barrett's thought on this and everyone else.
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Re: Functional Manual Reaction - November 18, 2005 5:12:00 PM
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Jon Newman
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Hi FBD,
I'll give my opinion. I'm not familiar with Gary Gray so I can't compare and contrast however.
The touching that occurs with Simple Contact is, perhaps, the least important part of the therapeutic effect. Also, there is no choreography of movement in SC per se. I'm not sure what context Gary is advocating this approach.
It sounds interesting though. I posted a research article using this (Gary Gray sounding) approach not to long ago.
What rationale does he give for this approach?
jon
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[URL=http://www.sonymusic.com/clips/selection/30/064887/064887_03_03_30.wav]Evidence[/URL]
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Re: Functional Manual Reaction - November 19, 2005 1:29:00 AM
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Barrett
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Does the word "ideomotor" appear anywhere in Gray's literature?
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Re: Functional Manual Reaction - November 19, 2005 3:59:00 AM
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srcase
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I've been to both seminars and I don't see many similarities. Gary Gray's approach is strictly biomechanical, focusing on triplane loading and unloading of segments (eccentric and concentric contractions) in functional positions to facilitate proprioception/motor learning. His manual techniques are "functional" and he doesn't advocate moving one bone on another "fixed" bone to mobilize a joint (aka Kaltenborn) because that is not how the joint acts in real life. He has categorized movements into a functional profile (excursions, reaches, lunges, steps, jumps, and balance) in an attempt to provide reliable and valid functional tests which are then used to create functional exrcises. He extrapolates methods and theories from current research, but has not conducted any of his own that I am aware of. Overall, I think Gray has done much to move the profession into the "functional" realm. He also invented the BAPS board and some lesser known PT tools.
Barrett's approach is not biomechanical, but neurophysiological. He doesn't care what direction a joint is moving in as long as it is moving ideomotorically (driven by an unconscious self-corrective system). Simple Contact aims to teach the patient how to increase his/her adaptive potential (ability of a system to tolerate a repetitive movement, forceful blow, or a prolonged position). It is based on the deep model that pain originates from adverse neural tension. He also bases his work on past and present research and scientific inquiry, but has not conducted any of his own research specifically. Barrett has done much to educate therapists about pain mechanisms and neurophysiology, as well as provide a new paradigm of thought regarding musculoskeletal problems.
Hope this helps!
Sarah
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Re: Functional Manual Reaction - November 19, 2005 9:02:00 AM
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nari
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Sarah
Just out of curiosity - what is a BAPS board?
Does Gray advocate "functional" activity based on a theory of pain reduction through motor control?
I thought that was fairly 'traditional'physical therapy practice, just with no hands-on emphasis.
I'm not sure he is advocating anything unusual?
But as I don't know anything about him, I may be oversimplifying the concept.
Nari
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Re: Functional Manual Reaction - November 19, 2005 11:09:00 AM
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FunctionbyDesign
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Jon,
His rationale for this approach is using manual consistent drivers based on the activity/movement that is desired.
Driving the body's systems (muscular, skeletal, neurological i.e-proprioceptors) in the manner it will be functioning.
Sarah,
I appreciate your input on this b/c I think there's something strong b/n the 2 thought processes. It would be a fun round table with both of their minds. By the way, I noticed that you live in michigan(same as Gray). Ever get a chance to visit any of his clinics and see it apply on an everday basis?
Barrett,
I don't believe he has a lot of literature on his methods. I think Sarah summed it with how he extrapolates methods and theories from current research. Are you familiar with his past and current methods? If so I would love to hear your thoughts on it. How it applies in the treatment of pain, strengths, weaknesses, etc. Thank you in advance.
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Re: Functional Manual Reaction - November 19, 2005 11:57:00 AM
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Barrett
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I don't treat weakness or dysfunction. Neither are connected to pain's origin and, as my students will tell you, this is what I focus upon. If what he does to people (or suggests they do) reduces their pain it is because the movement has reduced the relevant mechanical deformation in the offending tissue. I can't imagine anybody refuting that.
Of course, mine is not a method of rehabilitation, and, I gather, Gray's is. I don't see patients needing such care so I don't feel it's appropriate to offer any sort of opinion.
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Barrett L. Dorko P.T.
http://barrettdorko.com
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Re: Functional Manual Reaction - November 19, 2005 11:57:00 AM
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Jon Newman
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Fbd,
I didn't quite understand your explanation.
Based on Sara's post, it seems Gary's approach addresses specific functional movements versus pain. Am I understanding that correctly?
jon
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[URL=http://www.sonymusic.com/clips/selection/30/064887/064887_03_03_30.wav]Evidence[/URL]
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Re: Functional Manual Reaction - November 19, 2005 4:34:00 PM
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JLS_PT_OCS
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Being familiar with both methods, I will second Sarah's post.
J
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Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
**I no longer post on RehabEdge**
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Re: Functional Manual Reaction - November 21, 2005 3:57:00 AM
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FunctionbyDesign
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Are there any practitioners in the boca raton area who are familiar in the application of "Simple Contact"? If so, could you please forward the contact info to FunctionbyDesign@yahoo.com.
thanks in advance
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Re: Functional Manual Reaction - November 21, 2005 3:58:00 AM
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FunctionbyDesign
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I appreciate everyone's input on the topic and look forward to seeing "Simple Contact" done in person.
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Re: Functional Manual Reaction - November 27, 2005 6:04:00 AM
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srcase
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From: Michigan
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FBD,
No, I haven't been to his clinic in person, just his seminar and watched all of his Video Digest series.
Jon, yes.
Nari, BAPS stands for biomechanical ankle platform system. It's a tool used to rehab ankle injuries with movements based on the true axis of movement of the talocrural and subtalar joints.
Barrett, this is the first time I've heard you say that you don't do rehab. That's very interesting. Where do you refer patients who need rehab? To another PT? Just curious.
Sarah
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Re: Functional Manual Reaction - November 27, 2005 7:00:00 AM
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Barrett
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Sarah,
I just don't see them. If someone calls requesting that sort of care I tell them to ask their doctor who he/she knows and trusts. Isn't that part of their job?
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Barrett L. Dorko P.T.
http://barrettdorko.com
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Re: Functional Manual Reaction - November 28, 2005 6:23:00 AM
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JLS_PT_OCS
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I think there are quite a few people out there with chronic pain, for whom rehabilitative therapy per se may not help.
It is my personal opinion that these are the least favorite kinds of patients for many PTs.
It seems there would be plenty for Barrett to do, if he chose to limit his practice to those who did not need rehabilitative services, and in fact primarily needed pain relief.
Just my thoughts.
J
_____________________________
Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
**I no longer post on RehabEdge**
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Re: Functional Manual Reaction - November 28, 2005 12:00:00 PM
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nari
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I agree with Jason's post; there is a considerable percentage of people with pain who would not benefit from 'rehab' (I am never sure what that means anyway, it is not a word we use except in the stroke/TBI field). I would go so far to say that 75% of people requiring PT would benefit from SC, including the "orthopaedic" ones.
A combination of the two models may be quite useful; eliciting awareness first, then go with a movement-focus program.
I imagine Barrett would have more than he could manage from week to week.
Nari
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Re: Functional Manual Reaction - November 29, 2005 6:38:00 AM
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FunctionbyDesign
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Back to the topic at hand. Somewhere in this post, Nari said:
"A combination of the two models may be quite useful; eliciting awareness first, then go with a movement-focus program.
Though you may not have been referring to Gary Gray's model of treatment, You put in words what I was trying to get at with my original post.
I'm very interested in learning more about SC so I can start integrating it with the functional model.
SJBird55,
You should attend Barrett's workshop b/c I think it will end a lot of the communication problems you two have. It will answer a lot of your questions about his approach (see it in action). Maybe "Simple Eye Contact" will help clear things up. Just my thoughts. You two need to grab lunch together during the workshop and lighten up.
p.s- I did suggest that there should a seperate thread devoted for Barrett vs. SJBird55. It could be the paid portion of this site(kinda like paperview) :)
p.p.s- still looking for someone in the palm beach area who uses Simple Contact.
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Re: Functional Manual Reaction - November 29, 2005 10:22:00 AM
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nari
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From: Australia
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FBD
I don't know anything about Gary Gray's work; it had occured to me that it would be logical to combine the two 'models' if one wished to continue with traditional movement routines (qv exercises). May even meet the patients' expectations in a useful way; but I would always try SC first before anything else.
Nari
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Re: Functional Manual Reaction - December 5, 2005 1:14:00 AM
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SJBird55
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From: Michigan
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Hmmm... another time of posts being deleted.... what's up with that? This wasn't the first time things went astray of the current topic. Amazing... and more than my posts were deleted! All of you, welcome to the SJ world of being deleted! I know Jon's was... and Barrett's too... anyone else's? I'm not quite sure how that action should be interpreted. Oh, wait.. our views were irrelevant, that's the ticket this time.
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Re: Functional Manual Reaction - December 5, 2005 1:15:00 AM
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Sebastian Asselbergs
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I just started reading this thread (I came back from out of the country)and seem to miss something here - references sjbird posts - but not seeing them...Are they deleted?
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Re: Functional Manual Reaction - December 5, 2005 1:16:00 AM
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Sebastian Asselbergs
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Ah here she is!
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Mundi vult decipi
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