Bad Ragaz Clinical
Ring Method® & Ai Chi®
*Full Certification Course*
Coming to the United States – March 4-6, and 7-8, 2015
Skillful Aquatic Therapy depends on a proper clinical reasoning process that finally ends in an intervention strategy with adequate tactics. Tactics include the specific concepts that are used in the pool. Clinical Ai Chi® and the Bad Ragaz Ring Method® are two of these concepts, with pool practice focusing on an evidence based patient treatment.
This is what the Swiss Association IATF offers their students all over the world in their courses, developed in Valens (Bad Ragaz). Continuing a long tradition of e.g. Halliwick® Aquatic Therapy (HAT) and the Bad Ragaz Ring Method (BRRM), additional concepts like Clinical Ai Chi® have been added in order to comply with treatment goals that can be derived from the international classification of functioning, disability and health (ICF). The information is embedded in a European network (Aqua-evidence/outcome) and has recognition for the EU educational credit system (ECTS). Expertise of the IATF lecturer is the basis for teaching up-to-date knowledge, and superb handling / guiding skills are the foundation of every course.
Case related contents provide students with a comprehensive picture of current research that supports decision making, clinical reasoning, problem-solving and goal-setting in aquatic therapy. This intensive postgraduate aquatic therapy course is based on “learning-by-reasoning-and-doing” or “think-pair-share”: pool practice encompasses 70% of the total contact hours. Preparatory and additional studying time needs about 4 hours.
Two aquatic treatment concepts form the practical implementation of evidence based, and competence guided approach to therapy. Both classes come with a (digital) course book.
www.badragazringmethod.org www.clinicalaichi.org
Registration Fee:
Bad Ragaz Ring Method® 3 day class: $895.00
Clinical Ai Chi® 2 day class: $695.00
2 Class Combined Regular Registration ($100 off): $1490.00
2 Class Special Early Registration ($200 off): $1390.00
(Early Registration is before December 31, 2014)
Bad Ragaz Ring Method®
Full Certification Course
Wednesday-Friday, March 4-6, 2015
28 Continuing Education Hours-
The Bad Ragaz Ring Method (BRRM) is a hands-on aquatic therapy concept, based on e.g. Proprioceptive Neuromuscular Facilitation (PNF). It developed at Bad Ragaz in Switzerland in the 1960s and aims at increasing muscular function at different levels of muscular intensity. Mainly inter-muscular coordination, intra-muscular coordination and muscular endurance are known to be addressed. Muscles are activated via patterns of movement, performed against operator resistance and utilizing a variety of techniques such as combination of isotonics and dynamic reversals.
BRRM and especially PNF are used widely in physical therapy / rehabilitation. BRRM includes some 20 well-described patterns, based on PNF but adapted to make a patient additionally stable when floating in water. Patterns exist for the upper extremities (1), the trunk (10) and the lower extremities (13). All patterns have shown to influence trunk muscles, either directly or indirectly.
Understanding the muscle activation patterns during the BRRM patterns in impaired persons may help target therapy more effectively. BRRM can be used in all clients with neuro-musculoskeletal problems who have problems to activate muscles.
BRRM provides infinite possibilities for variation of exercise for the neurologic, orthopedic, & rheumatologic client.
1. Tone reduction
2. Relaxation
3. Increasing range of motion
4. Muscle re-education
5. Strengthening
6. Spinal traction/elongation
7. Improving alignment & stability of the trunk
8. Preparation of the lower extremities for weight
bearing.
9. Restoration of normal patterns of upper & lower
extremity movements.
10. Improving general endurance
11. Training functional capacity of the body as a
whole.
Bad Ragaz Ring Method® with Low Back Pain:
Water offers the possibility to lower the confounding information of nociceptive input: it is a safe environment with potential to lower mechanical load because of buoyancy. This is an excellent starting point for spinal motor control as advocated by Hodges et al (2013).
Indeed, active aquatic exercise treatment in water is a potentially to moderately beneficial form of exercise for people with low back pain (Waller et al, 2009; Barker et al, 2014). A key element is trunk muscle control. This control can range from finely tuned proprioceptive contractions when pain is prevalent to (high level intensity) strength training in cases of muscle weakness without pain (Hodges et al, 2013).
The BRRM can include the entire range of contractions and the exercises as suggested in Hodges et al (2013) will be adapted to the BRRM. Support of the choice for active exercise therapy can be found in recent guidelines (Staal 2013), also stating that success of the intervention method depends on the knowledge and skills of the therapist.
BRRM not only includes finely tuned contractions, but also eccentric contractions, and dynamic reversals with plyometric possibilities. These contraction modes are important to address the plastic properties of connective tissue and help to restore tensegrity.
References
Hodges PW, Cholewicki J, Dieën van JH (2013). Spinal control, the rehabilitation of back pain. Churchill Livingstone, Edinburgh
Staal JB, Hendriks EJM, Heijmans M, Kiers H, Lutgers-Boomsma AM, Rutten G, Tulder van MW, Boer den J, Ostelo R, Custers JWH.(2013) KNGF-richtlijn lage rugpijn
Waller B, Lambeck J., Daly D. Therapeutic aquatic exercise in the treatment of low back pain: a systematic review. Clinical Rehabilitation,2009;23:3-14.
Barker AL, Talevski J, Morello RT, Brand CA, Rahmann AE, Urquhart DM. Effectiveness of aquatic exercise for musculoskeletal conditions: A meta-analysis. Archives Physical Medicine Rehabilitation,2014:DOI:10.1016/j.apmr.2014.04.005
Bad Ragaz Ring Method®
Class Objectives-
At the end of this module, each participant will be able to:
– Use the original arm, trunk and leg patterns
– Relate the patterns to principles from PNF,
functional kinetics, exercise physiology and
fluidmechanics
– Use PNF techniques (e.g. hold/contract relax,
combination of isotonics, dynamic reversals and
fine tuning) in selected patterns
– Use principles from clinical reasoning to use BRRM
in various patient populations
CLASS SCHEDULE:
Bad Ragaz Ring Method®
Tentative Schedule
(Class and Lab times will vary)
WEDNESDAY, March 4, 2015
7:00-7:30 Registration/Breakfast (Provided)
7:30-9:00 Lecture & land lab
9:30-12:00 Pool lab
12:00-1:00 Lunch (Provided)
1:00-2:00 Lecture & land lab
2:30-4:30 Pool lab
5:00-6:30 Pool lab
– – – – – – – – – – – – – – – – – – – – – – – – – – – –
THURSDAY, March 5, 2015
7:00-7:30 Breakfast (Provided)
7:30-9:00 Lecture & land lab
9:30-12:00 Pool lab
12:00-1:00 Lunch (Provided)
1:00-2:00 Lecture & land lab
2:30-4:30 Pool lab
5:00-6:30 Pool lab
– – – – – – – – – – – – – – – – – – – – – – – – – – – –
FRIDAY, March 6, 2015
7:00-7:30 Breakfast (Provided)
7:30-9:00 Lecture & land lab
9:30-12:00 Pool lab
12:00-1:00 Lunch (Provided)
1:00-2:00 Lecture & land lab
2:30-4:30 Pool lab
5:00-6:30 Pool lab
6:30-7:00 Certification, Celebration & Wrap-up
Clinical Ai Chi®
Saturday-Sunday, March 7-8, 2015
19.5 Continuing Education Hours-
Ai Chi has proven to be effective for persons with various diseases, like e.g. multiple sclerosis. Recent research has shown (very) positive effects on fatigue, balance, muscle strength, pain, stiffness, and autonomy. What is Ai Chi and why is this method look so effective?
The basis of Ai Chi are it’s 19 kata’s: continuous movements that form a sequence with gradual increasing difficulty. There is no need to perform all movements. Different protocols exist, consisting of a choice of the 19 movements and/or a different amount of repetitions.
Mostly, music is used to guide the rhythm of movements and breathing. Rhythm functions as an auditive cue to continue smooth movements and is highly valued by persons with various impairments.
Movement initiation is also supported by the relative instability because of buoyancy. Breathing changes the buoyancy effect constantly, which means that a person in fact always moves a little bit: basis for the start of an intentional movement.
Ai Chi also includes important elements, necessary for balance (and fall prevention): continuous weight transfer, not using arms to support en also narrow supporting surfaces. The Association IATF in Valens (CH) has developed variations to challenge balance even more, according to research in fall prevention. These variations and the application to patient categories belong to Clinical Ai Chi® (registered by Jun Konno and Johan Lambeck in the EU).
Ai Chi in Fall Prevention:
Falls are a major problem, leading not only to an increase of incapacity but also to an increase of morbidity and mortality. Tai Chi is used successfully to increase balance and to reduce fall risk, Ai Chi has the same effects. A pool adds extra advantages however. When persons are safe (and feel safe), they are able to make larger movements than on land without the risk of losing that balance.
Controlling large reaching movements at the end of a large range of movement is essential for safe activities of daily living. The 19 kata’s have been modified with important evidence based elements of fall prevention in order to comply with the state-of-art in this area.
Maintaining an end-position for a short while is essential in daily living. To this end short moments of posture can be included and open the possibility to also include the Yoga “asana’s”. Asana’s and simple yoga (pranayama) breathing are the most recent extension of Clinical Ai Chi®.
Mobilizing connective tissue:
Ai Chi is known as a relaxation technique. Breathing, control of smooth movements and posture correction give a sense of relaxation. Physically this shows itself as reduced stiffness of connective tissue in and around muscles. Reduction of stiffness is facilitated by the repetitive movements, having direct effects on the ground substance of connective tissue. This means that gradually also small effects of range of movement can be acquired.
The possibility to relax is enhanced by the fact that slow movements in water, as well as maintaining a posture, only require about 25% of the muscular force of comparable land activities. This is another reason why Ai Chi is relaxing: it is easy to grade muscle activity and coordination of movements therefore needs less energy.
This also means that weak persons are able to perform Ai Chi (for an extended time) in the framework of “effortless strengthening”.
Ai Chi was created to help aquatic practitioners (including aquatic exercise instructors, personal trainers, and aquatic therapy and rehabilitation practitioners) and students enjoy the water in a flowing yet powerful progression. Effortless strengthening is also particular important for spinal motor control in persons with (non-specific chronic) low back pain and will be addressed as well in accordance with the possibilities to influence connective tissue in it’s existing range of motion (in the framework of “fascial fitness”.
Clinical Ai Chi®
Class Objectives-
At the end of this module, each participant will be able to:
– Describe the effect of influencing connective
tissue by Clinical Ai Chi®
– Follow the basic Clincal Ai Chi® kata’s
– Adapt the kata’s into challenging variations
– Apply Clinical Ai Chi® in fall prevention and
spinal motor control
CLASS SCHEDULE:
Clinical Ai Chi®
Tentative Schedule
(Class and Lab times will vary)
SATURDAY, March 7, 2015
7:00-7:30 Registration/Breakfast (Provided)
7:30-9:00 Lecture & land lab
9:30-12:00 Pool lab
12:00-1:00 Lunch (Provided)
1:00-2:00 Lecture & land lab
2:30-4:30 Pool lab
5:00-6:30 Pool lab
– – – – – – – – – – – – – – – – – – – – – – – – – – – –
SUNDAY, March 8, 2015
7:30-9:00 Lecture & land lab
9:30-12:00 Pool lab
12:00-1:00 Lunch (Provided)
1:00-2:00 Lecture & land lab
2:30-4:30 Pool lab
5:00-6:30 Pool lab
6:30-7:00 Exam, Celebration & Wrap-up