What is Dynamic Movement Intervention (DMI)?
DMI stands for Dynamic Movement Intervention. It is a therapeutic technique used to treat children with gross motor impairments. The techniques and exercises used in DMI promote the improvement of automatic postural responses and therefore promote progress towards developmental milestones. The goal of DMI is to provoke a specific active motor response from the child in response to a defined dynamic exercise prescribed by a certified therapist.
Regardless of a child’s level of cognition or extent of neurological deficit, there is a benefit to using DMI techniques and exercises for motor intervention as they stimulate neuroplastic changes in the developing brain. This includes children who have been diagnosed with Down Syndrome, Cerebral Palsy, global developmental delay, hypotonia, chromosomal abnormalities and genetic disorders, spinal cord lesions, and acquired brain injury (such as traumatic brain injuries, infections involving the brain and strokes). Children at risk of developmental delays, such as children born prematurely, can also benefit from this therapy.
DMI is based on the following 3 theoretical foundations.
Neuron Group Selection Theory (NGST)— NGST states that the brain is a combination of cortical (outer layer of the brain) and subcortical (neural formations deep within the brain) layers that are organized into variable networks. The structure and function of these networks are then selected based on motor output (movement) and sensory input. NGST postulates that unused networks will be pruned as part of the normal maturational process with the goal of leading to more efficient and effective motor responses. In simpler words, “the use it or lose it” neuroplastic concept specific to these neuron groups.
Neuroplasticity— see our previous post for more information.
Maturational theory— Maturational development proceeds in fixed sequences. Things are learned in a top down (head to toes) and proximal to distal (core to extremities) manner. Babies first learn control of their lips and tongue, then their eye movements, followed eventually by neck, shoulders, arms, hands, fingers, legs, and foot control. Additionally, control is learned in general bilateral movements first and then more specified opposing unilateral movements.
DMI focuses on gross motor skills, gradual progression of challenges, alignment and range of motion, balance, functional movements, somatosensory development, modifying tone, modifying abnormal movement patterns, and global development. DMI has an impact on functional movements as it improves the actions and skills that lead to attaining milestones such as rolling, sitting, standing, walking. DMI also focuses on primitive reflex integration and movement dissociation.
What happens during DMI?
The therapist will be able to identify areas of potential growth after a brief assessment. This will help create a treatment plan, select appropriate exercises and guide subsequent sessions. The therapist will maneuver and guide the child in specific ways in order to encourage novel movements in a more typical pattern. Exercises are repeated until the movements become automatic. This results in improvements in balance and function. The exercises used involve movements against gravity with progressively more challenging support (less and less support from the therapist) in order to provoke the desired movement and postural changes.
What about Bobath and NDT?
DMI is based off of many of the same principles as Bobath and Neurodevelopmental treatment (NDT). All three techniques and styles of treatment are founded on creating proper postural alignment for activities. NDT is an American developed technique based on the Bobath principles which originate from Great Britain. While all have developed independently resulting in slight differences, they are based on the premise that normal postural reflex mechanisms are fundamental to performance and development of motor skills. Lastly, all three techniques incorporate the combination of an external sensory input to produce an internal motor output.
If you are interested in knowing more about how we can help to get your child moving and progressing towards their motor milestones, please reach out to us!