Perturbation training is pushing the patient’s limb or body in order to cause instability that the patient is asked to resist. An example of this that I used to do is at the shoulder. I would have the patient lay on their back and hold their arm straight up in the air. Then I would push the arm in all different directions and say to the patient “don’t let me move you.” So the patient would try to resist my pushes. Perturbation training is rarely done in neuro physical therapy. Or maybe it’s done more often than I think, but it’s not done soon enough. My last post talked about falling and how falls are a necessary evil for our recovery. Dean commented that therapists need to push and shove patients when they are learning to walk and I agree. Most PTs would be horrified to try this. PTs are all about safety, safety, safety. Well when you have a stroke, absolutely everything is incredibly unsafe no matter what we’re taught. I think all that safety stuff should still be taught but therapy sessions should be focused on not safe stuff instead of safe stuff.