Sensorimotor stimulation (SMS)

This method has been founded in the 60’s on the neurophysiological basis. Sensorimotor stimulation (SMS) is very effective treatment method, used especially in physiotherapy but also during fitness training and in sports.

DEVELOPMENT OF THE SENSORIMOTOR STIMULATION

General knowledge about sensorimotor stimulation was brought by english orthopedist Freeman, who based his work on the studies of Hervéou and Messean. Freeman established the term “attenuation” and “incoordination”, which he explained based on the wrong afferentation (transmission of information from periphery to the center) from the injured joint. He used balance exercises on the balance board, but he limited himself only to the injury of the ankle.

Prof. MUDr. Vladimír Janda DrSc. has significantly enriched the area of the sensorimotor stimulation. He elaborated this topic and showed the connection between the functions of the whole musculoskeletal system. He explained the connection between chronic instability of the ankle and chronic back pain based on the damaged proprioception. Along with his colleagues PhDr. Kabelíková and Vávrová he described a very detailed and global method “sensorimotor stimulation”, their findings and learning are abundantly used in Czech republic as well as in the world.

In sensorimotor stimulation (SMS) are next to the general sensorimotor exercises (“small foot” etc…) also used various balance exercises performed from different default positions. Exercises are based on deflecting the mat or the person from a balanced position. These exercises lead to activation of proprioception and significantly improve the activation of the neural pathways. Furthermore you can use various exercising tools for improving the sensorimotor stimulation.

BALANCE SURFACES AND SENSORIMOTOR TOOLS:

• Round and oval balance boards
• Balance sandals
• Gym ball
• Mini trampoline
• Foam balance pad
• Posturomed
• Swing stick (propriomed)
• BOSU
• Balance disc

Exercising on these unstable surfaces positively affects muscle tension in single segments of the musculoskeletal system. Sensorimotor stimulation (SMS) helps to unconsciously involve muscles that are usually consciously hardly affected, it also helps to automatize the muscle activity. At the same time it leads to harmonization of the muscle game, and it recovers the muscles balance of the organism. By training on the balance pads the stability and reactive ability of the muscles, the sensorimotor stimulation becomes effective as a prevention against falling.

Sensorimotor stimulation is also used for optimization of common movement stereotypes - sitting, standing, walking. Exercising the sensorimotor stimulation (SMS) leads to removal of wrong movement stereotypes and consecutive re-learning optimal execution of these stereotypes.

PRINCIPLES OF THE SENSORIMOTOR STIMULATION (SMS)

For the 1. type it is characteristic to master a new movement and creating a functional pathway between your brain and the affected part of the body on the level of the cerebral cortex. Controlling the activities on the cerebral cortex level is very complicated, because you have to concentrate on the movement and learn from that. Example could be the first ride on the bicycle. At first it’s difficult and exhausting , until the child learns these movement stereotypes and masters it.

The 2. type of the motor skill is controlled by the visceral brain (cerebellum). Control from the cerebellum is usually easier and faster and less tiresome. It leads to automatization and fixation of the movement stereotypes. As soon as a child learns how to ride on a bicycle and learns the needed movement stereotypes, the child then doesn’t think about the ride anymore and just rides spontaneously.

Sensorimotor stimulation has a goal to fully master the 2nd type, reaching the automatic activation of the needed muscles in such degree where the movement would be coordinated but at the same time as least demanding as possible.

INDICATION:

• Joint instability (especially instability in the ankle joints, knee, shoulders and parts of the spine…)
• Insufficient muscle fixation of the pelvis by chronic and vertebrogenic algic syndrome (local pain in different spine areas with limited movement in the spine segment)
• Wrong posture
• Idiopathic scoliosis
• Cerebellum and vestibular disorders
• Proprioceptive dysfunctions
• Post-operative condition of the musculoskeletal system (ankle joint, knee joint, hip joint, shoulder joint, spine, etc…)

Sensorimotor stimulation is used not only for treating but also prevention, it speeds up the regeneration time after injury and operations, it positively affects the myoskeletal (manual) system, it secures the regained stability in the unstable joints, it helps against the back pains or disorders of stability and coordination. At the same time it increases the reactional ability of the organism to the terrain conditions, it strengthens the muscles and thanks to that it is usually used in the sports for improving the stability, reactional ability and physical ability.

Author: Mgr. Iva Bílková, FYZIOklinika physiotherapy Ltd., Prague, Czech Republic