15/09/2025
Implementing Shaping Through Hands-On Facilitation โจ๏ธ
Shaping in Parkinson's rehabilitation is like being a movement coach who helps someone relearn how to move properly. When someone has PD, their brain forgets how to make normal-sized movementsโeverything gets smaller and smaller. Hands-on facilitation acts as a physical guide to help retrain these movement patterns.
Understanding the Approach: Think of hands-on facilitation like being a dance partner or sports coach who physically guides movement. The therapist places their hands gently on the client's arm, shoulder, or back, guiding them through correct movement patterns whilst helping them feel what normal-sized movements should be like.
- The Progressive Process: Just like learning to ride a bike with training wheels before riding independently, shaping follows a systematic progression:
1. Initial Guidance: The therapist provides full hands-on support, physically guiding the client through the desired movement pattern
2. Partial Assistance: Gradually reduce physical guidance whilst maintaining tactile cues to remind the body of the correct pattern
3. Independent Practice: The client practices the movement with minimal or no physical support
4. Automatic Integration: Through repetition, the brain begins to remember and execute the movement automatically
- Practical Application: For example, if a client's arm swing has become very small during walking, the therapist might stand beside them and gently guide their arm through a large, normal swing motion. They repeat this process multiple times so the body remembers what it feels like, gradually reducing assistance until the client can perform the large arm swing independently.
- Building Motor Memory: This hands-on approach works by showing the body what correct movement feels like, practicing it repeatedly until it becomes natural again, and building confidence that normal movement is possible. The physical guidance helps retrain the brain's "automatic pilot" for movement that Parkinson's has disrupted.