title: Behavior modification in physical therapy.
abstract: Behavioral techniques reported to improve ambulation skills among physically handicapped persons include both reward and desensitization procedures. This report describes the application of other behavior modification principles to two patients who resisted physical therapy (PT) designed to educate them in the use of orthopedic assistive devices. Peer modeling was used with case 1, a 2 1/2-year-old girl with complete L4 spina bifida who cried frequently when wearing her brace, and refused to walk except with much assistance. Case 2 was a 21-year-old hemiplegic man seen two years after a severe head injury. Initially, severe tantrum behavior accompanied all demands placed on him. Treatment involved a combination of contingent music for being quiet and contingent aversive auditory feedback for yelling. In both cases clinically significant behavioral changes were observed. Results are discussed with respect to the cost effectiveness of behavioral interventions and the interdisciplinary coordination of rehabilitation team members.
mesh_terms: D000328:Adult; D001521:Behavior Therapy; D001915:Braces; D002675:Child, Preschool; D005260:Female; D006429:Hemiplegia / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D009128:Muscle Spasticity / Q000534:rehabilitation*; D026741:Physical Therapy Modalities / Q000523:psychology; D016136:Spina Bifida Occulta / Q000534:rehabilitation*