History and mission
OUR VISION:
Every person living with the effects of neurological impairment — and those who care for them — will have access to skilled therapists who guide and empower them to participate actively in their own rehabilitation: in the clinic, at home, and in meaningful everyday life.
OUR MISSION STATEMENT:
WHO WE ARE
The PANat accredited Teachers Group is an international network of physiotherapists and occupational therapists dedicated to advancing evidence-based neurorehabilitation for adults and children.
Our work was inspired by Margaret Johnstone and has grown into the PANat approach — an evolving clinical framework developed and taught by therapists across many countries.
Our scientific foundation draws on neuroscience, motor control, neuroplasticity, contemporary fields of motor learning, biomechanics, and the cognitive and psychological sciences of behavioural change that influence recovery.
OUR INSPIRATION
We are driven by a shared commitment to patient-centred care, professional curiosity, and collaboration across disciplines and cultures. Above all, we are committed to people who depend on lifelong rehabilitation — and guided by the conviction that their potential for improvement and participation must never be underestimated.
We believe in rehabilitation as an active, ongoing process. Prevention of secondary complications — including learned non-use, muscle weakness, soft-tissue contractures, spasticity, and pain — is central to our work, especially for people with moderate to severe impairments. To meet these specific challenges, we integrate Urias® air splints, the PANat-Laptool®, and other low-tech tools into our training and treatment, giving patients and carers the means to remain active in rehabilitation beyond the clinic.
We aspire to be a team of professionals who act as a sounding board for one another, guided by principles of integrity, open-mindedness and holistic thinking.
OUR COMMITMENTS
As PANat accredited teachers and trainees, we
- continuously improve our own clinical expertise and teaching standards, keeping our knowledge current through ongoing engagement with with evidence-based neurological research and developments in clinical practice.
- organise and support courses, workshops, webinars, and collaborative projects to advance the quality of PANat teaching and practice worldwide.
- train and mentor the next generation of PANat teachers, ensuring that the approach continues to grow and endure.
We welcome future colleagues who share this vision and wish to contribute actively to the development of the PANat approach.
The History of PANat – From Margaret Johnstone to a Modern Evidence-Based Approach
The History of PANat – From Margaret Johnstone to a Modern Evidence-Based Approach
Margaret Johnstone, FCSP, was a Scottish physiotherapist whose pioneering ideas laid the foundation for what would eventually become the PANat approach. Widely recognised in the field of neurological rehabilitation, she was appreciated for her commitment to active participation, functional recovery, and the essential involvement of relatives, nurses, and helpers in the rehabilitation process. Her dedication was formally acknowledged in 1990, when the Chartered Society of Physiotherapists awarded her a Fellowship for her clinical innovations and influential publications.
Johnstone’s career began during World War II, working with young head-injured soldiers under Professor Norman Dott—an experience that shaped her clinical reasoning and understanding of neurological damage. She later spent 17 years in orthopaedics, further refining her practical problem-solving skills. These two chapters of her early career profoundly influenced the rehabilitation concepts she would develop later.
From 1965 onwards, Johnstone devoted herself to long-term stroke patients. In order to work closely with severely impaired individuals, she deliberately accepted a basic-grade post on a long-stay ward; she strongly believed that even the most disabled patients could make meaningful progress if given the right opportunities. Her conviction was simple yet radical for its time: active, supported use of the affected side could restore function and improve quality of life. This philosophy guided the creation of her most influential innovation — the inflatable air splints, which enabled safe, structured, and repeatable movement practice even when voluntary control was minimal.
Her work gained international resonance, leading to extensive teaching travels — often together with her sister and lifelong ally, Ann Thorp, also a physiotherapist. Even in retirement, Johnstone continued writing, teaching, and working with young head injury patients.
Over her career, she published five books, with Restoration of Normal Movement after Stroke (1995) summarising her concept. Her book Home Care for the Stroke Patient (1996) later inspired a CD-ROM to help therapists promote autonomous home-based training — long before self-directed practice became standard in rehabilitation.
Margaret and Ann also contributed to paediatric neurorehabilitation, supporting therapists who adapted their ideas for children.
To ensure the continuity of Margaret’s work, they appointed Gail Cox Steck, physiotherapist at Bürgerspital Solothurn (Switzerland), as Senior Instructor. Supported by a network of accredited teachers across Europe, the team worked to preserve Johnstone’s methods while updating them with new scientific knowledge. Margaret Johnstone passed away on April 13, 2006, leaving a legacy that continues to inspire therapists worldwide.
In 2007, her original ideas were formally expanded and modernised into what is now known as PANat — “PRO-Active approach to Neurorehabilitation integrating Urias® air splints and PANat-Laptool®”, led by Gail Cox Steck and an international group of physiotherapists and occupational therapists. The group integrated Johnstone’s practical approach with contemporary research in motor control, motor learning, neuroplasticity, and motivation psychology, creating a coherent, evidence-based framework for neurological rehabilitation across all recovery stages.
A key development during this period was the introduction of PANat-Laptool®, designed by occupational therapist Franziska Wälder. These low-tech therapy tools were created to enable more active, hands-off and self-directed training, providing stable surfaces, controlled movement channels, and clear sensory cues. When used alone or in combination with the Urias® Johnstone air splints, the PANat-Laptool® helps structure highly intensive and safe practice aligned with principles of motor learning.
Today, PANat stands as a modern, proactive, and adaptable approach, honouring Margaret Johnstone’s visionary work while integrating decades of scientific progress. Its ongoing mission is to strengthen academic partnerships and contribute to the growing evidence base supporting restorative, activity-driven neurorehabilitation.