RiVision® incorporates a succession of questions and answers between the therapist and the patient regarding feelings and sensations. The process’ flow is based on patient responses. One part of the underlying principles of RiVision is to achieve greater range of expansion within the patient’s movement patterns. An example of expansion of motion leading to a more balanced usage of the movements would be a patient who learns to extend her spine and movements upward and open herself up to the world, after years of moving her spine downward and being closed off to the world. Often times, restriction of spine motion and body movements implies being defensive and protective, while opening up and expanding imply emotional openness and greater confidence.
The art of integrating various modalities, incorporated within RiVision, that will best fit the patient’s needs, is a complex one. The treatment method is specifically tailored to each patient. RiVision gradually identifies the appropriate mode of therapy as the treatment progresses, without a pre-determined protocol. It is based on the therapist-patient’s continuous communication. Some patients may be open to practice part or the full range of RiVision modalities, while others maybe reluctant to do so. Without patient openness and belief in the possibilities this process holds, change and success can not occur.
THERE ARE SEVEN PROTOCOLS THAT ARE USED IN RIVISION
- Single therapies -
- Combined therapies -
• Combination of physical therapy and dance/movement therapy
• Combinations of physical therapy and guided imagery
• Combination of dance/movement therapy and guided imagery
• Combination of physical therapy, dance/movement therapy and guided imagery
HANDS-ON TECHNIQUES, THERAPEUTIC EXERCISES AND FUNCTIONAL APPROACHES
Manual therapy is defined as a clinical approach utilizing skilled, specific hands-on techniques, including but not limited to manipulation/mobilization used by the physical therapist to diagnose and treat soft tissues and joint structures. These techniques are used for modulating pain, increasing range of motion (ROM), reducing or eliminating soft tissue inflammation, inducing relaxation, improving tissue repair, extensibility, and/or stability, facilitating movement and improving function.
Manual/Hands-on techniques that she found to be the most helpful to her patients are: joint mobilization, soft tissue mobilization, myofascial release and body-tuning.
- Joint mobilization involves painless loosening up of the restricted joint and increasing its mobility by providing slow speed and increasing range of movement directed at the actual bone surface.
- Soft tissue mobilization consists of rhythmic stretching and moderate pressure to break up inelastic or fibrous muscle tissue. The procedure is usually applied to musculature surrounding the spine and is done in various intensities based on the patients’ needs.
- Myofascial release is a connective tissue technique that combines fascial elongation with varying amounts of stretch.
- Body tuning developed by Dr. Tatz, crosses modalities of many techniques combining Western and Eastern practices and emphasizing hands-on work on multiple joints related to the disorder. For example, elbow pain treatment includes treatment of the entire arm and upper body.
- During therapeutic exercises commonly used in physical therapy, stresses and forces are placed on the body systems in a progressive fashion in order to develop, improve, restore or maintain normal function through the development of strength, endurance, flexibility, relaxation and coordination.
Functional approaches, concentrate on educating one's neuromuscular or sensory-motor system to expand the range of ones movements thus affecting how one function (Knaster, 1996). These include among others, the Alexander and Feldenkrais technique
- Alexander technique is a method that works to change (movement) habits in everyday activities. It is a simple and practical method for improving ease and freedom of movement, balance, support and coordination. The technique teaches the use of the appropriate amount of effort for a particular activity. It is not a series of treatments or exercises, but rather a reeducation of the mind and body.
- Feldenkrais technique focuses on replacing old habits of movement with new, healthier ones. It comprises a set of exercises that focus on slow, non-aerobic movement with minimum effort and maximum efficiency
Dance/movement therapy (DMT) is a form of intervention that uses dance/movement as a process which furthers the emotional and physical integration of the individual. According to the Dance Therapy Association, dance/movement therapy involves the psychotherapeutic use of movement to further the emotional, cognitive, physical and social integration of the individual.
A basic premise underlying dance therapy practice is that there is no division between mind and body behavior. Body movements reflect emotional states and changes in movement behavior can lead to changes in the psyche (Knaster, 1996; Levy, 1988). Therapy starts at the patient’s current physical and emotional level and allows for change and growth through the expansion of movement and extension of self (Schmais, 1974).
Images are thoughts that draw on our senses. They may involve one, several, or all the following senses: hearing, taste, movement, vision, touch, smell and inner sensation. The goal of guided imagery is to make beneficial physical changes in the body by repeatedly visualizing the sensations associated with the experience. An example of guided imagery exercise to mop up an inflammation will be; "Breath out three times. Imagine that with a pure white cotton wad you mop up the red inflamed wet color until it permeates the cotton. Then take the cotton and throw it over your left shoulder. There, it is gone! When you look again, the area of your pain looks clean and light. The pain is gone. Breath out and open your eyes" (Shainberg, 2005. p.98). An image, like any other thought, sparks an electrical chain of events in the brain. For example, imagery influences endorphins secretion which then affects a person’s mood.