Motor control problems that result from damage to the central nervous system can make it difficult to learn functional activities. Although several therapeutic approaches attempt to address such problems there is little evidence of their efficacy. Targeted Training is a new approach, based on a biomechanical analysis of the problem, which usually relies on specifically designed equipment. This paper describes the underlying theory, the development of functional specifications, the translation of these specifications into an engineering design and the clinical results of applying the equipment. The promotion of head and trunk control provides an example of the process.
BernsteinN. A.The Coordination and Regulation of Movements, 1967, pp. 104–113 (Pergamon, New York).
2.
CampbellA. G.M.McIntoshN. (Eds) Forfar and Arneil's Textbook of Paediatrics, 1992, p. 802 (Churchill Livingstone, Oxford).
3.
BobathK.A Neurophysiological Basis for the Treatment of Cerebral Palsy, 1980, Spastics International Medical Publications (Blackwell Scientific Publications, Oxford).
HareN.Ideas developed at the Cheyne Centre 1969-1983. Friends of the Cheyne Centre for Spastic Children, London, 1984.
6.
VotjaV.The basics of treatment according to Votja In Management of the Motor Disorders Elements of Children with Cerebral Palsy (Ed. ScruttonD.), 1984, pp. 75–85 (Blackwell Scientific Publications, London).
7.
ScruttonD.Aim-Oriented Management In Management of the Motor Disorders Elements of Children with Cerebral Palsy (Ed. ScruttonD.), 1984, pp. 49–58 (Blackwell Scientific Publications, London).
8.
NHS Health Technology Assessment Programme, Evaluation of physiotherapy for cerebral palsy. Research and Development Directorate, NHS Executive, Leeds,1995.
9.
GreenE. M.MulcahyC. M.PountneyT. E.An investigation into the development of early postural controlDevelopmental Med. Child Neurology, 1995, 37, 435–448.
10.
PountneyT. E.GreenE.MulcahyC.NelhamR.The Chailey approach to postural managementJ. Ass. Paediat. Chartered Physiotherapists, 1999, 90, 15–33.
11.
ButlerP. B.MajorR. E.The learning of motor control. Biomechanical considerationsPhysiotherapy, 1992, 78 (1), 1–6.
12.
SheridanM. D.From Birth to Five Years. Children's Developmental Progress, 1997 (Routledge, London).
13.
BerthozA.PozzoT.Intermittent head stabilization during postural and locomotory tasks in humans In Posture and Gait: Development, Adaptation and Modulataion (Eds AmblardB.BerthozA.ClaracF.), 1988, pp. 189–198 (Elsevier, Amsterdam).
14.
KiddG. L.OldhamJ. A.StanleyJ. K.A comparison of uniform patterned and eutrophic electrotherapies in a classical procedure of rehabilitation of some movements in the arthritic handClin. Rehabil., 1989, 3, 27–39.
15.
PetteD.Activity-induced fast to slow transitions in mammalian muscleMedicine Sci. Sports Exercise, 1984, 16 (6), 517–528.
16.
ButlerP. B.An investigation of physiotherapy techniques used in treating children with cerebral palsy to define the parameters of orthoses and equipment to supplement this treatment. Internal Report, Institute of Orthopaedics, Oswestry, 1989.
17.
StallardJ.Reciprocal walking for paraplegic patientsMed. Horizons, 1988, 1 (4), 11.
18.
ButlerP. B.The physiotherapy management of motor impairment. PhD thesis, University of Birmingham, 1993.
19.
ButlerP. B.A preliminary report on the effectiveness of trunk targeting in achieving independent sitting balance in children with cerebral palsyClin. Rehabil., 1998, 12, 281–293.
20.
ButlerP. B.ThompsonN.MajorR. E.Improvement in walking performance of children with cerebral palsy: Preliminary resultsDevelopmental Medicine Child Neurology, 1992, 34, 567–576.
21.
ButlerP. B.FarmerS. E.MajorR. E.Improvement in gait parameters following late intervention in post traumatic hemiplegia: A long term follow up report of a single caseClin. Rehabil., 1997, 11, 220–226.
22.
FarmerS. E.ButlerP. B.MajorR. E.Targeted Training for crouch posture in cerebral palsyPhysiotherapy, 1999, 85 (5), 242–247.
