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Bad Ragaz Ring Method
The Bad Ragaz Ring Method (BRRM) is a type of aquatic therapy used for physical rehabilitation based on proprioceptive neuromuscular facilitation (PNF). BRRM is a water-based technique in which therapist-assisted strengthening and mobilizing exercises are performed while the patient lies horizontally in the water, with support provided by rings or floats around the neck, arms, pelvis, and legs.
== Background ==
The Bad Ragaz Ring Method (BRRM), originally developed by physiotherapists in Bad Ragaz, Switzerland, is an aquatic therapy treatment approach that uses a water-based strengthening and mobilizing resistive exercise model. BRRM is based on proprioceptive neuromuscular facilitation (PNF). PNF is commonly used in physiotherapy to enhance both active and passive range of motion, with the ultimate goal being to improve neuromuscular function using patterns of movement and therapist-assisted resistance. Therapy is performed while floating horizontally in the water, with rings or floats supporting the neck, arms, pelvis, and knees. The extremities are used as levers to activate the trunk muscles.〔Dutton, M. 2011. Orthopaedics for the physical therapist assistant. Page 187 Bad Ragaz ring method. Jones & Bartlett Learning. ISBN 978-0763797553.〕〔Behrens, BJ and Michlovitz, SL. 2005. Physical agents: theory and practice, 2nd edition. Chapter 5. Aquatics and hydrotherapy. pp 82-89. F.A. Davis Co. ISBN 978-0803611344.〕〔Prentice, W. 2011. Rehabilitation techniques in sports medicine and athletic training, 5th edition. Chapter 15. Aquatic therapy in rehabilitation. McGraw-Hill. ISBN 978-0073376615. 〕〔 Gamper, U and Lambeck, J. 2011. The Bad Ragaz Ring Method. In: Becker, BE and Cole, AJ and (eds). Comprehensive aquatic therapy, 3rd edition. Washington State University Press. ISBN 978-0615365671.〕
Bad Ragaz Ring Method (BRRM) gets its name from the famous Bad Ragaz natural spring and wellness spa in eastern Switzerland. "Ring" refers to the rings or floats that are used to support the patient at the water surface. BRRM combines early techniques of aquatic exercise, developed in the 1930s by German physician Knupfer, with proprioceptive neuromuscular facilitation (PNF) techniques developed in the 1950s and 1960s by American neurophysiologist Herman Kabat and his assistants Margaret Knott and Dorothy Voss. Dr Knupfer originally adapted land exercises to water, using floats to support the patient while the therapist acts as a fixed point for movement. Knott and Voss applied PNF extensively for therapeutic exercise and began presenting their techniques in workshops in the 1950s; PNF courses began to be taught at major universities during the 1960s; and subsequently PNF became a widely accepted technique used extensively by physical therapists, other health professionals, and athletes.〔McAtee RE and Charland J. 2007. Facilitated stretching: PNF stretching and strengthening made easy, 3rd ed. (Chapter 2. Focus on facilitated stretching, pp 11-18). Human Kinetics. ISBN 978-0736062480.〕 Adaptation of PNF for use in aquatic therapy took place between the early 1960s and 1990 at Bad Ragaz, initially by Dr W.M. Zinn and Nele Ipsen, and later by Bridget Davies and Beatrice Egger.〔Ainslie, T. 2012. The concise guide to physiotherapy - 2-volume set: Assessment and Treatment. pp 1096-1106, Bad Ragaz Ring Method. Elsevier Health Sciences. ISBN 9780702053030.〕
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