Portable Goblin Post Office by Gabor J. Barton and Malcolm B. Hawken

1. 11/09/2013
Management of cerebral palsy

Brain lesion – primary/secondary/tertiary problems

Three pillars of motor learning:
Portable Goblin Post Office:
How to enjoy physiotherapy
Gabor Barton MD PhD
Reader in Biomechanics
Research Institute for Sport and Exercise Sciences,
Liverpool John Moores University, Liverpool, United Kingdom
Specific focus: core control
 Repetition
 Feedback

 Motivation
Many names
(Rizzo, 2002)
 Core stability / Core control /
Lumbar stabilisation / Core
strengthening

• Facilitation
Many definitions
 “…the ability of the lumbopelvic hip
complex to prevent buckling and to
return to equilibrium after
perturbation.” (Willson, 2005)
 “…muscular control required around
the lumbar spine to maintain
functional stability”
Assessment? Training?
Proximal stability
for distal mobility (Kibler et al., 2006)
C
Computer
A
Assisted
R
Rehabilitation
EN
ENvironment
CAREN - Game play
Control scheme #1
(Akuthota and Nadler, 2004)


Cerebral Palsy
Unimpaired Control

U/D

B
R
Focus on stepping and
pelvic tilt
Making a step while
controlling the pelvis
 Variable priority multiple
L
tasks train best for novel
multiple tasks
(Silsupadol et al., 2005)
F
1

2. 11/09/2013
Control scheme #2
Pelvic tilt


U/D
L

Unimpaired Control
Isolated pelvic
movement to avoid
cheating with trunk
flexion
Trunk must remain
upright
B
R
Cerebral Palsy
Focus on tilt and
rotation
F
Barton et al. (2006)
Carpet trajectory
Cerebral Palsy
Straightness of trajectory
 Deviation from the “ideal” trajectory
Unimpaired Control
(mean distance)
http://mathworld.wolfram.com/
Point-LineDistance2-Dimensional.html
Barton et al. (2006)
GPO controls

Control scheme #1

Vertical game task
Trunk tilt
Up/Down
Pelvic tilt
2

3. 11/09/2013
GPO controls

Control scheme #2
GPO controls

Horizontal game task

Control scheme #3

Diagonal game task
Right/Left
Trunk tilt
Trunk rotation
Trunk rotation
Pelvic tilt
Pelvic rotation
Pelvic rotation
GPO controls

GPO controls
Randomised order

Forward speed
 Automatic adjustment (Taylor and Creelman, 1967)
Performance := Maximum settled speed
GPO controls

Postures
Kneel sitting
High kneeling
Standing
3

4. 11/09/2013
Audience participation

Portable Goblin Post Office
 Laptop, TV, Xsens MTx, D-Flow, GPO
4