quarta-feira, 4 de março de 2009

ARTIGO DO MÊS (11/2009)

Movement Variability and the Use of Nonlinear Tools: Principles to Guide Physical Therapist Practice
Harbourne, R.T.; Stergiou, N.
Physical Therapy (Mars/2009) Volume 89, Number 3: 267-282


Fields studying movement generation, including robotics, psychology, cognitive science, and neuroscience, utilize concepts and tools related to the pervasiveness of variability in biological systems. The concepts of variability and complexity and the nonlinear tools used to measure these concepts open new vistas for physical therapist practice and research in movement dysfunction of all types. Because mounting evidence supports the necessity of variability for health and functional movement, this perspective article argues for changes in the way therapists view variability, both in theory and in action. By providing clinical examples, as well as applying existing knowledge about complex systems, the aim of this article is to create a springboard for new directions in physical therapist research and practice

"Variability in human performance and the nonlinear manner in which skills and characteristics of movement change over time reflect the complexity of the movement system.

The therapists know that a given amount of practice cannot ensure the learning of a skill in a linear manner. Our patients usually learn sporadically, progressing in a nonlinear manner over time. In addition, rates and paths of progress vary among individuals with the same diagnoses who are similar in characteristics. Motor learning progresses nonlinearly, exhibiting nonlinear learning curves depending on the task, conditions, and characteristics of the learner (Newell KM, Liu YT, Mayer-Kress G., 2001)

Nonlinear, usually used with the term “dynamics,” as in “nonlinear dynamics,” can be defined as “not in a straight line,” or as a system whose output is not proportional to its input.* Nonlinear systems are more complex than linear systems, necessitating the use of sets of equations producing unpredictable outcomes that exhibit chaotic features. In general, biological systems, including humans, are complex, nonlinear systems with inherent variability in all healthy organisms (Walleczek J., 2000)

As (re) aprendizagens neuromotoras que os Fisioterapeutas procuram facilitar, orientar, induzir nos seus pacientes, no contexto da Reeducação Funcional, são momentos únicos, individuais, complexos, que estão dependentes de uma série de variáveis intrinsecas ao sujeito, de variáveis relacionadas com o meio envolvente e ainda com a interacção paciente/terapeuta.

Neste modelo de intervenção, que envolve a pessoa toda nas suas várias dimensões, condicionantes ou constrangimentos bem como na sua interacção com o FT, o tratamento não é SUSCEPTIVEL DE SER PRESCRITO, nem SE DEVE REALIZAR SEMPRE AS MESMAS ACTIVIDADES/TAREFAS

Raul Oliveira, Fisioterapeuta

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