The Swiss Bali is a familiar and inexpensive piece of eąuipment found in many physical therapy clinics which can easily be incorporated into individual or group irealmenl sessions as well as home programs. The Swiss bali offers clinicians limitless options in evaluation and irealment of healthy as well as disabled individuals. Whether the patiem has primary involvement in their musculoskeletal, neuromuscular or cardiopulmonary system, using the bali can add variety. challenge and fun to excr-cise programs. In healthy individuals, the bali may serve as a useful prcventive lool, by promoling good health through exercise.
To guide therapists in the rational design of trcatmcnls or programs using the Swiss bali. it is helpful to work front a coherent theoretical foundation. Many physical therapists are advocating the use of information front the field of motor control as a framework from which to base our work. Motor control is the process by which the central nervous system uses "...current and previous infor-ntation to coordinate effective and efficient functional moventents..." [Horak. 1991] Reference to "previous information" underscores the importance of motor learning in gcnerating movcment. Motor learning is defined as "the process of acąuiring the capability for producing skilled actions." [Schmidt, 1988]
The goal of this chapter is to integrate the practical applications of the Swiss bali into a contemporary theoretical framework based on a systems model of motor control and on principles of motor learning. It is not intended to be a comprehensive literaturę rcvicw, but rather a discussion of generał principles.
Figuro 1:1 Dynamie systems model ot a biological organism. (Adapted Irom Horak, 1991. Reprinted with permission ot the American Physical Therapy Association).
According to the systems model of motor control humans can be viewed as multi-dimension-al, complex, cooperative systems.(Scholz, 1990] From this perspective. motor behavior is an emer-gent property that results from the combined activity in all the functionally related subsystems. [Kanim, et. al., 1990] The efficiency of motor behavior depends upon the integrity of all the interacting subsystems. Functional movcment, that is, movement aimcd at performing a panicular goal-directed task, emerges from the interaction betwcen intrinsic systems:
• cognitive-limbic
• cardiopulmonary
• musculoskeletal
• neuromuscular
• sensoriperceptual plus extrinsic physical characteristics of the environment and environ-mental forces; and the individual's morphology (see Figurę 1.1). For example, the ability to ride a bicycle successfully depends upon the individ-ual having sufficient interest and motivation to use this modę of transportation; endurance to ride a functional distance; strength in multiple muscle groups to overcome friction
7