The authors present their own views on the development of therapeutic gymnastics methods for the rehabilitation of motor neurological disorders. The long and ambiguous process of physical therapy evolution from the use of passive movements to modern kinesitherapy based on the laws of neurophysiology is described. It took more than half a century for the elementary passive gymnastics,originally used in the treatment of motor neurological disorders, to become modern kinesitherapy. The gradual accumulation of clinical experience and scientific knowledge made it possible to first introduce empirically found methods of excitation of some paretic muscles into rehabilitation practice, and then supply them with methods of including individual parts of the body in the motor activity due to the forced contraction of adjacent surviving muscle groups. The Soviet physiologists had developed functional systems doctrine and the concept of voluntary movements multilevel organization based on inborn and acquired motor programs. This investigation helped to understand that the skillful use of preserved motor abilities is the key to successful reconstruction of the basic functions, as well as every day and working skills (reflexes, synkinesis, mechanical coordination and reactive forces). In this case, the process of voluntary movement development is always associated with the patient’s volitional inhibition ability. So, it possible to counton impaired functions compensation in a reduced form long before the complete mobilization of all components of the movement. In chronological order, a critical review of several well-known kinesitherapy techniques is given (sisters Kenny, G. Kabat, S. Brunnström,spouses Bobat, etc.).

INTRODUCTION. Effective kinesitherapy of peripheral and central paralysis of the mimic, masticatory, lingual and pharyngeal muscles requires in-depth study of the features of the cooperative work of these muscles in the norm and in pathology. AIM. To acquaint rehabilitation specialists with motor automatisms of the brachiofacial area and show the principles of their practical use. MATERIAL AND METHODS. We studied more than 70 literature sources on involuntary activity of the maxillofacial region and adjacent regions muscles as well as we summarized our own experience in rehabilitation of patients with peripheral facial neuropathies and with bulbar and pseudobulbar syndromes RESULTS AND DISCUSSION. The study showed that the face, neck, and arm are involved in various mesencephalic-bulbar automatisms, both normal (ontogenetic and psychosomatic synkinesia, postural-ocular and postural-mandibular reflexes) and pathological (trunk eye-facial synkinesia, oral automatic reflexes), much more closely than other body parts. All of them, with the exception of facial hyperkinesias, may serve as a basis for optimizing kinesitherapy methods for movement disorders of the brachiofacial region. CONCLUSION. The face, neck, and hand are closely involved in a variety of stem and subcortical automatisms. The better the physical therapist is familiar with the features of the existing or potentially available to the patient reflex activity in the part of the body being rehabilitated, the more effective the rehabilitation treatment will be. The face, neck and arm are closely involved in a variety of stem and subcortical automorphisms. The better a doctor or an instructor in exercise therapy is acquainted with the reflex activity present or potentially available in the part of the body to be rehabilitated, the more effective the rehabilitation treatment will be.

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Pseudobulbar paralysis is neurological pathology caused by the interruption of cortical connections with the motor nuclei of the medulla oblongata of various etiologies. Aim: to describe the original complex of kinesitherapy for pseudobulbar syndrome, adequate to the competencies of physiotherapy exercises instructors and available for home use by relatives of patients. Material and methods. The object of observation was a patient with post-traumatic pseudobulbar syndrome, manifested by dysphagia, hypersalivation, anarthria, and bilateral central prosopoplegia. The methods of endo-oral and acupressure massage were used as well as the blockade of trigger points along the interested muscle-tendon meridians. Therapeutic gymnastics techniques were used based on friendly reaction, initiating the activity of the paretic lingual and laryngeal-pharyngeal muscles with the help of their unaffected agonists which were supplemented by electrical stimulation with impulse currents. Results. The observed two-year catamnesis indicates the presence of a positive effect when using this approach. Conclusion. The described methods of pseudobulbar paralysis kinesitherapy are simple and intuitive, they are suitable for development by nurses, social workers and relatives of patients, which allows them to be used at the third stage of rehabilitation.