Johnstone—Treatment of Cerebrovascular Accident

Johnstone—Treatment of Cerebrovascular Accident

Johnstone approach was founded by Margaret Johnstone, a Scottish physiotherapist who has worked with patients with neurologic deficits when she had to treat patients with gunshot wounds of the brain in the mid 1940s. This approach is based on a hierarchical, reflex model where sensory and motor plays a important emphasis, Johnstone approach also relies on a proximal to distal approach based on the movements and a person’s normal developmental model. The main objective of her treatment approach is to attack spasticity in the patient with a cerebrovascular accident (CVA) 24 hours a day. Treatment is based on reflex inhibition with special attention to inhibiting the tonic neck reflexes through use of air splints and positioning. Main problems are considered to be an imbalance of muscle tone and the presence of unwanted, disabling postures from loss of CNS control from higher centers.

With proper positioning techniques and inflatable air splints, we have biomechanical advantages which include influencing associated tissue changes and muscle tone. There will be stabilization and mobilization of the affected joint. Air splint plays a major role in preventions and treatment of muscle contractions, especially in delayed cases.

The air splint is designed to apply even, deep pressure to the soft tissues to address sensory dysfunction. The air splint gives dynamic boost to sensory input when used dynamically, such as during weight bearing exercises/activities, the constantly changing pressure gives additional sensory input to the joints. Weight bearing exercises with air splints also influence the proprioceptive receptors sensory input can also be boosted when air splints is used in combination with the intermittent pressure pump

Based on Johnstone concept, it has a practical and psychological advantage. By allowing active participation and independent practice, patient is able to be independent. Air splints also...