Conductive Education (CE) is a method of teaching children and adults with motor disorders. It treats the whole person, not just the brain injury or deficit. Conductive education practitioners believe that progress comes from a blend of medical treatment and education and they try to build a learning process that permeates throughout the patient’s life:
‘CE focuses on problem solving, looking at symptoms caused by the condition and finding techniques and strategies to help with overcoming these. However, alongside mobility skills, CE also places an equal focus on the development of self-confidence, self-esteem and social inclusion.’1
Each patient actively participates in the treatment and learns how to make connections to his or her body through a series of exercises. The practitioners, called ‘conductors’, teach the healthy part of the brain to take over from the damaged area. In this way, the patient can learn how to move. Many practitioners claim that this treatment can help stroke survivors many years after their stroke. However, it is a slow process.
Conductive education is usually a group-based treatment. It was developed by András Pető in Hungary in the 1940s. Since then, CE has been a popular choice for children with neurological problems, such as cerebral palsy.
The treatment focuses on a series of tasks. These are designed to improve basic movements at first, progressing towards more complex movements. This form of learning does not need sophisticated machinery. It uses simple tools, such as stools and hand rails, combined with the effort of the patient. Treatment times vary for stroke. We have found courses ranging from one week to nine weeks.
Possible benefits of Conductive Education for stroke
A pilot study published in 2006 concluded that conductive education helped 12 stroke survivors to make significant improvements. The participants ranged in age from 55 to 74. They had each suffered a stroke between six months and three years prior to the study. The researchers measured both movement and quality of life at the start of the experiment and then tracked their progress over 10 diagnostic sessions. They found significant percentages of improvement in the participants:
‘Physical functioning: 72.7%
Role limitation – physical: 54.6% – emotional: 58.3%
Social functioning: 83.3%
Mental health: 83.3%
General health perceptions: 58.3%
Changes in health: 72.7%’ 2
While these results are promising, the author points out that a study of 12 people is too small and we need larger-scale studies.
Some practitioners argue that conductive education is most effective for stroke when it is combined with hyperbaric oxygen treatment. The increased oxygen to the brain helps to restore sleeping or dormant brain cells and the CE exercises rebuild the connections within the brain. They claim this helps to restore more functional movement than either treatment alone.
Arguments against using Conductive Education for stroke
The main argument against using conductive education in general is the lack of scientific evidence. There are lots of anecdotal reports from families of patients who claim that the treatment does work. However, there are very few high-quality clinical trials to prove its benefits. This is a typical comment from the published material:
‘The literature did not provide conclusive evidence either in support of or against CE. The limited number of studies and their weak quality make purely evidence-based decision-making on CE impossible. Further research is required.’ 3
Some trials have shown measurable improvements in the lives of stroke survivors; however, many of these trials have been small. Other trials have relied heavily on the anecdotal evidence of patients and their families. In addition, very few comparisons have been made between the effects of conductive education and treatments such as physiotherapy and occupational therapy.
Notes and references
- 'Adaptation and development in conductive education: responding to new demands, maintaining the essence of practice’ by Gombinsky L (2004). In Looking Back and Looking Forwards: Developments in Conductive Education. The Foundation for Conductive Education, Birmingham: 23-33
- ‘Conductive education for people with stroke: Pilot study’. In Nursing & Residential Care, April 2006, Vol 8, No 4.
- ‘Effects of conductive education intervention for children with a diagnosis of cerebral palsy: an AACPDM evidence report’ by Darrah J, Watkins B, Chen L, Bonin C. From Rosemont, IL, USA: American Academy for Cerebral Palsy and Developmental Medicine (AACPDM), (AACPDM Evidence Report), 2003: 34.