oa South African Medical Journal - Synkineses in neuromuscular re-education : in infantile cerebral hemiplegia
The foremost attempts to neuromuscular re-education in infantile cerebral hemiplegia are critically evaluated. They are: Phelps' method of 'confused motion', Kabat's and Knott's method of direct resisted motion and also of complex primitive pattern movement, Fay's method of defensive reflexes, and the still widely adapted faradic treatment. Attention is drawn to the presence of spasmodic synkineses in infantile cerebral hemiplegia. It is maintained that they can be used to elicit volitional contractions of zero-cerebral or weak cerebral muscles. It is further shown that resistance to muscular contraction on the healthy side is the main reinforcing factor for these synkineses. Neck, optic and labyrinthine reflexes are of less importance. Finally a theoretical foundation of the synkinetic treatment is offered.
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