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Obligatory synergy patterns are observed when a patient tries to make a minimal voluntary movement, or as a result of stimulated reflexes. [1] The flexion synergy for the upper extremity includes scapular retraction and elevation, shoulder abduction and external rotation, elbow flexion, forearm supination, and wrist and finger flexion. [1]
Obligatory synergy patterns can be further subdivided into flexion and extension synergy components for both the upper and lower extremities. This approach requires active participation from both the patient and the therapist. [6]
Spasticity and the influence of synergy begins to decline and the patient is able to move with less restrictions. The ease of these movements progresses from difficult to easy within this stage. 5: Spasticity continues to decline, and there is a greater ability for the patient to move freely from the synergy pattern.
A functional muscle synergy is defined as a pattern of co-activation of muscles recruited by a single neural command signal. [18] One muscle can be part of multiple muscle synergies, and one synergy can activate multiple muscles. Synergies are learned, rather than being hardwired, like motor programs, and are organized in a task-dependent manner.
The McKenzie method is a technique primarily used in physical therapy.It was developed in the late 1950s by New Zealand physiotherapist Robin McKenzie. [1] [2] [3] In 1981 he launched the concept which he called "Mechanical Diagnosis and Therapy (MDT)" – a system encompassing assessment, diagnosis and treatment for the spine and extremities.
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