Integrative Therapies in Rehabilitation by Davis Carol;

Author:Davis, Carol; [M. DAVIS, CAROL]
Language: eng
Format: epub
ISBN: 4613273
Publisher: SLACK, Incorporated

Muscle Relaxation

The procedure for training a patient in muscle relaxation techniques is much the same as for muscle reeducation training. The difference lies in the fact that instead of teaching the patient to increase motor unit firing, we are trying to inhibit or decrease the level of firing created by the tension or tone in the muscle. Again, electrodes should be attached over an unaffected muscle for demonstration of how muscle tension can be lowered after an initial muscle contraction. Only when the patient has thoroughly understood the relationship between muscle contraction, relaxation, and the corresponding changes in auditory and visual displays should the electrodes be placed on the affected muscle.

The patient must understand that relaxing a muscle that has abnormal tone will not be as easy as relaxing a normal muscle, but that it can be done with practice and perseverance. Repeated orientation is necessary. The individual must understand that he or she controls the feedback and that the equipment does not control him or her. Among the best tools to assist a patient in decreasing muscle tension are deep-breathing techniques focusing in on the abdominal region, music, relaxation tapes, and progressive relaxation exercises, such as those designed by Jacobson.3

To assist patients who have difficulty decreasing muscle activity, the therapist should point out any strained posture, labored breathing, noted lack of focus, or anything else that is interfering with the ability to relax. Ideally, for training practice sessions, the patient should be in a quiet, dimly lit room, free from outside distractions, and positioned for maximum comfort. It is sometimes helpful to begin training or practice sessions by having the individual imagine pleasant scenes or experiences. This allows the patient to clear his or her mind of any of the “built-in” tensions of everyday life. Clinical training sessions generally last 30 minutes, 2 to 3 times/week. After the patient makes progress in decreasing the microvolts level in a structured situation, he or she should be encouraged to practice these relaxation techniques in the environment where the tension arises.

For those individuals with muscle contraction or tension headaches, the electrodes are often placed on the skin over the frontalis muscle approximately 2 inches apart and approximately 1 inch above the eyebrows. It should be explained to the individual that the electrodes are measuring the amount of muscle tension that he or she is producing, and that this tension is a reflection of the tension throughout his or her whole body.9,10

Some clinicians feel that the frontalis is not necessarily the best reflector of body tension for every patient, and this author agrees. Another effective lead placement is suggested using a global technique. With this technique, the electrodes are attached to the flexor surface of each forearm. This electrode placement allows one to monitor the tension of all of the muscles of the upper body, which comprise approximately 60% of the controlled muscles of the body.4

To develop a complete program of muscle reeducation or relaxation, it is important that the patient be instructed in the use of the EMG biofeedback unit at home.

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