Neuromuscular Re-Education:


NMR emphasizes the role of the brain, spine, and nerves in muscular pain. One of the goals of Chiropractic and Physical Therapythis therapy is to relieve tender congested spots in the muscle tissue and compressed nerves that may radiate pain to other areas of the body.

Neuromuscular re-education & movement training is somewhat related to core training. These approaches can be used to for patients with spine-related symptoms, or for those with an underlying condition who are working to prevent recurrences. These techniques require an understanding of the relationship between stabilizing and mobilizing muscles, proper sequencing and optimal biomechanical motion patterns for a variety of daily tasks, occupational activities and sports-specific physical performance.

In these approaches, tasks are broken down into their most simple component single-joint movement patterns. These patterns are perfected with proper alignment, breathing, and muscle stabilization in non-weight bearing postures using manual or mechanical assistance. As the specific single-joint component pattern is mastered, without symptoms, the training becomes more complex and might include one or more of the following advances

  • Multi-joint movement
  • Non-linear motion (circular or diagonal)Chiropractic and Physical Therapy Chiropractic and Physical Therapy
  • Weight bearing postures
  • Proprioceptive challenges (eyes closed, unstable surfaces, etc…)
  • Progressive resistance
  • Variable speeds and durationsPower Plate Vibration Therapy

An assortment of techniques, tools and apparatus’ can be used to provide neuromuscular re-education and movement training including: one-to-one instruction, motion and task modeling, tactile cuing, taping and bracing, imagery, audiovisual aids, pressure biofeedback, EMG, assistive training environments such as Pilates or Gyrotonic, balance boards, dumbbells, and other devices.

The end goal with these types of approaches is to move a patient through a process that begins with:

  1. Unconscious movement incompetence (they don’t know what they don’t know), as it relates to efficiency and economy, to
  2. Conscious movement incompetence (they know what they don’t know), to
  3. Conscious movement competence (they learn through practice and repetition – this is the longest phase), and finally,
  4. A state of unconscious movement competence (Mastery). The last phase represents an integrated pattern of task performance that is safe and injury-resistant.

Article Source: Michael L. Reed, DPT, OCS on June 11, 2014.