Argumentation for Application of Intentionally Oriented Movements in Physiotherapy

Authors: B. Kolářová;  A. Krobot;  L. Hradilová;  P. Kolář
Authors‘ workplace: Ústav fyzioterapie, Fakulta zdravotnických věd, Univerzita Palackého v Olomouci přednosta MUDr. A. Krobot, Ph. D. ;  Oddělení rehabilitace Fakultní nemocnice Olomouc primář MUDr. A. Krobot, Ph. D.
Published in: Rehabil. fyz. Lék., 20, 2013, No. 1, pp. 4-10.
Category: Original Papers


In this paper we argue for the application of intentionally oriented movements in physiotherapy as well as the mere idea of a specific motion.

In our therapeutic practice we are well aware of the fact that for reeducation of motion disorders it is rather useful to use specific intentional movements (e.g. passing over a book from the bench or drinking a glass of water). Supposedly comparison with analytical movements result in joining in more motion components, increased activity of neural centers and marked neuroplastic changes. In our kinesiologic experiments we document accordingly a significant facilitation of muscular activity with purposeful motions of the upper extremity.

Changes in muscular activity of m. extensor digitorum, m. flexor digitorum and m. biceps brachii were evaluated by surface electromyography in relation to the purposefulness scale of the movement. Fours different situations were tested: 1. putting hand on the mouth, 2. idea of recruitment drinking from the glass, 3. pretence of drinking water from the glass with wax, 4. real drinking of water from a real glass

The results indicate that increasing purposefulness of tested movements correlated strongly with the character of recruitment of motoric units.

The highest muscular activation resulted only in an actual motion of drinking the glass of water (4). A significant activation was associated with a mere pretence of functional movement (2).

functional purposeful motion, idea of motion, surface electromyography, physiotherapy


1. Ansuin, C., Santello, M., Massaccesi, S., Castiello U.: Effects of end-goal on hand shaping. J. Neurophysiol., 95, 2006, 4, s. 2456–2465.

2. Arora, S., Aggarwal, R., Sirimanna, P., Moran, A., Grantcharov, T., Kneebone, R., Sevdalis, N., Darzi, A.: Mental practice enhances surgical technical skills: a randomized controlled study. Ann. Surg., 253, 2011, 2, s. 265–270.

3. Carey, J. R., Kimberley, T. J., Lewis, S. M., Auerbach, E. J., Dorsey, L., Rundquist, P., Ugurbil, K.: Analysis of fMRI and finger tracking training in subjects with chronic stroke. Brain, 125, 2002, 4, p. 773–788.

4. de Vries, S., Mulder, T.: Motor imagery and stroke rehabilitation: a critical discussion. J. Rehabil. Med., 39, 2007, 1, s. 5–13.

5. Goodale, M. A., Jacobson, L. S., Keillor, J. M.: Differences in the visual control of pantomimed and natural grasping movements. Neuropsychologia, 32, 1994, 10, s. 1159–1178.

6. Gauthier, L. V., Taub, E., Perkins, Ch., Ortmann, M., Mark, V. W., Uswatte, G.: Remodeling the brain plastic structural brain changes produced by different motor therapies after stroke. Stroke, 39, 2008, 5, s. 1520–1525.

7. Hermsdörfer, J., Terlinden, G., Mühlau, M., Goldenberg, G., Wohlschlägerb, A. M.: Neural representations of pantomimed and actual tool use: Evidence from an event-related fMRI study. NeuroImage, 36, 2007, s. 109–118.

8. Hubbard, I. J., Pardone, M. W, Nelson, C., Carey, L. M.: Task-specific trainig: evidence for and translation to clinical praktice. Occup. Ther. Int., 16, 2009, 3–4, s. 175–189.

9. Jakobson, L. S., Goodale, M. A.: Factors affecting higher-order movement planning: a kinematic analysis of human prehension. Exp. Brain Res., 86, 1991, 1, s. 199–208.

10. Jang, S. H., Kim, Y. H., Cho, S. H., Lee, J. H., Park, J. W., Kwon, Y. H.: Cortical reorganization induced by task-oriented training in chronic hemiplegic stroke patients. Neuroreport, 14, 2003, 1, s. 137–141.

11. Kleim, J. A., Jones T. A.: Principles of experience-dependent neural plasticity: implications for rehabilitation after brain demage. J. Speech Lang. Hear. Res., 51, 2008, 1, s. 225–239

12. Liu, K. P., Chan, C. C., Lee, T. M., Hui-Chan, C. W.: Mental imagery for promoting relearning for people after stroke: a randomized controlled trial. Arch. Phys. Med. Rehabil., 85, 2004, 9, s 1403–1408.

13. Luft, A. R., McCombe-Waller, S., Whitall, J., Forrester, L. W., Macko, R., Sorkin, J. D., Schulz, J. B., Goldberg, A. P., Hanley, F.D.: Repetitive bilateral arm training and motor cortex activation in chronic stroke: A randomized controlled trial. JAMA, 292, 2004, 15, s. 1853–1861.

14. Miller, T. E.: Central Control of grasp: Manipulation of objects with complex and simple dynamics. Neuroimage, 36, 2007, 2, s. 388–395.

15. MURPHY, M. A., SUNNERHAGEN, K. S., JOHNEL, S, B., WILLEN, C.: Three-dimensional kinematic motion analysis of a daily activity drinking from a glass: a pilot study. J. Neuroeng. Rehabil., 3, 2006, 18.

16. NUDO, R. J.: Adaptive plasticity in motor cortex: implications for rehabilitation after brain injury. J. Rehabil. Med., 41, 2003, s. 7–10.

17. Nudo, R. J, Friel, K. M., Delia, S. W.: Role of sensory deficit in motor imapairments after injury to primary motor cortex. Neurophramacology, 39, 2000, 5, s. 733–1019.

18. REMPLE, M. S, BRUNEAU, R. M., VANDENBERG, P. M., GOERTZEN, C., KLEIM, J. A.: Sensitivity of cortical movement representations to motor experience: evidence that skill learning but not strenght training induces cortical reorganization. Behav. Brain Res., 14, 2001, 123, s. 133–141.

19. Richards, L. G., Stewart, K. C., Wooddbury, M. L., Senesac, C., Cauraugh, J. H.: Movement-dependent stroke recovary: a systematic review and meta-analysis of TMS and fMRI evidence. Neuropsachologia, 46, 1, s. 3–11.

20. Sainburg, R. L., Kalakanis, D.: Differences in control of limb dynamics during dominant and nondominant arm reaching. J. Neurophysiol., 83, 2000, 5, s. 2661–2675.

21. UNGERLEIDER, L. G., DOYON, J., KARNI, A.: Imaging brain plasticity during motor skill learning. Neurobiol. Learn.Mem., 78, 2002, 3, s. 553–564.

22. Warraich, Z., Kleim, J. A.: Neural plasticity: The biological substrate for neurorehabilitation. PM & R, 2, 2010, 12, s. S208–219.

23. WEISS, P. H., JEANNEROD, M.; PAULIGNAN, Y.; FREUND, H. J.: Is the organisation of goal-directed action modality specific? A common temporal structure. Neuropsychologia, 38, 2000, 8, s. 1136–1147.

24. You, S. H., Jang, S. H., Kim, Y. H., Hallett, M., Ahn, S. H., Kwon, Y. H., Kim, J. H., Lee, M. Y.: Virtual reality-induced cortical reorganization and associated locomotor recovery in chronic stroke: an experimenter-blind randomized study. Stroke, 36, 2005, 6, s. 1166–1171.

Physiotherapist, university degree Rehabilitation Sports medicine
Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.


Don‘t have an account?  Create new account