More about CENT - Principles of Controlled Eccentric Neuromuscular Training.

Now to the meat...

CENT stands for Controlled Eccentric Neuromuscular training. It is partly because the acronym spells something that it was chosen. It will stick in your head and make writing about it easier. (See "Introducing DAP notes" article for some of my views on acronyms.)

Guiding Principles:

Switching between agonist / antagonist muscle actions takes time, effort and is not necessary to start.

The Flexor Synergy exists for a very good reason, if you're a caveman...

Praxis is the key to purposeful movement.

"The more you do the more you can do" (a basic Functional Therapy tenent that applies here too).

Next time we'll break these out a little.


Ed Kaine, OTR/L, RFT
President of the League of Functional Therapists, LLC.

Introducing CENT - Controlled Eccentric Neuromuscular Training.

Today I am introducing CENT - Controlled Eccentric Neuromuscular Training. Over the next few days I will give you more information about this marvelous treatment option I am exploring and developing. I will tell you the foundational tenents of CENT in a moment but first a bit of history.

I desperately want to give credit where it is due... but I can't find that person. Instead I will tell you a brief story and maybe you can help.

About 5 years ago we had a Physical Therapist from India come to our facility. While transitioning and looking to finish requirements to allow her to be licensed here she volunteered on Bridgeport Hospital's Acute Rehabilitation Unit in Bridgeport, Connecticut. Her name was Priti or Preeti. If you read this or know Priti please contact me at RegisteredFunctionalTherapist@gmail.com.

Priti gave a presentation on a paper she had read that she said came out of Australia. From this she identified several things, and I have refined those into this this:

• Work on movements opposite to abnormal synergies (the flexor synergy in the arm).
• Overflow movements or movements outside of the specific action you want should be discouraged and stopped.
• Eccentric muscle actions are often first to recover.
• Work on one muscle action eccentrically and concentrically to keep the patient's focus on a single effort.
• Any muscle action could be your starting point. Just get some success.

Using this on many patients and experimenting in light of other observations I have about stroke I have come to the synthesis known as CENT. I know that the novel direction this has taken would not have occuring without Preeti. Unfortunately I can't find any papers from Australia or elsewhere about this approach. If you read this and think it is referring to something you had heard, read or done I would love to hear about it. Also, if you'd like to collaborate on this and develop your own skills please contact me.

I will give you the meat of this great technique over the next week.

Ed Kaine, OTR/L, RFT
President of the League of Functional Therapists

"Functional Therapy... the Next Generation of Occupational Therapy."

www.FunctionalTherapist.org