Archive | August 2016

Baby Time, Down Time, Internalizing Time

baby-toes-940x198One mother wrote to us: My girl is sleeping a lot since we started with ABR. My husband thinks that I am doing too much and making her tired. Is ABR making her tired? Should I do less?

In order for a special needs child to be able to develop further it is essential for him or her to be able to return to the baby stages. This is true on both the bodily level, as well as on a cognitive level, although the mechanisms are somewhat different.

ABR treatment is based upon restoring the baby stages to the body’s development. The tissues that are being regenerated with ABR are very primitive and basic bodily structures, but at the same time absolutely fundamental to the child’s further functional development. Without a restoration of this primary tissue system of fascia and connective tissues, the child will be caught and captured in his limited muscular skeletal development. Stages that a child missed in his or her early years, can be re-gained through the work that the parents do with ABR.

In order for the body to regenerate, sleep is essential. Requiring more sleep, is one of the signs of a child who is starting with the ABR program. During the sleep, the child rebuilds inner structures and strengthens his internal system. So, if the child sleeps more, or falls to sleep during the exercising times, then be assured that the efforts are paying off and that the child is utilizing the ABR input to the most optimal degree.

Not only is it important that the children in the ABR program get enough sleep, but also that they are allowed what we call “down time”. This is time where the parents and therapists are not running around after them, trying to get them to crawl or to creep or to perform some tasks that one thinks are important for them to learn to do; but where the child simply has time to himself to internalize his own inward bodily sensations.

For the healthy child and the special needs child alike, this type of “quiet time” is equally important. During such minutes and hours, a child explores the possibilities of his own system. He explores a great magnitude of the so-called “mini movements”. He rocks back and forth, he pushes with his feet against the crib, he grasps his own hands or feet, he tilts the pelvis slightly to the right or to the left, and so on. All of these mini-movements and explorations of the own body are absolutely essential for both integrating the movement capacity of the body, as well as for the actual mechanical strengthening of the joint connections! Moreover, these mini-movements, which parents tend to overlook, are important transition to what is called long chain movements, which involve many joint connections and are executed over long kinematic chains.

So, our fundamental advice to parents is: Allow your children lots of this down time, for internalizing and exploring the potentials and capacities that one is creating through the ABR work.

Unfortunately in today’s electronic world, one needs to add, that such internalizing cannot be done when the child is sitting in front of the computer or watching television. For this internalizing activity, the child needs to free up his sensory system for inward investigation, and not be caught up in the consuming impressions of a television screen.
Formal “training” of a special needs child usually is based upon the philosophy that the child is simply not smart enough to do the things that the parents or the therapist wish for him to do or to achieve. If he is not smart enough, then we have to show him, and train him to be able to do the things better. This philosophy can go to great lengths – even to the extent of forcing a child with a weakened muscular skeletal system to crawl long distances each day. Here again the underlying thought is: The child is not smart enough – and then, by taking the philosophy that one must teach the child everything to the extreme, justifies filling up every moment of the day for forcing the child beyond its own natural limits.

Unfortunately this philosophy overlooks some essential elements about the developmental system of both a healthy and a special needs child.

All children instinctively seek an inner equilibrium in their performance of movements! They take the path which is easiest for themselves and which comes most naturally. Why is this? – Simply because the muscular skeletal system is one of the bodies most expensive systems. It not only demands extensive involvement of the nervous system, but it “costs” the body a huge amount of expensive energy to run. Studies have shown that a child with spasticity uses four or five times as much of this expensive energy to perform even simple movements as the healthy person does.

On the other hand the structure of a special needs child is only similar to a healthy child on a superficial level. When one begins to analyze the muscular skeletal system of a special needs child one can notice that many of the movements or activities that one often tries to “train” a special needs child to do, such as to crawl, to creep, or to walk with some type of assistance, have no similarity with the crawling or creeping of a healthy child. And this “fake crawling” that a special needs child can be forced into doing excessively, is always stereotyped in nature, never varies in momentum or in speed or in distribution of weight to the joints and muscles, always uses the same muscle groups, and by over-using a small group of muscles, eventually leads to further disintegration and spasticity of these parts.

It is therefore that ABR focuses its attention on addressing the fascia as being a more primitive and basic connective tissue structure. These tissues are not “expensive” for the body. They do not require the expensive ATP supply of energy, but run on a back burner both with respect to energy and also with respect to the attention needed from the nervous system. Strengthening these tissues means that the child receives the background support from inner structures, to allow the muscles to work more efficiently and effortlessly.

At the same time the child’s cognitive system is freed up from extensive muscular effort and can be utilized for the development of cognitive activities.

If we take the healthy child as our starting point, we can see that the healthy child is always busy – from early until late. He explores in the early years the extents to which his body can move, and then goes on to use the body to explore the world around him. If left to his own devises, he develops a beautiful and organic way of using his muscular skeletal system. He explores new movements daily, integrates the newly gained elements into the already attained system, strengthening the system as he goes, in order to be able to maintain the new challenges that he is putting on the system.

The special needs child – and especially the children in the ABR program – require this quiet time, down time and baby time, not only for extensive regeneration, but for exploring, internalizing and realizing the newly born potentials of his or her motor skeletal system.

Diane Vincentz

 

Tiempo de bebé, tiempo de reposo y tiempo para internalizar

Una madre nos escribió: Mi niña está durmiendo mucho desde que empezamos con ABR. Mi marido cree que estoy haciéndole demasiado y la estoy cansando. ¿Puede ABR dejarla cansada? ¿Debo hacer menos?

Para que un niño con necesidades especiales pueda seguir desarrollándose es fundamental que él o ella sea capaz de volver a las etapas del bebé. Esto es cierto tanto en el nivel corporal, como a nivel cognitivo, aunque los mecanismos son algo diferentes.

El tratamiento ABR se basa en la restauración de las etapas del bebé para el desarrollo del cuerpo. Los tejidos que se regeneran con ABR son estructuras corporales muy primitivas y básicas, pero al mismo tiempo absolutamente esenciales para un mayor desarrollo funcional del niño. Sin una restauración de este fundamental sistema de tejidos conectivos y fascia, el niño quedará atrapado en su limitado desarrollo músculo-esquelético. Las etapas que un niño ha perdido en su primeros años, pueden ser re-adquiridas a través de la labor que los padres hacen con ABR.

Para que el cuerpo se pueda regenerar, el sueño es esencial. El que requieren más horas de sueño es una de las señales de un niño que está empezando con el programa ABR. Durante el sueño, el niño vuelve a generar estructuras internas y fortalece su sistema interno. Por lo tanto, si el niño duerme más, o se cae dormido durante las horas de ejercicio, entonces tengan la seguridad de que sus esfuerzos están dando frutos y de que el niño está utilizando el estímulo de ABR en el grado óptimo.

No sólo es importante que los niños en el programa ABR duerman lo suficiente, sino que también se les permita lo que llamamos “tiempo de reposo”. Este es el momento en que los padres y los terapeutas no están corriendo tras ellos, tratando de hacerlos gatear o arrastrarse o realizar algunas tareas que se piensa son importantes que ellos aprendan a hacer, sino que el niño tiene tiempo para sí mismo para internalizar sus propias sensaciones corporales.

Para el niño sano y el niño con necesidades especiales por igual, este tipo de “tiempo tranquilo” es igualmente importante. Durante estos minutos y horas, el niño explora las posibilidades de su propio sistema. Se explora una gran magnitud de los llamados “mini-movimientos”. Se balancea hacia atrás y adelante, se empuja con sus pies contra la cuna, se agarra sus propias manos o los pies, inclina la pelvis ligeramente hacia la derecha o hacia la izquierda, y así sucesivamente. Todos estos mini-movimientos y las exploraciones del propio cuerpo son absolutamente esenciales para la integración de la capacidad de movimiento del cuerpo,¡así como para el fortalecimiento mecánico real de las articulaciones! Más aún, estos mini-movimientos, que los padres tienden a pasar por alto, son de importante transición para lo que se llama movimientos de cadena larga, que implican muchas conexiones de articulaciones y se ejecutan en largas cadenas kinésicas.

Por lo tanto, nuestro consejo básico a los padres es: permitan a sus hijos mucho de este tiempo de inactividad, para la internalización y la exploración de las potencialidades y capacidades que se están creando a través del trabajo ABR. Desafortunadamente en el mundo electrónico de hoy, hay que añadir, esta interiorización no se puede hacer cuando el niño está sentado frente al ordenador o viendo la televisión. Para esta actividad de internalización, el niño necesita liberar su sistema sensorial para la investigación hacia el interior y no ser atrapados consumiendo las impresiones de una pantalla de televisión.

En “entrenamiento” formal de un niño con necesidades especiales por lo general se basa en la filosofía de que el niño simplemente no es lo suficientemente inteligente como para hacer las cosas que los padres o un terapeutas desean de que él haga o alcance. Si no es lo suficientemente inteligente, entonces tenemos que mostrarle cómo y entrenarle para que sea capaz de hacer las cosas mejor. Esta filosofía puede extenderse mucho, incluso hasta el punto de obligar a un niño con un debilitamiento del sistema músculo esquelético a gatear largas distancias cada día. Una vez más la idea subyacente es: El niño no es lo suficientemente inteligente y, a continuación, llevando al extremo la adopción de la filosofía de que hay que enseñar al niño todo, se justifica llenar cada momento del día para forzar al niño más allá de sus límites naturales.

Desafortunadamente esta filosofía pasa por alto algunos elementos esenciales sobre el sistema de desarrollo tanto de un niño sano como de un niño con necesidades especiales. ¡Los niños instintivamente buscan un equilibrio interno en el desempeño de los movimientos! Toman el camino que es más fácil para ellos y que viene lo más naturalmente posible. ¿Por qué es esto? Simplemente porque el sistema músculo esquelético es uno de los sistemas más caros del cuerpoNo sólo exige una amplia participación del sistema nervioso, sino que además le “cuesta” al cuerpo una enorme cantidad de costosa energía para funcionar. Los estudios han mostrado que un niño con espasticidad utiliza cuatro o cinco veces mayor cantidad de esta costosa energía para realizar los movimientos más simples que puede realizar una persona sana.

Por otra parte, la estructura de un niño con necesidades especiales es sólo similar a la de un niño sano superficialmente. Cuando uno comienza a analizar el sistema múscoloesquelético de un niño con necesidades especiales, puede notar que muchos de los movimientos o actividades que a menudo se tratan de “entrenar” a un niño con necesidades especiales para que haga, como a gatear, arrastrarse, o caminar con algún tipo de asistencia, no tienen ninguna similitud con el gateo o arrastre de un niño sano. Y este “falso gateo” que un niño con necesidades especiales puede ser obligado a hacer en exceso, siempre es estereotipado por naturaleza, nunca varía en momentum o en velocidad o en la distribución de peso en las articulaciones y los músculos, siempre utiliza los mismos grupos musculares, y por el exceso de uso de un pequeño grupo de músculos, con el tiempo conduce a una mayor desintegración y la espasticidad de estas partes.

Es por esta razón que ABR centra su atención en trabajar la fascia al ser una estructura de tejido conectivo más primitiva y básica. Estos tejidos no son “caros” para el cuerpo. No requieren el costoso suministro de ATP de energía, sino que se ejecutan en un segundo plano, tanto en lo que respecta a la energía como también con respecto a la atención necesaria del sistema nervioso. El fortalecimiento de estos tejidos significa que el niño recibe el apoyo de fondo de las estructuras internas, para permitir a los músculos trabajar más eficientemente y sin esfuerzo. Al mismo tiempo, el sistema cognitivo del niño se libera de los extensos esfuerzos musculares y puede ser utilizado para el desarrollo de actividades cognitivas.

Si tomamos el niño sano como punto de partida, podemos ver que el niño sano está siempre ocupado – desde temprano hasta tarde. Explora en los primeros años hasta donde se puede mover su cuerpo, y luego utiliza el cuerpo para explorar el mundo que le rodea. Si se deja a sus propias capacidades, desarrolla una manera hermosa y orgánica de la utilización de su sistema músculo esquelético. Explora nuevos movimientos diariamente, integra los elementos que acaba de adquirir en el sistema que ya ha obtenido, fortalecimiendo el sistema a medida que avanza, con el fin de poder mantener a los nuevos retos que está poniendo en el sistema.

El niño con necesidades especiales – y especialmente los niños en el programa ABR – requieren de este tiempo de tranquilidad, el tiempo de reposo y tiempo de bebé, no sólo para una extensa regeneración, sino también para la exploración, la internalización y la realización de los potenciales recién nacidos de sus sistemas motores.

Diane Vincent

ABR is: Parent Driven Development

Today’s world is a world of “specialists”. But there is at least one jewel of knowledge that even the poorest and the richest parents of special needs children share!  The richest parents know it because they have traveled the globe searching for the best doctors that modern medicine can supply –  and they have found out what the poorest parents know by default:  That in the end, the parent is responsible for a handicapped child.  The destiny of this child lies exhaustively in the hands of the parent in a more intense manner than that of any healthy child ever does.

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What is it that definitely does not help a handicapped child to improve:

  •  parent uncertainty
  • parent exhaustion
  • parent remorse
  • parent pressure (on the child)

What ABR can do for all parents of children with cerebral palsy, brain injury, genetic illness and other disorders is to give a deep sense of reassurance that lies in the knowledge of the developmental potential of each person no matter how severe the illness.

Every child can improve.

When you the parent become the driver of your child’s rehabilitation, your focus changes from “cure” to “development”.   Improvements matter, each increment of change matters.  You realize all this because it is happening under your own hands.  You observe how small increments of change accumulate and one day begin to bring huge transformations!  A “cure” does not happen from one day to another, but is a process that can occur over time.  You start to see that the unique thing about human beings is that they develop – they can transform and that development is the most essential aspect of childhood – and even of adult life.

It is a great tool – ABR Method – for child developmental promotion.  Having this tool in your own hands as a parent,  brings an immense satisfaction that ABR parents learn to cherish.

Diane Vincentz

 

ABR es:  Desarrollo Dirigido por los Padres

El mundo actual es un mundo de “especialistas”. Pero hay al menos una joya de conocimiento que todos los padres de niños con necesidades especiales, tanto los ricos como los más pobres pueden compartir. Las familias más ricas lo saben porque han viajado por todo el mundo buscando a los mejores médicos que la práctica moderna permite – y han descubierto algo que las familias más pobres ya sabían: Que, al final, los padres son los responsables del niño con discapacidad. El destino de su hijo depende exhaustivamente en las manos de sus padres de una manera más intensa que el de cualquier otro niño sano.

Lo que de ninguna forma ayuda a que mejore un niño con discapacidad es:

  • La incertidumbre paterna.
  • El agotamiento paterno.
  • El remordimiento
  • La presión paterna (sobre su hijo)

Lo que ABR puede hacer para todos los padres de niños con Parálisis Cerebral, daño cerebral, afecciones genéticas y otros desórdenes es ofrecer una sensación profunda de seguridad que viene del conocimiento del potencial de desarrollo que hay en cada persona, sin importar la severidad de su afección.

Todos y cada uno de los niños pueden mejorar.

Cuando te conviertes como padre en el responsable de la rehabilitación de tu hijo, tu foco pasa de buscar una “cura” hacia un “desarrollo”.  Cualquier mejora es importante, cada pequeño incremento en un cambio importa. Te das cuanta de todo esto porque todo sucede bajo tus propias manos. Observas como las pequeñas mejoras se acumulan y un día comienzan a aparecer transformaciones enormes. La “cura” no es algo que suceda de un día para otro, sino que es un proceso que puede suceder con el tiempo. Empiezas a ver que lo único seguro en un ser humano es que se desarrollan – se pueden transformar y que el desarrollo es el aspecto más esencial en la juventud – e incluso en la vida adulta.

Es una herramienta fantástica – el Método ABR – para la promoción del desarrollo del niño. Al tener esta herramienta en tus propias manos como un padre, permite una satisfacción inmensa que las familias ABR han aprendido a celebrar.

Diane Vincentz

Bio-Tensegrity

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The concept of “Bio-tensegrity” plays a big role in ABR technical development and ABR based understanding.

Together with  Dr. rer. nat., Dipl. phys. Danièle-Claude Martin, Dr. Steve Levine and others Leonid Blyum initiated the Biotensegrity Interest Group – a think tank which researches into biotenesegral ideas, concepts and effects.

ABR Assessment development and ABR Technique development are closely connected with the understanding coming from this work.

When writing her book called Living Biotensegrity – www.kiener-press.com/books, Daniele Martin asked us to write a chapter about the effects of Biotensegral ideas in the practical work with children with cerebral palsy.

You may read the chapter written by Diane Vincentz here: Living Biotensegrity – ABR but also feel inspired to read the entire book that can be ordered online at this link as well: https://www.amazon.com/Living-Biotensegrity

Diane Vincentz

ABR Denmark

Director

What Can Be Achieved Through TheraTogs Usage?

 

TheraTogs usage is advantageous for persons with muscular skeletal or sensory impairments. Improvements while wearing a TheraTogs system are evident both immediately through the fitting and donning as well as long term through continuous usage. More important for the user however are the effects accumulated through term usage.

Instantaneous Usage Advantages:

When donning the TheraTogs the user will experience:

  1. Immediate improvement in trunk and spine stability through the attainment of an internal trunk pre-stress
  2. Immediate improvements in posture and postural competence
  3. Immediate improvements in skeletal alignment through garment and strapping applications
  4. Functional weight bearing improvements
  5. Improvements in counter balancing
  6. Improvements in limb functioning

The first three above outlined advantages allow for reduction of both sensory and energy costly muscular “over-drive” in weak and stiff (spastic) individuals. The magnitude of the importance of a reduction of the “over-drive” for a person with motor impairments can be understood when considering the following:

  • It has been shown that – in comparison to a healthy individual – a walking individual with cerebral palsy has a three to five times higher energy expenditure for performing an equal task.  This reveals that the reliance upon “muscular overdrive” for performing tasks in an individual with cerebral palsy is an energy expensive endeavor. The question then arises: With such a high energy expenditure, how can the patient gain sufficient energy resource availability which would allow him able to “invest” in the strengthening and rehabilitation of weak tissues and in tissue reconstruction?

TheraTogs usage – through reducing the reliance on muscular overdrive – contributes to muscular relaxation, which in turn allows for the needed biomechanical remodeling and improvement.

  • It has been shown that human tissues remodel based upon force transfer and bio-mechanical loading. Poor skeletal alignment in patients with muscular-skeletal impairments presents itself as a self-sustaining vicious cycle that is difficult or impossible to overcome. Faulty mechanical loading through weight bearing activities serves to promote further modeling of tissues following the preferred – though faulty – stress transfer lines  – contractures and scoliosis being only a few of the later and more profound outcomes.

Through improving the mechanical loading properties and providing new preferred pathways the TheraTogs is able to promote a more biomechanically sound tissue remodeling for the user. This has a long-term effect upon both preventing joint degeneration, actually improving the condition of weakened joints, and improving faulty muscular skeletal alignment.

  • At the same time a person with cerebral palsy or other muscular skeletal disorders must constantly over engage the usage of the central nervous system when performing motor functions – meaning – that these individuals have little or no “auto-pilot” mode of motor function.

Through achieving a heightened trunk stability, it becomes possible for the patient to begin to rely on the “auto-pilot” functioning that is normally present in the healthy person who possesses trunk and core strength and stability. This then frees up the central nervous system for other activities – both emotional and cognitive.

Here we can observe both immediate improvements and improvement over time in emotional and cognitive development of users.

  • The attained improved alignment and posture is sending a more normalized proprioceptive “feedback” to the central nervous system on a continuous basis, allowing for an improved muscular skeletal integration within the CNS.

The user is able to emerge from the sensory chaos that impaired structure is imposing upon his sensory system and to gain an improved organization of the proprioceptive base – both for further development of both his motor functions and the emotional and cognitive functions as described in 3 above.

Gains in Function

The TheraTogs provides the trunk with support and alignment of the pelvis and ribcage – improving trunk and core stability. This is achieved through a unique fabric design.  The fabric works in such a way as to provide a healthy “pre-stress” to the tissues that does not in any way disrupt the healthy micro-vascularization of the tissues.

Ordinary compressional garments have been shown to disrupt the micro-vascularizational flow, which then in turn has a negative effect upon tissue development and tissue remodeling.

The TheraTogs fabric construction integrates into the tissue system of the body of the user. As it is worn directly on the skin, the specialized foam construction grips to the external layers of the connective tissues and fascia reaching even the fascia-profound level at the muscular transition. This grip to the skin quality – instead of inhibiting tissue health and “squeezing the tissues” works to improve tissue health.

When donning the garment one first adjusts the pelvis and rib cage manually and thereafter stabilizes the improved position utilizing the garment. This has an immediate and a long-term effect upon function.

A more stable core allows for improvements in:

     Head and neck control

     Hand and arm usage and coordination

     Mini – adjustments and counter balancing movements important for all attempts of the user to find and maintain the upright position.

     Stabilization of the shoulder girdle with respect to the pelvic girdle

     Leg positioning in respect to the pelvis

     Improvements in walking function

     Etc.

Users experience a much greater ease of motor function. Many children are suddenly able to “do things” they could not or did not do without the TheraTogs. The repertoire increases significantly which in turn gives the child/adult a positive emotional feedback, strengthens the user’s motivation and confidence for additional motor exploration. Counter balancing and micro movement adjustments become more readily available with TheraTogs usage showing us that it is not the central nervous system alone that is responsible for the motor impairment but that the ensuing trunk weakness plays a great role in impairment expression.

Further TheraTogs advantages:

  • Proper usage implies that the garment and strapping is regularly adjusted to follow the users improvements in structure and function.  The TheraTogs is not a “fixed” garment but evolves along with the structural and functional development and improvements of the user.
  • The garment is backed with special foam that clings to and in effect merges with the skin. This means that the garment does not slide over the users body when the user moves, but it is fully integrated into the users dynamic movements and positional changes through a connection to the muscles and deep fascia layers.
  • The garment provides stability but does not impair the users own movements.  This is a great advantage as many orthotics provide stability but significantly limit movement.  Limitation of movement as well as a compressional level that reduces the micro-vascularization has been shown to further promote structural degeneration and reduce improvement potential.
  • The physical therapist can also use a variety of strapping applications during the physical therapy sessions to promote various activities in the user.

Diane Vincentz

Director

ABR Denmark

ABR Dietary Guidelines / Guía Nutricional ABR

las-reglas-de-la-alimentacion-saludable1Many families have asked about ABR and diet. Because ABR is about building small increments of health from the very basic level, it is of course important to include a sensible diet as one of the basic foundations of health building and health regeneration.

As described in the ABR assessments all parents should have attained the understanding that the special needs children have generalized metabolic and digestive weakness.  Therefore anything one can do to assist the digestion and metabolic system can relieve it of stress and help it to work better.

Below we will give some general guidelines.

Size and Consistency of the Food

If the child cannot chew well – and most of the Level III, Level IV and Level V children do not chew sufficiently – then it is always good to think about the size of the food pieces and whether the food should be pureed or not.  If the child cannot chew the food sufficiently, then the big pieces that land in his/her stomach turn into a problem for the child.  The digestive enzymes that are already in under-production cannot handle the big pieces.  In fact digestive enzymes are not meant to be able to digest big pieces – they can only work from the outside layers of the food.  Therefore large pieces will either stay in the stomach for a long time or they will pass the stomach as large pieces where they will be even more indigestible for the system.

Therefore – observe how your child eats and adjust the piece size or pureed state of the food accordingly.

Your ABR Team is always observing the condition of the jaw of your child and works on giving you appropriate exercises for jaw and palate strengthening.  Still, until the chewing capacity of the child has advanced enough, remember to take care and not give food in too large pieces.  If one would like the child to have some “chewing practice” regularly, then try with raisins or dried fruits and see how the child handles these.

Type of Food

In general it is best to buy food that is organic in quality and as little processed as possible.  This means “food” in its raw state:

  • Fresh vegetables
  • Fresh grains
  • Fresh meats or fish
  • Dairy Products (non-pasteurized if at all)

All of the above should be in as fresh a condition as possible and as little “altered” as possible – through being treated or industrialized or refined.  It is important to avoid and eliminate:

  • Processed foods and frozen foods
  • Sugars – especially refined white sugar – but in any case – use sugar with discression – (especially with children with epilepsy eliminate sugar all together.)
  • Already prepared foods such as frozen pizzas, frozen dinners, chips, etc.
  • All colas and soft drinks, sweet sugary drinks

In addition we recommend that parents also eliminate grains that have gluten in them and milk products.  Children with weak metabolic systems all seem to thrive much better when casein and gluten are taken out of their diet.

Please continue reading here: ABR Dietary Guidelines

En Español: Guía Nutricional ABR

Diane Vincentz