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  • #16
    Mike seems miles away in his own dreamy little world. Do patients get sleepy or a bit "out of it" as they relax with simple contact? Also, Barrett, any plans on coming to Europe? Please?
    Daniel

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    • #17
      Barrett,
      I appreciate you/Karen posting the videos of ideomotion. I do have to admit I am a bit skeptical and am curious about the "effortless" motion of the patient. How do you truly inhibit ones brain? Does the patient have to be a 100% believer in the technique for it work? I feel that any percentage of skepticism would force them to resist complete relaxation. I state this due to you stating "whenever a movement unhesitatingly and immediately follows upon the idea of it, we have ideomotor action". I have read your 2003 piece in the Journal of Osteo Medicine on the analgesia of movement, and despite you saying it has been well documented, I have been unable to find much literature on it outside of this website (I did read the McCarthy piece for chronic neck pain which demonstrates promise)...

      I also have questions on the effects of this technique being characterized by softening of the muscles and warmth. Who is perceiving this and what research has been done to conclude this is what is occurring?

      You guys have a vast array of literature reference and if you could just point me into the direction of some good readings (I have access to tons of journals--just need references) I would be happy to read more and continue to mold my beliefs.
      Joseph Brence, DPT, FAAOMPT, COMT, DAC
      "Great spirits have always encountered violent opposition from mediocre minds" - Albert Einstein
      Blog: www.forwardthinkingpt.com

      Comment


      • #18
        Hi Joe,

        Diane said:
        Interesting.
        It's a very cool experience to stop inhibiting one's own brain, get out of its way, just let it respond in the moment to whatever is going on around.
        I am wondering if you mistook Diane's comment. As the person experiencing/receiving handling (SC), the inhibition she alludes to is auto-suppression of movement i.e., sitting still for long periods in an office, classroom or other culturally repressive environment. People these days are quite conditioned to suppress their needs or desires to move. Not the therapist or patient inhibiting their brain but allowing its instinctive expression. You can and do engage in ideomotor activity yourself, you don't need a facilitator. Reaching for your coffee, swatting a fly, running your fingers through your hair, shifting in your chair.

        The person experiencing Simple Contact reports the warming and softening. I would really like to see one day Neuroscience Research Australia (Lorimer Moseley's group) take on research on ideomotion. I think the warming and softening could be measured much in the way the rubber hand experiment was conducted.

        This is something I have seen before from massage-research.com Fascial Unwinding: Ideomotor Action (7) Unwinding as an ideomotor action
        The use of ideomotor therapy in the treatment of chronic neck pain: A single systems research design Mason, J. (2009). The use of ideomotor therapy in the treatment of chronic neck pain: A single systems research design. Unpublished thesis submitted in partial fulfillment of the degree of Master of Osteopathy, Unitec Institute of Technology, New Zealand.
        Cogn Affect Behav Neurosci. 2010 Dec;10(4):454-9.
        Planning not to do something: Does intending not to do something activate associated sensory consequences?
        Kühn S, Brass M.
        Source
        Ghent University, Belgium. simone.kuhn@ugent.be

        Abstract

        The present fMRI study investigated the central assumptions of ideomotor theory that actions become associated with their sensory consequences. Furthermore, we tested whether sensory effects can also become associated with the voluntary omission of an action. In a training phase, participants had to decide between executing an action and not executing it. Both decisions were followed by a specific effect tone. In the test phase, the participants had to carry out actions without hearing the effect tone. They either had to decide whether to execute an action or not or were instructed to execute an action or not. Our results reveal an increased activity in the auditory cortex elicited by responses that formerly elicited a tone-namely, self-chosen actions and self-chosen nonactions. Moreover, we found binding effects for stimulus-cued actions, but not for stimulus-cued nonactions. These findings support ideomotor theory by showing that a link exists between actions and their effects. Furthermore, our data demonstrate on a neural level that effect tones can become associated with intentionally not acting, therewith supporting the idea of a binding between the voluntary omission of an action and its effects in the environment.
        Am J Physiol. 1999 Jul;277(1 Pt 2):H261-7.Even slight movements disturb analysis of cardiovascular dynamics.
        Fortrat JO, Formet C, Frutoso J, Gharib C.
        Source Laboratoire de Physiologie de l'Environnement, Faculté de Médecine Lyon Grange-Blanche, 69373 Lyon Cedex 08, France.
        Abstract
        We hypothesized that spontaneous movements (postural adjustments and ideomotion) disturb analysis of heart rate and blood pressure variability and could explain the discrepancy between studies. We measured R-R intervals and systolic blood pressure in nine healthy sitting subjects during three protocols: 1) no movement allowed, 2) movements allowed but not standing, 3) movements and standing allowed. Heart rate and blood pressure were not altered by movements. Movements with or without standing produced a twofold or greater increase of the overall variability of R-R intervals and of the low-frequency components of spectral analysis of heart rate variability. The spectral exponent beta of heart rate variability (1. 123 at rest) was changed by movements (1.364), and the percentage of fractal noise (79% at rest) was increased by standing (91%, coarse-graining spectral analysis). Spontaneous movements could induce a plateau in the correlation dimensions of heart rate variability, but they changed its nonlinear predictability. We suggest that future studies on short-term cardiovascular variability should control spontaneous movements.
        Pubmed has other papers that might help you more, it is all in how you pose the query.

        Karen
        Last edited by Karen L; 28-05-2011, 08:07 AM. Reason: wording

        Comment


        • #19
          Joe,

          I really don’t understand your asking “How do you truly inhibit ones brain?” I can’t figure out what you mean.

          What I say repeatedly is that behavior is influenced by context, that ectodermal activity is context dependent and that the culture inhibits instinctive expression. Changing context is our job as therapists. When Cory says we are “contextual architects” he articulates something inevitable in our relation to the patient and identifies our responsibility.

          Please remember that Simple Contact is a form of communication, not a way to coerce others with a certain manner of handling. The patient tells me what they sense in response to their own ideomotion, I sense it in the same manner anyone with a hand on them or talking to them would. No real skill is involved.

          That quote?

          "
          Whenever a movement unhesitatingly and immediately follows upon the idea of it, we have ideomotor action"
          I didn’t say that, William James said that. He’s a pretty good reference. You seem to be under the impression that I either invented the term or discovered the movement. I have simply described its place in movement therapy for painful problems and proposed a method of amplifying its expression within a therapeutic context.

          You can’t find any literature about ideomotor activity? Karen has offered some and Luke has compiled a ton. Doesn’t Spitz’s text count?

          Try Googling "ideomotor" and see what happens.
          Barrett L. Dorko

          Comment


          • #20
            Hi Joe,
            Karen pegged brain inhibition exactly right. The job of the cortex, overall, is to select, evaluate, and add meaning to raw sensory perception; only sensory perception that is deemed "salient", by the cortex, is ever given any "thought" by it - all the rest (way over 90%, according to researchers who study visual input, for example) is simply inhibited.

            Here is a link to a recent piece about how maybe sometimes, normal inhibition fails. Brain scans reveal why some people feel your pain.

            Barrett suggests, if the normal job of the cortex is to inhibit, then why not disinhibit it somewhere else, e.g., ask it to stop inhibiting movement, so it can (and will, naturally) get busy inhibiting what it should be inhibiting (i.e., "pain" output/nociceptive input/threat), instead.

            To get the basics on what brains are, what comprises them, and how the parts work, I recommend Mayo Clinic Medical Neurosciences, 5th Ed. Great, great textbook, organized by systems conceptualized as horizontal and vertical (rather than as rostral, caudal, dorsal and ventral the way normal neuroscience texts are, which can be a bit confusing from a human perspective).
            Diane
            www.dermoneuromodulation.com
            SensibleSolutionsPhysiotherapy
            HumanAntiGravitySuit blog
            Neurotonics PT Teamblog
            Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
            Canadian Physiotherapy Association Pain Science Division Facebook page
            @PainPhysiosCan
            WCPT PhysiotherapyPainNetwork on Facebook
            @WCPTPTPN
            Neuroscience and Pain Science for Manual PTs Facebook page

            @dfjpt
            SomaSimple on Facebook
            @somasimple

            "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

            “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

            “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

            "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

            "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

            Comment


            • #21
              I want to add that the text I recommended discusses the nervous system as an "inner tube" of internal regulation, from sacral parasympathetic ganglia to anterior cingulate cortex, and an "outer tube" of selectivity, awareness, and conscious input into the internal regulation system, to affect it, dampen its constant upwardly inputting activity.

              Conscious motor output is one of the most accessible means the entire human organism has, of changing its own context. However, if it doesn't think it has the right to do this, it won't. Period.

              Barrett is all about asking people to go in, find movement, then let it come out, whatever kind they have. When the cortex gets busy feeling its organism moving in novel ways, it pretty much takes up all its attention span, and shortly thereafter, feels delicious in all the appropriate ways. This exercises the afferent pathways (in that inner tube) in new or at least in unaccustomed ways, that the cortex approves of and that the person is likely to feel much better with. People being primates, however, usually need the idea to do this (or anything that should just come naturally) to come from outside ourselves, from someone in authority. So Barrett says, fine, I'll be your "therapist" who doesn't "do" anything to you, and instead I'll help you help yourself.
              Motion is lotion. How SomaSimple.
              Diane
              www.dermoneuromodulation.com
              SensibleSolutionsPhysiotherapy
              HumanAntiGravitySuit blog
              Neurotonics PT Teamblog
              Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
              Canadian Physiotherapy Association Pain Science Division Facebook page
              @PainPhysiosCan
              WCPT PhysiotherapyPainNetwork on Facebook
              @WCPTPTPN
              Neuroscience and Pain Science for Manual PTs Facebook page

              @dfjpt
              SomaSimple on Facebook
              @somasimple

              "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

              “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

              “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

              "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

              "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

              Comment


              • #22
                People looking to "release" something may want to consider disinhibition, keeping in mind that it's also possible to disinhibit an inhibitory pathway.

                I read a blog entry recently and was intrigued by the following quote

                The actions of others may be a stimulus, but not a cause, of our feelings
                I thought about this as it relates to physical therapy and pain and what we discuss here on a routine basis.
                "I did a small amount of web-based research, and what I found is disturbing"--Bob Morris

                Comment


                • #23
                  Originally posted by Jon Newman View Post
                  keeping in mind that it's also possible to disinhibit an inhibitory pathway.
                  What I meant to convey here is the idea of a currently inhibited inhibitory pathway (i.e. a pathway that inhibits something else when active) becoming active secondary to disinhibition from the neurons providing stimulus to it.
                  "I did a small amount of web-based research, and what I found is disturbing"--Bob Morris

                  Comment


                  • #24
                    I'm afraid I have to echo Joe's questions to Barrett.

                    I have a lot more reading to do I'm sure, and I plan on taking Barrett's course to gain some better insight. However, "softening" and "warming" have always been difficult for my mind to embrace. In my reading to this point, I have yet to see them operationally defined elsewhere in the literature.
                    Rod Henderson, PT, ScD, OCS
                    It is useless to attempt to reason a man out of a thing he was never reasoned into. — Jonathan Swift

                    Comment


                    • #25
                      Originally posted by TexasOrtho View Post
                      I'm afraid I have to echo Joe's questions to Barrett.

                      I have a lot more reading to do I'm sure, and I plan on taking Barrett's course to gain some better insight. However, "softening" and "warming" have always been difficult for my mind to embrace. In my reading to this point, I have yet to see them operationally defined elsewhere in the literature.
                      TO, you'll gain a great deal more depth about that by listening to Will's latest interview with Roy Sugarman.
                      Diane
                      www.dermoneuromodulation.com
                      SensibleSolutionsPhysiotherapy
                      HumanAntiGravitySuit blog
                      Neurotonics PT Teamblog
                      Canadian Physiotherapy Pain Science Division (Archived newsletters, paincasts)
                      Canadian Physiotherapy Association Pain Science Division Facebook page
                      @PainPhysiosCan
                      WCPT PhysiotherapyPainNetwork on Facebook
                      @WCPTPTPN
                      Neuroscience and Pain Science for Manual PTs Facebook page

                      @dfjpt
                      SomaSimple on Facebook
                      @somasimple

                      "Rene Descartes was very very smart, but as it turned out, he was wrong." ~Lorimer Moseley

                      “Comment is free, but the facts are sacred.” ~Charles Prestwich Scott, nephew of founder and editor (1872-1929) of The Guardian , in a 1921 Centenary editorial

                      “If you make people think they're thinking, they'll love you, but if you really make them think, they'll hate you." ~Don Marquis

                      "In times of change, learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists" ~Roland Barth

                      "Doubt is not a pleasant mental state, but certainty is a ridiculous one."~Voltaire

                      Comment


                      • #26
                        Originally posted by TexasOrtho View Post
                        I'm afraid I have to echo Joe's questions to Barrett.

                        I have a lot more reading to do I'm sure, and I plan on taking Barrett's course to gain some better insight. However, "softening" and "warming" have always been difficult for my mind to embrace. In my reading to this point, I have yet to see them operationally defined elsewhere in the literature.
                        I don't think they have been operationally defined. To my knowledge they are explained as a change in the state of the autonomic nervous system and as felt senses of the patient. I think like the ideomotion itself - we see these things in the clinic with patients - we are looking for a scientific explanation for these things. In Maitland and McKenzie's books they describe felt senses of the patient and what they think those mean and how those are used in a clinical reasoning process. I've always seen Barrett's description of these felt senses as just like that. But there is actually a good deal of research on the autonomic nervous system and what it's influence is on felt sensation - so in that way Barrett''s characteristics of correction are more closely aligned with what we know than, for example, the centralization phenomenon.
                        Jason Silvernail DPT, DSc, FAAOMPT
                        Board-Certified in Orthopedic Physical Therapy
                        Fellowship-Trained in Orthopedic Manual Therapy

                        Certified Strength and Conditioning Specialist


                        The views expressed in this entry are those of the author alone and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the US Government.

                        Comment


                        • #27
                          Originally posted by Jon Newman View Post
                          What I meant to convey here is the idea of a currently inhibited inhibitory pathway (i.e. a pathway that inhibits something else when active) becoming active secondary to disinhibition from the neurons providing stimulus to it.
                          Disinhibition is an old thread I started back in RehabEdge days. The last link I provide in the thread is worth a re-read, or a first read for those who haven't given it a look before.
                          "I did a small amount of web-based research, and what I found is disturbing"--Bob Morris

                          Comment


                          • #28
                            I understand warming and softening to be the result of autonomic changes, but I sometimes wonder if they impede or at least delay the integration of ideomotion into the broader PT population.

                            You'd think with PTs eagerly embracing things like "unwinding" and "release", softening and warming wouldn't be too much of a conceptual reach. Not implying equivalence between unwinding and warming as constructs, just trying to figure out why my mind is more capable of pouncing on something like hypomobility yet winces at the notion of warming or softening.

                            Sounds like a personal issue, Rod. Probably is. But I wonder, based on similar questions from curious newcomers, how these concepts and constructs can be framed and integrated into mainstream practice. I suppose this would entail some combination of shaping the message and shaping the recipients' ability to retain and use it.

                            It's happened for me but taken quite a bit of time and work. I wonder if we can ever condition ourselves as a profession to have the patience it takes to truly learn.

                            I often ask students on rotation what they hope to learn/achieve on this rotation. My current student on 12-week rotation asks predictable questions about rehab protocols and the timing of adding specific exercises, etc... I asked him this week which he preferred - give him the answers or provide resources to discover the answers on his own. Knowing the intense desire of students to please their instructors, I told him there would be no judgment if he wanted my direct guidance.

                            I will admit that his answer was troubling nonetheless. He basically said with all the time he devotes to studying for the boards, he'd rather just be shown what to do. I appreciated his honesty but spent the rest of the day asking myself - what do I do with this?

                            I have a plan and hope it will work out. Jumping back on this forum, reading, and re-reading should help quite a bit.
                            Rod Henderson, PT, ScD, OCS
                            It is useless to attempt to reason a man out of a thing he was never reasoned into. — Jonathan Swift

                            Comment


                            • #29
                              I've suggested before that plethmysmography and thermography are commonly used measurements in the health and biological sciences that could be used to at least quantitatively define as well as document softening and warming, respectively.

                              Since we know that the autonomic nervous system is responsible for mediating these effects, it makes clear sense to me that they would accompany corrective movement.

                              I suppose McCarthy and Rickards (aka, Luke) could've measured these in their study, but chose to use the currently popular "patient-centered" outcomes tools that we see in so much of the PT/manual therapy outcomes research these days.

                              Someone could just replicate their SSRD, get a grant for this perhaps expensive measurement equipment, and then have at it. Et voilà! evidence for (or against) softening and warming with ideomotion.

                              Rod, I nominate you.
                              John Ware, PT
                              Fellow of the American Academy of Orthopedic Manual Physical Therapists
                              "Nothing can bring a man peace but the triumph of principles." -R.W. Emerson
                              “If names be not correct, language is not in accordance with the truth of things. If language be not in accordance with the truth of things, affairs cannot
                              be carried on to success.” -The Analects of Confucius, Book 13, Verse 3

                              Comment


                              • #30
                                Yeah I'm all over it. Right now I'm too busy doing an observational case report on infantile ideomotoric behavior.

                                Based on what the NIH funds these days, I figure that's good for a $250K grant.
                                Rod Henderson, PT, ScD, OCS
                                It is useless to attempt to reason a man out of a thing he was never reasoned into. — Jonathan Swift

                                Comment

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