The Path Level Training System (LTS) was designed through a collaboration between JJ Fowler and Brian Cassidy of the ADAPT Training Center in Oregon. With Brian’s immense expertise in the field of neuromuscular therapy and JJ’s background in training people with spinal cord injuries, Path’s LTS creates a road map for recovery that is unequalled in the field. This system ensures that the progression of stimuli is delivered in safe manner, which guarantees that the client is continually building tools of recovery before needing to use them. This progression speeds up the recovery process by minimizing plateaus, and rebuilds the client following nature’s laws of movement.

Performance Activation Training Healing

Neuromuscular Therapy

LEVEL 1
Neurological Efficiency with Angles

The human body was designed with a specific blue print, the effects of sitting in a chair for extended periods of time changes that design.  In order to facilitate healing of the nervous system and body, there must be a minimum standard of muscle length to hold neutral joint angles. Level 1 is where we begin to fight the negative response of sitting in a wheelchair. As the joints fall out of neutrality, the ability to send and receive nervous system signals is dramatically reduced.  This builds in deep restrictions in the joints that may increase in severity as the client heals;  leaving basic fundamental weaknesses in the body. Addressing these weaknesses later increases the client’s overall healing time. When the joints are able to hold a neutral position and the muscles are allowed to relax completely, not only will the nervous system signals have maximized opportunity, but also, the overall health of muscle and bodily circulation will increase significantly.

LEVEL 2
Neuromuscular Activation of Hip and Shoulder Girdle

Level 2 clients may have  little or no energy in the body. Their  legs may lack positional spasticity, and the hip/knee/and ankle joints could be hyper-mobile. There might not be nervous system signals going down past the level of injury. The shoulder girdle and hips may still have some restricted range of motion due to lack of movement.  The most important goal of Level 2 is to get the client’s nervous system signals  past the level of injury and into the structural joints. Their is a low demand placed on the level 2 client, this may be in the form of static supported load bearing or hip/ leg/ and shoulder dynamic range.  These and other moves are designed to siphon the nervous system signals down and around the injury site. These signals will begin to bring about a kinesthetic awareness of the body, beginning to reeducate the nervous system. Visualization will begin to bring an overall awareness by the client while elevating their connection to their body parts below the level of injury. It may be very important to begin with supported load bearing as a means of siphoning nervous system signals into the shoulders and hips.

LEVEL 3
Activation with Manually Assisted Range of Motion

After siphoning the nervous system signal down past the level of injury into the hips in Level 2, the connection needs to be strengthened. Joint range of motion must not be increased at this point. This is a major concern for two reasons; firstly, lengthening the muscle may deactivate it, thus turning off the weak connection we have already established. Secondly, the muscle might lack the resiliency needed to handle that type of demand and muscle health would be compromised. Strengthening the nervous system signal involves a tremendous amount of repetition of movement patterns designed to increase the efficiency of the nervous system pathway. These movements must include all the directions the hips and shoulder girdle were designed to articulate. Consistent maintenance of the neutral joint angles already established for maximum nervous system efficiency will be very important. The overall health of the muscles begin to increase rapidly, assuming there is ample quality nutrient and water intake by the client. All of these factors will increase the overall healing rate.

LEVEL 4
Introduction to Integrated Activation

The Level 4 client will begin to activate muscles with the use of responsive positional assistance.  As the nervous system signals are repeatedly remapped down through the hips and legs, the connections will improve, and the efficiency of the pathways will bring about self-activation.  Going from positional activation to self activation requires neutral joint angles to allow for the best possible signal pathways.  As the nervous system matures the client begins to focus on muscle pairings (mover and stabilizer) in order to integrate the individual muscles that attach to the same joint. When multiple muscles learn to stabilize a joint, they work together and will strengthen isometrically, beginning to create the dynamic tension that will lay the groundwork for ideal joint function. As the client learns to create coordinated contractions of the muscles we will begin to teach them to stabilize the joints, making active load bearing now possible. If done prematurely, the demands of active load bearing may create deep compensation patterns, developing restrictions whose later correction could result in slowing the overall healing rate.

LEVEL 5
Isolated Range of Motion with Demand

Level 5 is where the client begins to integrate multiple muscles to create coordinated movement. The sequencing of the movements will lay the groundwork for proper dynamic tension and ideal joint function. As the nervous system continues to heal the client will learn to create strength through the entire range of motion.  Neutral joint angles are maintained. The training will mirror the Nature’s Strength Progression as the client learns to move freely on the floor. As the client moves around on the floor, the intrinsic muscles in the hips develop the stabilization necessary for motor muscles to be educated to do the job for which they were designed. The mechanics of walking are now introduced; by waiting until the client can create movement without the aid of energy or positional assistance, we ensure compensation-free movement. The gait trainer and the spin bike now become tools to assist the training of the musculature in the movement patterns necessary for efficient gait.

LEVEL 6
Introduction to Vertical Training

The Level 6 client is now beginning to spend time training with less contact points on the floor. They have the coordinated movement, ideal dynamic tension, and structural integrity to load their entire body both horizontally and vertically in a safe manner. The client learns to get on and off the floor by themselves.  There are two connection points to the floor with multiple load angles laying the ground work for the independent hip function in Level 7.  The muscles are beginning to build resiliency and resistance to fatigue. Every nervous system pathway possible has been remapped and the client now becomes similar to an extremely weak, able-bodied person. The gait movement pattern is reinforced daily as the client requires less assistance with body weight. This is also the stage where the client may begin to leave the chair for short periods of time in controlled settings.

LEVEL 7
Independent Loaded Articulation

Level 7 requires that the client be able to support his or her own body weight off the floor. The number of contact points to the floor during training is reduced and independent hip function is strengthened. Lateral weight transfer and single leg hip coordination are the major goals of this level. Training both sides of the hips to be symmetrical and functional not only allows for maximum efficiency of movement, but also reduces the chance of non- impact injury in other areas of the body. The client learns to react to any demand placed upon the body in the outside world.  The client learns to fall to the ground in such a way to dissipate the energy of movement smoothly.  The amount of movement necessary to create a balanced state reduces.  As confidence grows the chair becomes a thing of the past. By the time this level is finished the client possesses the integrity to safely complete large, whole-body range of motion.

LEVEL 8
Loaded Range with Demand

Level 8 is purely about being able to handle more demand; the muscular coordination and dynamic tension have already been created. As the time under tension increases, muscular endurance elevates and fatigue is reduced. Cardiovascular endurance is also increased due to the tremendous requirement on the system. The client has confidence in the knowledge of having the ability to react subconsciously to the unpatterned demand that occurs outside of the gym. The structural integrity provides the resiliency the whole system needs in order to alleviate all movement symptoms of SCI under normal, everyday demand.

Performance Adaptive Training Healing

Adaptive Therapy

Details coming soon, please contact us for more information.