Parkinson's disease and conductive education
History
Conductive education was first developed in Budapest, Hungary, in the 1940s by a physician, Professor Andras Peto. He developed the concept that motor disability was a learning difficulty and placed an emphasis on helping those with motor disabilities to learn to help themselves. He established the State Institute for Conductive Education of the Motor Disabled in Budapest. This work was done mostly with children suffering from spina bifida, spasticity, and ataxia, but also with adult patients who suffered from Parkinson's disease (PD). The main aim of this therapy was to attain 'orthofunction', or independent functioning in daily life.
The successor to Peto, Maria Hari, saw conductive education as a creative process that permitted the central nervous system to restructure itself. In addition, to present understanding of the neuropathology of the condition, PD may be described neuropsychologically as causing a break in a functional system in which higher order mental functions usually remain intact.
At first, limited information about the work done with children was the only indication of the use for this type of therapy. However, it seemed to suggest that adults with a motor disorder could benefit from the programmes run at the Institute.
Students of the programme have achieved some amazing results, suggesting that structural intervention and practice can bring about a neuropsychological reorganisation with a significant rehabilitative outcome.
Techniques
In practice, conductive education is a learning programme for people with motor disabilities. It focuses on the practical functions of daily life and teaches individuals skills that will enhance their daily functioning and increase their independence. The primary aim is to teach children and adults with a neurological disability to control their movements and to function in society. The main concept is educational rather than medical.
The programmes are run with groups of 10 to 15 individuals held together by a conductor. The conductor, who has been trained for 4 years in areas of psychology, basic sciences and the teaching methodology, is responsible for the structure, rhythm and tempo of each session. The mode of teaching is verbal, with the conductor calling out instructions for each activity as it is being done. The members are encouraged to join in with the calling, which may be in the form of counting or saying a word which emphasises the action (e.g. 'stretch, stretch, stretch').
At the beginning of each session is a warm up that is different for each individual. The session progresses through several different activities in a variety of positions: lying down, moving into sitting, standing and walking.
The activities vary from simple to more difficult, with an emphasis on the accomplishment of a task. The sessions are goal oriented, although the means to accomplishment may differ with each individual. Each activity is directed towards a specific function commonly difficult for the individual. With PD, for example, a task could be rolling over. Successful achievement of this function is the goal.
The conductor is responsible for keeping the tempo of the session as well as being firm and encouraging. 'Rhythmical intention' is used to maintain motivation and helps people initiate the movement and continue to move through the exercises smoothly.
Practice is viewed not as a mechanistic repetition of meaningless motor acts but as a conscious process of learning optimal motor solutions to particular problems. Again, this emphasises the point that the achievement of the functional goal is of the utmost importance.
Conductive education has been shown to increase a person's self esteem, level of motivation and general health as well as increasing their ability to function independently.
Since its beginning, the Institute has worked with people who have PD, although little has been known about the methods. Due to a bias in Hungary towards pharmaceutical and pharmacological research and development, the neurologists there showed little interest in the Peto Institute and its non-medical treatment. However, interest in the programme has grown since the group's senior conductor presented a paper at the Hungarian Neurological Congress which sparked an amazing amount of interest and surprise at the results being achieved with people with PD.
In Britain in the mid 70s, a group of physiotherapists, having learnt a little about conductive education through Ester Cotton, who visited Hungary in the mid 60s, reported using 'Peto methods' in their work, with PD people. However, little detail about the methods used has been published and short-term evaluations were not encouraging.
A trained conductor in Australia working with PD would help to resolve the problems and allow proper evaluation.
Conductive education in Australia
The National Association for Conductive Education (Australia) attempts to:
- make known the principles and methods of conductive education in Australia and New Zealand;
- assist in the training of candidates as conductors;
- encourage research and evaluation; and
- promote and co-ordinate all conductive education activities in Australia.
The association can be contacted for information and enquiries.
Last Reviewed: 23 July 2002
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