FACILITATION, STIMULATION, FACILITATING ELEMENTS AND METHODS

Facilitation = make easier, usually exercise or activity (this is improving the conditions for
performing motion)

Stimulation = activity that promotes or encourages a reaction by stimuli (activity is induced, the
movement is executed, the muscle contracts)

The activation of motor effectors is going through the reflex arc on the basis of facilitation and
stimulation of the afferent systems (the sensory receptors, the visceroreceptors, the
exteroreceptors in the skin reacting for the pain, touch, pressure, heat and cold, the
proprioceptors in the muscles, tendons and articular capsule responsive to the change of the
muscle’s length, to the change of the tension in the muscle).

The reflex arc consists of sensors (receptors), the centripetal (afferent) pathways, the center,
the centrifugal (efferent) pathways and the executing body (effector).


Monosynaptic reflex

Výsledek obrázku pro monosynaptic reflex The simplest kind of reflex consists only of two nerve
cells (neurons). The afferent (sensory, centripetal) neuron leads an impulse through single synapse
onto the efferent (motor, centrifugal) neuron.



Související obrázek  The stretch reflex is the only type of the monosynaptic reflex in the true
sense in the body. The function of this reflex is a protective reaction to the sudden unwanted
muscle elongation.  Very simple terms: When a muscle is stretched by rapid passive motion thus it
contracts. This avoids the rupture.

The muscle spindle is the receptor of the stretch reflex. It is formed an intrafusal fibers, which
are disposed in parallel with an extrafusal fibers (muscle fibers) and they react to the stretching
of the muscle. The afferent pathway ends on the excitatory synapse of the alpha motor neuron in the
front horn of the spinal cord. The efferent pathway ends on the motor junction of the extrafusal
fibers of the same muscle.

Výsledek obrázku pro divergent of spinal reflex arc Because in the dorsal spinal horn the
divergence occurs, the further motor neurons of agonistic muscle groups (synergists) are activated
during the stretch reflex and the contraction is amplified.

Polysynaptic reflex

Bisynaptic reflex

One interneuron (2 synapses) is inserted into the course of the reflex arc.

Reciprocal innervation: In order to be implemented the movement, the interplay between agonists and
antagonists must operate. It means that relaxation of antagonists is necessary when activating
agonists. This condition occurs on the basis of the reciprocal innervation. Part of the branches of
afferent pathways creates synapses on Ia inhibitory interneuron through the divergence, they are
linked to the alpha motor neurons of antagonists, and thereby their activity is inhibited.


Výsledek obrázku pro golgi organ tendon Tendon reflex: The receptor - Golgi organ is located in the
muscle tendon. Its fibers are stored into the muscle-tendon transition in a series to the muscle
fibers and they react to the muscle stretching and above all on increasing the muscle tension. The
afferent fiber Ib via the inhibitory interneuron is transferred to an alpha motor neurons of the
same muscle, and thereby allow it to relax agonists. The Golgi organ builds on the activation of
the muscle spindle and cooperates with it. The Golgi tendon organ prevents overloading of the
muscle and tendon.



Polysynaptic reflex: A greater number of interneurons are inserted into the reflex arch. Examples
the tonic stretch reflex (monosegment), the tonic neck reflex (polysegments) and the crossed
extensor reflex.

                           Výsledek obrázku pro polysynaptic reflex arc













Facilitating elements

1.        Breathing:

The inspiration – activation of the trunk extensors

The expiration - activation of the trunk flexors

General: the movements towards out the body with inspiration, the movements towards in the body
with expiration

2.        Vision:

Monitoring and checking of movements

view up - to activate extensors of the head and the neck

view down – to activate flexors of the head and the neck

3.        Hearing

I as a physiotherapist say what the patient is doing.

4.        Stimulation of the heat sensors

Heat decreases muscle tone.

Coldness increases muscle tone.

5.        Stimulation of the skin exeteroceptors for pressure and touch

Stroking, brushing, pinching, scratching

6.        Stimulation of the proprioceptors

Fast passive stretching of the muscle

Vibrations

To evoke reflexes