Home Who We Are What We Do Equipment Prices New Patients

Staff

Home Who We Are What We Do Equipment Prices New Patients

Neurological Rehabilitation

Staff

Yorkville Location

1075 Bay Street, Suite 603

Toronto, ON

M5S 2B1

*specialized equipment only available at the Scarsdale Rd. location

Hours

9am – 5pm Weekdays

*Contact us for availability outside of office hours or for community appointments

Contact

T: 416-490-8243 Ext. 0

E: Admin@physio-logic.com

F: 416-490-9961

North York Location

96 Scarsdale Rd

North York, ON

M3B 2R7

*Ample Free Parking On-Site

PhysioLogic Plus

1 Bridgepoint Drive

Toronto, ON

M4M 2B5

Check us out on Instagram!

@PhysiologicToronto

Have you ever pushed on a door you were supposed to pull❓🤔⁣
⁣⁣
Good news! It might not be your fault! ⁣⁣
If the door is poorly designed and affordances were not taken into consideration, the shape of the handle might have given you the idea that you should push on it.⁣⁣
(But it also might just be a you thing😅🙊).⁣⁣
⁣⁣
Affordances are the properties of an object that predetermine how we interact with the object.⁣⁣
The way we reach for a cup or the way we reach to pick up a smaller object such as a spoon are different, we pre-shape our hand in preparation before⁣⁣
we reach full extension of our arm and arrive at the object.⁣⁣
⁣⁣
✋ Hand pre-shaping is dictated by the characteristics of the object and its use (Sangole 2008)⁣ ⁣
⁣⁣
👌Movement in the palmar arch occurs prior to movement at the metacarpo-phalangeal joints (Sangole 2008)⁣⁣
⁣⁣
🖖Grasp pattern is corticospinal driven and strongly supported by reticulospinal function (Fukui & Inui 2013)⁣⁣
⁣⁣
When working on a functional reach and grasp we have to be conscious of the types of objects we use. It helps the object is particularly meaningful to the patient. If they a painter, use a paintbrush. If they love being on their smartphone (and who doesn’t?) use their phone as the object they are reaching for. We can throw out the clothespins and orange cones that have been traditionally associated with hand therapy! ⁣⁣
⁣⁣
We also need to work with different objects to maintain the novelty of therapy but also to work on different hand shapes which require different intrinsic muscles which will further support development of other grasp patterns.

🧠Our neurological patients are already over relying on a feedback balance system and often fixating though their trunk and pelvis. If we want to make a change to their functional abilities, by improving their dynamic balance, we need to help them develop efficient feedforward postural stability that is adaptable to a variety of environmental contexts.⁣
⁣
⁣
Set up your treatment so that you are engaging the corticoreticulospinal system, which is responsible for anticipatory postural adjustments at a level that is challenging yet achievable for that individual. Internal perturbations can be as easy as turning the head, reaching an arm, throwing a ball, or stepping a foot while maintaining balance. As they improve their responses increase the level of difficulty such as increasing the speed or weight of the internal perturbation or changing the posture to be more challenging such as decreasing the base of support.⁣
⁣
⁣
🏃Dynamic balance requires efficient postural control strategies both in anticipation of, and in response to destabilizing forces allowing the maintenance of equilibrium in multiple environmental contexts⁣
⁣
⁣
📚Anticipatory postural adjustments (APAs) are feedforward mechanisms which prepare the body for upcoming perturbations to decrease the anticipated displacement of the centre of mass and maintain stability⁣
⁣
⁣
📚Feedback strategies such as the stepping response, reach response, or hip strategy are strategies used to bring the centre of mass back to equilibrium after displacement⁣
⁣
⁣
📚While both strategies are necessary for dynamic balance, most patients with central nervous system injuries are over reliant on feedback responses due to a lack of postural stability and inefficient development of APAs⁣
⁣
⁣
📚Over relying on hip flexor fixation negates hip extension (through reciprocal inhibition) which is necessary for single leg stance and for rhythmical stepping in central pattern generated locomotion. As well as lowering the centre of mass which further decreases drive for postural extension and stability⁣
⁣
⁣
📚Over relying on the stepping or reach response limits balance to environmental contexts for which this is appropriate and has

$Cookie cutter treatments? 🍪🚫🙅🏽‍♀️👎 No thank you 🤚.⁣ ⁣ What we do like - therapists who treat based on assessment and continual re-assessment of the patient's movement ✅⁣ ⁣ What we don't like - treatment administered based on medical diagnosis (ie. "This is what I do with stroke patients") 🚫🙅‍♂️❌⁣ ⁣ Though both these patients have similar medical diagnoses...One is working on improving knee control of a low tone leg through achieving better hip extension and the other is working on fractionating lower limb movements of a high tone leg. ⁣ ⁣ These two patients have very different movement disorders yet clinical reasoning 💡 lead both therapists to choose similar positions to work in, but with very different therapeutic goals.⁣ ⁣ (📚Standing requires the patients to work against gravity and to control their trunk, while having their arms supported in proper alignment helps them to stabilize and decrease the tendency to push down on the bed with their arms📚)⁣ ⁣ Our therapists have hundreds of hours of post graduate education specifically on working with patients with neurological conditions. Treatment plans are designed from a thorough understanding of human movement and neurophysiology.⁣ ⁣ Sometimes this understanding leads to treatments looking the same, sometimes the therapist beside you is doing something completely different!⁣ ☀️ 🔄🌜...and that's ok!$

Another great weekend of learning at Physio-Logic with the always inspiring and thought provoking Dr. Julie Vaughan Graham, PT, PhD.⁣
⁣
Body-Weight Support Treadmill (BWST) 🏃‍♀️🏃👟training is not just for walking. We use it to:⁣
⁣
- Improve postural control 🎛️ ⁣
⁣
- Facilitate stepping at speed 🚄 ⁣
⁣
- Modulate muscle tone 💪 ⁣
⁣
- Improve single leg stance ☝️🚹 ⁣
⁣
- Mobilize the foot 👣 ⁣
⁣
- Strengthen the lower limbs ⁣
⁣
- Other benefits: cardiovascular endurance, bone density, bowel and bladder function, psychological benefits⁣
⁣
Check out this article summarizing the neurophysiology behind posture and gait: Takakusaki, K. (2017). Functional Neuroanatomy for Posture and Gait Control. JMD, 10(1), 1-17. doi:10.14802/jmd.16062⁣
⁣
Join us next for: ⁣
⁣
- 5-day Advanced Bobath Course: Connecting Upper and Lower Limb Function: Exploring the relationship of postural control and inter-limb coordination (May 30-June 3) ⁣
⁣
- 2-day Intro Bobath Course: Pusher Syndrome: Integrating current neuroscience and clinical application of the Bobath concept in the assessment and treatment of the ‘pusher’ patient (June 14-15)

Physio-Logic Rehabilitation Services

96 Scarsdale Road,

Toronto, ON, M3B 2R7,

Canada

416-490-8243 admin@physio-logic.com

Hours

Mon 9:00 - 17:00

Tue 9:00 - 17:00

Wed 9:00 - 17:00

Thu 9:00 - 17:00

Fri 9:00 - 17:00

Sat Closed

Sun Closed

Patient Portal Login PhysioLogic Plus