Pediatric Specialty Day - Keynote Address

Hand therapists have long known, both academically and experientially, that to effectively treat the hand and upper extremity, one must include the brain. The drive to move, the program for movement, its intentionality, and the intricate balance of dexterous movement can only be exquisitely coordinated by the brain and, of course, by the body's feedback.

This lecture, a PowerPoint-style presentation, generously illustrated with videos, will encompass foundational principles of neurophysiology to support the Case Study in the Keynote address. Key concepts include the reflex circuit, neuromodulation, and maturation of the circuit as a foundation for coordinated movement. This concept of innate patterned movements, or reflexes, as building blocks of movement was first explored by the Nobel Prize-winning British physiologist, Charles Sherrington, in the late 19th century, whose research established many concepts of modern neuroscience, namely “the reflex is the simplest unit of nervous integration”. He coined the term synapse and elucidated Sherrington’s Law, the concept of reciprocal innervation. Additionally, he coined the term “reflex integration” and demonstrated that reflexes are not isolated, automatic events but are coordinated by the central nervous system and lead to purposeful behavior. Fast forward to modern day, and the research and practice of Dr. Svetlana Masgutova, PhD, has extrapolated this concept to effect real change in the human body by paving, or re-patterning, the reflex circuit.

Familiar reflex patterns, such as the Asymmetric Tonic Neck Reflex and Robinson’s Hands Grasp, seen in
infants are revealed in a different light than CHTs, both OTs and PTs, have been previously trained. The
full circle is revealed to the hand therapist when this movement is observed in the paralyzed limb of an
infant, when the brain is tapped for its genetically encoded knowledge of the pattern.