Kinesthesia: everyday movement

People tend to measure their state of health by their ability to control and perform everyday activities. On the basis of this realization, kinesthesia now occupies a solid position in the holistic rehabilitation of patients with paraplegia. The Swiss Paraplegic Center (SPZ) in Nottwil uses its specialist knowledge of movement to optimize and (literally) lighten the care of these patients. Kinesthesia helps to optimize the rehabilitation of patients with paraplegia.

 Being able to actively move your own legs is extremely important for the health and development of all human beings. People with paraplegia have lost many of their movement resources, which makes it all the more important for them to take an active part in a variety of different treatments that can be tailored to their particular condition.

What kind of treatment is kinesthesia and why is it useful?

In the initial rehabilitation, patients try to adapt the performance of everyday tasks to their new situation. If they are to take responsibility for their own lives, they will need to learn some highly specialized skills. In other words, they must be very well informed about their own abilities and limitations. Valuable assistance – with multiple benefits – can be provided by the versatile instrument of kinesthesia. This term embraces models, ideas and aids that help each individual to exploit their mobility potential through optimized care and improved quality of life. Through continuous training and a range of practical exercises, patients can discover new ways of moving, internalize patterns and constantly refine them with the help of their carers.

How can kinesthesia benefit family members?

The concepts employed in kinesthesia can also be adapted for use by relatives caring for a person with paraplegia. The very specific way in which movements and mobilization processes are planned and executed make it possible for everyone to interact with safety and care.
The first steps can be taken while the person is still receiving stationary care, by actively confronting worries such as:

- How can I make transfer easier (back problems)?
- What can I do when spasms make moving difficult?
- How can I help my partner move from the floor to the wheelchair?
- What more can I do to support/encourage my partner?

We can illustrate this using the practical example of Erich Stauffer, who has quadriplegia, and his family. While their husband and father was still in early rehabilitation at the Swiss Paraplegic Center in Nottwil, his wife Beatrice and sons Renato and Tim enrolled in a foundation course in kinesthesia. Here they acquired some basic knowledge about movement and human function. In addition, they all addressed the problems associated with spasms. On the one hand these involuntary muscle contractions in the paralyzed parts of the body can be used for various activities, including transfers and changes of position. On the other, they can often lead to long-lasting and severe tensional conditions that have a negative influence on the mobility of healthy parts of the body. The family worked together to find ways of influencing and gaining more control over the spasms. During the practical sessions they established the positive influential factors:

- Exploiting all movement levels (joints) in basic care, mobilization, etc.
- Using the patient’s active movements to influence spasm conditions.
- Touching the stable, hard parts of the body (mass) triggers fewer muscle spasms.
- Choosing positions in which the legs can be placed in an outward rotation (transportation movement).
- Not heaving and lifting parts of the body, but allowing the patient’s weight to carry the strain, etc.
- The elements of movement (time/space/effort) must be adapted to the patient’s abilities.

Kinesthesia: a new subject at the Swiss Paraplegic Center

The kinesthesia department at the Swiss Paraplegic Centre in Nottwil has been under construction for about a year. It is run by a level 3 trainer with the assistance of two other trained staff. The team is responsible for both internal and external training and for practical induction and project supervision. Over 200 members of staff at the SPZ Nottwil have so far taken part in training courses in this new area. On the one hand, it is proving beneficial to patients, relatives and carers who take part in the basic training courses. However, the courses are also being attended by staff from other hospitals and health institutions.
The kinesthesia training course comprises four days of basic and continuation courses as well as peer tutoring courses (which last six days). The knowledge acquired is then applied in planned learning stages of around six months. These include practical instruction at the patient’s bedside with the trainer, attending two workshops, and organizing study groups in which participants work on and analyze four cases together. Special emphasis is given to teaching the six basic principles of working with people with paraplegia.

Source: Marcel Schlecht, qualified nurse and kinesthesia trainer, writing in Paraplegie, No. 102, Paramedia

Edited by PmcC- MyH