Perception-Action (PA) Therapy

(Formerly Tcharnuter Akademie for Motor organization – TAMO)

P-A holds that perception is an active process of seeking information about the environment through all available sensory channels. All human senses can thus be considered as perceptual systems. [1]

A perception-action loop is one in which perception guides actions which are necessary for gathering the perceptual information that, in turn, guides actions. Both parts of the loop seem to operate simultaneously. Actions also provide information about one’s own body, movement, and capabilities. [1]

For example, information from many perceptual systems is needed to maintain postural control. The somatosensory system (touch and pressure) is sensitive enough to easily detect small changes in position and in the rate of postural sway while standing. The P-A Approach takes advantage of this sensitivity by attending to the body-ground interface during movement, and using manual strategies to enhance the PPC input at those sites.

This therapeutic guidance does not conflict with the patient’s current postural control mechanisms, but may add perceptual information that aids the patient in creating better posture or a new movement. In this way, the patient’s ideas and motivations for moving are respected while he or she is provided an opportunity to change a movement pattern. Variability and complexity in movements during exploration and play are considered essential to perceptual-motor learning and are fostered by the therapist.

Evidence supporting the P-A Approach:

Rahlin M. TAMO therapy as a major component of physical therapy intervention for an infant with congenital muscular torticollis: a case report. Pediatr Phys Ther. 2005;17:209-218.

Stergiou N, Harbourne RT, Cavanough JT. Optimal movement variability: a new theoretical perspective for neurologic physical therapy. J Neurol Phys Ther. 2006;30(3):120-129.

Dusing SC, Harbourne RT. Variability in postural control during infancy: implications for development, assessment, and intervention. Phys Ther. 2010;90:1838-1849.

Harbourne RT, Willett S, Kyvelidou A, Deffeyes J, Stergiou N. A comparison of interventions for children with cerebral palsy to improve sitting postural control: a clinical trial. Phys Ther. 2010;90:1881-1898.

Rahlin M. Case report: an individualized intermittent intensive physical therapy schedule for a child with spastic quadriparesis. Physiother Theory Pract. 2011 Oct;27(7):512-520.

For much more information about P-A, go to: http://p-a-approach.weebly.com/theoretical-foundation.html.

References

[1] Tscharnuter I. Clinical application of dynamic theory concepts according to Tscharnuter Akademie for Movement Organization (TAMO) therapy. Pediatr Phys Ther. 2002;14:29-37.