Archive | September 2016

The Influence of Altered Mechanical Properties in Hypertoned Fascia on Muscle Activational Strategie

Authors: Mark Driscoll , Leonid Blyum

Affiliation: Advanced Biomechanical Rehabilitation Ltd., 11991 Pierre Baillargeon, Suite 201,Montreal, Quebec H1E 2E5.

Purpose: Recent interpretation of musculoskeletal dynamics has highlighted the important involvement of fascia. Moreover, various authors have isolated and quantified altered passive mechanical properties in hypertoned muscle groups when compared with healthy patients, while others speculate and explore the possibility of myofascial force transmission. However, the influence of fascial mechanics on muscle adoption techniques has yet to be investigated. The purpose of this study was to explore the effect of fascial properties on muscle activational strategies.

Methods: A finite element model of the humeroradial joint was developed using mean morphological and mechanical properties from published literature. A gravitational load was introduced over the humeral head while boundary conditions of respective physiological degrees of freedom were selected. An iterative control system, that minimized the sum of cubed muscle stresses, was programmed to maintain and govern the model’s stability. The fascial (passive) mechanical properties of the biceps and triceps were then varied to mimic those observed in patients with degenerative musculoskeletal disorders such as cerebral palsy. Prior to interpretation of results, the model was validated by comparing predictions of humeroradial joint stress with published literature and a sensitivity analysis was performed. Stress distributions in the biceps and triceps were compared and the influence of altered fascial modulus was correlated.

Results: The model with healthy properties returned internal stress distributions and a stability configuration that corroborate with similar studies. The model with fascial properties representative to those of a musculoskeletal disorder showed non-physiological stresses within the biceps and triceps following stability. More specifically, the increase (1.5x) in the passive modulus of the biceps reduced the triceps/biceps internal stress ratio by up to 50 %. Further, the final stability position showed a convincing correlation with the manipulation of fascial properties (r = 0.9). The humeral radial angle reduced from the 120 degrees (healthy model) to 70 degrees (model with the greatest offset in fascial modulus between the biceps and triceps) as regulated by the adopted muscle activation strategy.

Conclusion: It appears that altered fascial properties influence musculoskeletal mechanics by shifting internal muscular stress distributions. Therefore, the presence of irregular mechanical properties of connective tissues may invoke restrictions on muscular performance as a result of altered adoption patterns. Acknowledgement of this phenomenon may provide insight into the pathomechanism of progressive musculoskeletal disorders.

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How to nurture the development of the proper limb trunk coordination in children and adult individuals with special needs.

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The human movement is dependant upon precise limb/trunk coordination.
Due to the lack of a sufficient intrinsic structural stability of the trunk – most notably in the spine itself – children with special needs lack the spinal strength and mobility necessary for initiating movements from the trunk.

The stiff or immobile spine leads to disrupted limb trunk coordination, which becomes obvious when the children attempt to move or when movements are imposed from without.

The inhibitions in the sequence of movement between trunk and limbs in a child with special needs leads to the various difficulties the children experience when trying to carry out movement sequences and weight bearing functions. When the child is small it is often possible to attain a functional level through training and exercising, but this level often diminishes when the child grows and the limb trunk proportions change through normal growth.

Typical of this functional level is also a tendency to consist of “robotic” movements, excessive muscular effort and a high level of necessary concentration.
Adult individuals on the other hand may have developed some level of gross motor function, but this function can also most frequently be characterized as ”stereotype” or ”robotic” in nature. This robotic function often leads to joint distortions, stiffness, etc.

The purpose of ABR exercises is to create the environment and the conditions that support the child or adult to develop and to initiate the undulatory motions of the spine that initiate the proper trunk limb coordination at ages and stages where it is normally no longer possible for the person to establish this themselves. In fact the integration of these movement stages belong to the earliest motor developmental moments of life – from zero to six months of age. If this coordination is not already established by then, the child or adult can no longer initiate and establish these intrinsic movements on his own.

The exercises offered opens a new door of opportunity for such individuals.

The sequences of activation necessary relate not only to the trunk and the limbs in their related coordination, but also correspond to specific muscle fiber types belonging to the trunk and limbs respectively.

The muscle fiber types that react first during normal muscular activation belong to the trunk (type one) and those that have a higher reaction threshold (type two) are mostly the superficial muscle layers typical of the limb movements.

Training through ordinary rehabilitation and other exercises – in the case of special needs individuals and others with a variety of chornic illnesses –  will tend to initiate an inverted sequence of reaction within this highly organized muscle reaction sequence.

The waking up of and activation of the type one muscle fibers of the trunk belongs intrinsically to ABR work which is designed to install the “baby stages” of deep intrinsic undulatory spine movement in children and adults who have long left the baby age – and also in those who at this young age are too weak to initiate the proper coordination between the deep intrinsic muscles of the trunk and those of the limbs on their own.

The offered program is based upon the establishment of two separate sectors of ABR applied techniques and support. These are:

1. ABR based active exercises that we call PAVES or “Peri-Articular Visco-Elastic Stimulation”. These exercises work to strengthen the trunk, encourage the development of deep undulatory trunk movement, stabilize the joints, etc. without causing stress to the persons weak structures and without creating a high cost to the individual’s energy household level. These exercises involve the application of specific and well-controlled movements applied : soft gymnastic balls, soft room trampolines and visco elastic pillows and materials.

2. TheraTogs Usage – The TheraTogs is a specialized garment that helps children with special needs to stabilize their trunk and to establish the proper sequence of activation of the limbs in respect to the trunk that are so necessary for movement development and coordination. Due to the lack of a sufficient intrinsic mobility in trunk structures – most notably in the spine, children with special needs have a difficult time initiating movements from the trunk. This leads to disrupted limb trunk coordination. This garment can easily be integrated into daily routines. It will add a significant advantage to all movements performed by the users. It highly increases coordination based also upon the added intrinsic pre-stress to the trunk, which in turn allows for a higher freedom of limb activation. At the same time it encourages physiologically sound tissue remodelling – creating a continuously improved intrinsic foundation for movement development.

Diane Vincentz
Director
ABR Denmark Aps

Osteo-Tapping

Why Osteo-Tapping?

In children with cerebral palsy and other related disorders, as well as in all individuals with reduced muscular skeletal function, one is dealing with widespread degenerative processes that have a negative effect on all tissue systems.

The bone layer, in the sequence of layers from the surface of the body inwards, is the deepest structure. – If we name the main layers of tissues from the surface of the body moving inwards we find:  skin, fat, muscles  – and then bones.  The bones are structures that are also highly dependent upon sufficient mechanical stimulus in order to maintain their structural integrity.  When sufficient mechanical loading or mechanical stimulus comes to the bones through the outer layers, then the bones will “model” and “re-model” themselves in respect to the stimulus from the surrounding tissues.

In the case of children or adults with a weakened connective tissue system, these very “bone structures” receive much too little mechanical stimulus from the interaction with the physical forces of the environment through the surrounding tissues.  In this case, the bones do not grow sufficiently and do not go through the structural transformations necessary to bring the person to the next functional level.  Or – even if they more or less keep growing in the length, the bones do not achieve the needed bone density that is necessary to carry the weight of the child.  Problems such as hip-subluxation, scoliosis, contractions, spontaneous fractures are only the most obvious problems showing up.  All of these difficulties have deeper lying origins, which are related to the general weakness of tissue quality and the inability of the surrounding tissues to transfer mechanical stimulation.  Of course – at the same time – the entire organism is lacking the physical movement necessary for tissue remodelling.

When the general respiratory/metabolic level is weak, the individual will exhibit a diminished tissue quality.  The skin, the adipose fat, the muscles – all show signs of weakness and depletion – or in some cases the fat layer will be thick and overly dense. Neither the overly dense tissues nor the depleted tissues can provide a proper surrounding and base for sufficient bone stimulation.

When the bone – as being the most dense layer of the body – is weak, then this also has a cascade effect outwards towards other tissues.  In general the connection between the bones and the surrounding tissues is of poor quality.

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Direct mechanical stimulation of the bones is made possible with the Osteo-tapping method.  With this method we can achieve:

Improved bone remodelling and growth

  1. Leading to an improvement in bone density
  2. Improved “roughness” of the bones – the roughness being necessary for the bone attachments to surrounding tissues and to muscles. (Smooth bones do not have enough ridges and rough areas that are necessary for the connective tissue attachments.)
  3. Improved “enthesis” or attachments between the muscles and the bones. The enthesis is the connective tissue between the ligament/tendon and the bone.
  4. By stimulating the bones in this fashion, we stimulate the entire connective tissue “cake” – meaning all other layers are stimulated with the improved bone stimulation.
  5. The vibrational movement of the stick done in an open chain fashion also helps the child or adult to release a great amount of accumulated tension. Wheel chair bound persons collect tensions the entire day, because they cannot perform basic movements, move their arms and legs and do other activities all of which allow for tensional release.
  6. The tensional release also translates into improved sleep and relaxation. Many families are reporting an improved sleep of the children when tapping is performed during the day and before bed.
  7. Reduction of spasticity in the feet and in the hands is apparent with consistent Osteo-Tapping combined with the power socks or other wrap methods.

At the same time this is one of the easiest of all the ABR methods to perform.  It can be done at any time of the day with a most minimal set up.  Positioning is not difficult!

We have been happily observing the positive development effects of the Osteo-Tapping method and encourage our families to use this method on a day-to-day basis.

Diane Vincentz
ABR Denmark
Director

The Wrong Movement in the Wrong Place

The clearest means of describing the connection between structural deficiencies and functional limitations is through an understanding of the ABR based concept described as: “Wrong place, Wrong movement “ .

This concept of “Wrong place, wrong movement” allows us to administer a more exact analysis of functional limitations of movement, than the commonly recognized ideas regarding the range of motion, spasticity, etc. These classic concepts fail to recognize obvious structural links within the musculoskeletal system that directly lead to conditions such as: hypotonic cases, cases of fluctuating tonus or even the more classic cases of spasticity. And because they fail to analyse the deficiencies of the musculoskeletal structure, the classical methods of treatment also target false areas of the body for treatment through stretching, training and even surgery.

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If we take the example of a classic case of a spastic child with Cerebral Palsy (CP), the most obvious and visible problems would be regarded as limited mobility of the arms and poor alignment – or even deformities – of the shoulder, elbow, wrist and hand. The classic approach of physical therapy in such a case would be to try to force extra mobility, either through stretching or weight bearing – via attempts at crawling, kneeling, etc. However, even when hundreds of hours are invested, such attempts most often fail for the quadriplegic CP child.

Why is this?

The concept of the wrong movement – wrong place helps to illustrate why direct forceful measures fail to succeed in improving the mobility of the arms in such a case. The healthy individual serves as a comparison for wrong place/wrong movement whereby the opposite situation is at hand: right place/right movement.

For the healthy movement of the arm right place/right movement requires two fundamentals:

Stability of the entire shoulder girdle including the shoulder blade, the clavicle, and the connections between them and other neighboring elements.
Mobility at the shoulder joint – which provides the ‘right place’ of movement for the variety of arm performances.

In a typical case of quadriplegic CP, one can see that the primary difference between such a child and a healthy person is the excessive instability of the shoulder girdle. In such children it is not uncommon that the shoulder blade can slide as far as onto the posterior neck. At the same time – due to instability of the joints at the sternum – the clavicle typically collapses into the lateral neck. The limited mobility at the shoulder joint, as well as the poor alignment and distortion of the entire arm, is a secondary consequence – although the easiest to notice. This is exactly the situation described by “wrong place/wrong movement”. This also explains why direct attempts to force improved movement of the arm via stretching, in the end results in increasing the instability of the shoulder girdle – in other words the movement in the “wrong place”. What we actually need to achieve is to increase the stability at the level of the shoulder blade – in the ‘right place’ – instead of promoting the mobility at the “wrong place”. ‘Wrong” mobility of the upper arm then causes the ‘wrong’ movements in the elbow, wrist etc. These ‘wrongs’ accumulate and amplify with each level of the body, and as a result, the hand is usually the most visibly affected area.

In addition, in severe cases the shoulder girdle could easily become so distorted that the ‘wrongs’ compound upon each other: due to the initial instability it could shift its position so badly as to become immobile as well. These are the situations where ‘fixed’ deformities are visible.

Obviously, the same principles are true for the legs as well, where distortions and wrong places of movement at the level of the pelvis, abdomen and lumbar spine cause secondary spasticity and limited movements at the levels of the hip, knee, ankle and foot.

This concept of the right movement in the right place gives us a working roadmap for rehabilitation. Right place, right movement could be seen as an obvious neutral point or “zero” level − as the starting point from which a normal or healthy child begins to develop his motor functions. Depending on the extent of distortion of the musculoskeletal structure and the general depletion of the internal structures, a CP child might have reached a negative level being as low as [-5] or [-6] below the zero level.

This understanding of the zero level as being equivalent to “right movement – right place” is essential for any rehabilitation strategy. Any attempt to teach the child to have some function within the limits given by a structure composed of negative components, can at best be a gamble at best The outcomes are unpredictable and even the achievements are very short-lived. Any extra motor activity based on the “wrong movement – wrong place” achieves functional gains at the expense of further distortions and aggravations of the structural negatives.

The ABR approach is based on a long-term improvement strategy. A child progresses by reducing structural negatives with functional results following spontaneously. Only after arriving at the “zero” level of normalised bodily structure and mobility, can the focus of rehabilitation legitimately shift to true gains in function. First at this level, can a child truly begin to build the strength and coordination necessary for dynamic function.

Hence ABR is often described as the process of the reduction of negatives. It is necessary to significantly reduce the negative structural components before the child can obtain the momentum required to begin achieving functional improvement through increasing motor activity. First then can the child’s own motor activities bring extra strength and improvement of structure at the right places via healthy movements.

ABR Special Needs Winter Wellness

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Snow is falling and wind blowing hard here in Denmark. Before I met ABR, winter was a time of continuous sore throats, bronchitis’s, ear infections and pneumonias. ABR work changed this situation dramatically for my son Gawain, but also keeps our whole family much more healthy because we can react quickly to the oncoming colds and flues.

Many of our ABR families do not realize that some of the basic exercises can be applied for acute winter illnesses like bronchitis, sore throats, ear infections and pneumonia. In fact, one could even say that for a CP child, these ABR applications are really the best “first aid actions” should any of the above sicknesses occur. For an otherwise healthy child or adult, one can often cure sore throats and bronchitis within several minutes with these ABR techniques.

The passive ABR applications – (excluding of course the PAVES and active exercises done upright involving active participation from the child) cannot be compared to gym exercises or training. When a child is ill, it is the normal reaction of the parents to “give the child a break” from ABR exercises. But this instinctive reaction – which would be correct in respect to any other kind of training – does not actually serve the basic needs of the child and overlooks the fact that in the case of illness, the special needs child is even more vulnerable when faced with common colds, than the otherwise healthy individual is. They often require, and can profit immensely from extra “biomechanical care” in order to overcome even a simple bronchitis or cold and to prohibit it developing into a serious bronchitis or pneumonia.

ABR exercises do not cause any energy expenditure for the child, but on the opposite, through the path of mechano -transduction, serve as an additional source of energy that the child could not otherwise gain access to.

Biomechanical compresses and plasters

Traditionally colds, flues and earaches have been successfully treated with household remedies. The usage and knowledge of these remedies has been widely forgotten, but their effectiveness remains for those who know how to apply them.

Substances like onions, boiled potatoes, quark, cabbage, lemon and black mustard seeds have been used traditionally with good success for hundreds of years. Antibiotics – even though they have dubious long term effects, forced household remedies almost into oblivion.

These compresses are easy enough to apply, but involve some knowledge of how to do it and are often a bit time consuming.

On the other hand, for the parent equipped with ABR towels, foam constructions and soft balls, one can go to work immediately without involving any messy kitchen substances, and help the child to recover quickly. For the special needs child, the ABR methods serve even better help than the age-old house hold compresses and remedies.

Sore throats: It is not often easy to detect a sore throat in a non-verbal child. Even a healthy and speaking child will not always tell the parents that the throat is hurting. Sometimes one can hear that the voice sounds hoarse, but not always. Early detection of a sore throat is important because a sore throat can often develop into a bronchitis or pneumonia, and it is much easier to get rid of if one can stop it early and at the throat level.

The basic 3-Q U-Shaped exercise is a great application for sore throats. In fact, one should always have the U-Shaped construction prepared and ready to use in the winter months. If the child cries with a sore throat, or if one looks into the back of the throat with a small flash light or torch and sees that the throat is bright red at the back, then one should do some frequent bursts of the U-Shaped exercise to stop the cold at this level before it becomes a lower respiratory problem.

If one gets a sore throat oneself then it is possible to take the U-Shape construction and apply the exercise for ten or twenty minutes until the soreness disappears. Long movements mixed with rhythmical oscillating movements serve best.

Bronchitis – it is important to detect and to treat a bronchitis infection in a cp child as fast as possible due to the danger of the bronchitis developing into pneumonia. Many families chose to take immediate flight to the hospital when a bronchitis appears, let the child receive high doses of antibiotics, which, when given repeatedly, serve to further weaken the child’s immune system. Not all families have access to a good homeopathic doctor, naturopath or an anthroposophical doctor who can advise and support the parents in the treatment of these illnesses without antibiotics usage.

ABR Bronchitis first aid help consists of:

Frequent Chest applications of both 3 – Q and Ball Rolling.

3-Q – using a large melon construction. One can work on the upper and lower thorax for several short periods during the day. Utilize the long movements as well as periods of rhythmical oscillating movements.

Super Soft Ball Rolling – should be done on the anterior and posterior thorax

In addition, especially if the child cannot cough or is not coughing successfully, one should add clapping techniques. Clapping has been done for centuries, and one can add to the effectiveness of simple clapping on the chest, but putting some foam and towel layers between the clapping hand and your child’s chest. The wrist is relaxed and the hand is allowed to fall with its entire weight on the chest. Clapping should also be done frequently, all around the thorax, front, sides and back. It also helps to release mucus that is lodged in the bronchial system.

Parents who have learned PAVES exercises can also combine the above with short intervals of placing the child on a gymnastic ball or peanut ball together with a soft memory foam pillow. The oscillating applications can be done with the child in various positions resting on his thorax over the pillow and ball.

Between the parent’s hands and the child, one can place a few layers of foam batting and back up foam.

Oscillations:

1. Pre-compression – a deep volume touch
2. Pause
3. Small , short, oscillating bounces starting downwards
4. Fifty to one hundred oscillations in each position

If the child should get pneumonia in spite of one’s efforts, then the above applications are also suitable.

Ear Infections:

3-Q – Use a medium sized melon that sufficiently covers the ear area.

Super Soft Ball Rolling – use a foam ball filled pocket and a small ball like the kiga overball to roll the area especially downwards and forwards towards the face.

Diane Vincentz

 

 

 

 

 

Bienestar invernal con ABR

La nieve está cayendo y el viento sopla fuerte aquí en Dinamarca. Antes de conocer ABR, el invierno era una época de continuos malestares de garganta, bronquitis, infecciones de oído y neumonías. El trabajo con ABR cambió esta situación significativamente para mi hijo Gawain, pero también mantiene a toda la familia mucho más saludable porque podemos reaccionar rápidamente ante los resfríos y gripes venideros.

 

Muchas de nuestras familias en ABR no saben que algunos de los ejercicios básicos pueden ser aplicados para enfermedades agudas de invierno como bronquitis, dolores de garganta, otitis y neumonía. De hecho, uno podría incluso decir que para un niño con Parálisis Cerebral, estas aplicaciones de ABR son realmente las mejores “acciones de primeros auxilios” en caso de ocurrir cualquiera de las enfermedades previamente mencionadas. Para un niño saludable o adulto, uno comúnmente puede ayudar con dolores de garganta o bronquitis con unos cuantos minutos de estas técnicas de ABR.

 

Las aplicaciones pasivas de ABR (excluyendo PAVES y los ejercicios activos hechos hacia arriba que requieren la participación activa del niño) no pueden compararse a ejercicios de gimnasio o entrenamiento. Cuando un niño se enferma, es una reacción normal de los padres “darles un descanso” de los ejercicios de ABR. Pero esta reacción instintiva, que sería muy apropiada para cualquier otro tipo de entrenamiento, no sirve realmente a las necesidades básicas del niño y olvida el hecho de que en casos de enfermedad, el niño con necesidades especiales es aún más vulnerable cuando se enfrenta a resfríos comunes en comparación con un individuo saludable. Generalmente requieren y pueden beneficiarse inmensamente de este “cuidado biomecánico” extra para poder sobreponerse a una simple bronquitis o resfrío e impedir el desarrollo de una bronquitis más seria o neumonía.

 

Los ejercicios de ABR no causan un gasto energético para el niño, todo lo contrario, por el camino de la mecanotransducción, sirven como una fuente adicional de energía a la cual el niño no tendría acceso de otra manera.

Compresas biomecánicas y apósitos

Tradicionalmente, resfríos, gripes y dolores de oído han sido tratados exitosamente con remedios caseros. El uso y conocimiento de estos remedios ha sido ampliamente olvidado, pero su efectividad perdura para quienes saben cómo aplicarlos.

 

Sustancias como cebollas, papas hervidas, queso quark, repollo, limón y semillas de mostaza negra se han usado tradicionalmente con buenos resultados por cientos de años. Antibióticos, que tienen dudosos efectos a largo plazo, llevaron a los remedios naturales casi al olvido. Estas compresas son bastante fáciles de aplicar, pero implican algo de conocimiento sobre cómo hacerlo y generalmente consumen tiempo.

 

Por otro lado, para un padre equipado con las herramientas de ABR como toallas, construcciones de espuma y pelotas suaves, uno puede ponerse a trabajar inmediatamente sin sustancias enredadas en la cocina, y ayudar al niño a recuperarse más rápido. Para los niños con necesidades especiales, los métodos ABR ofrecen incluso una mejor ayuda que los antiguos remedios y compresas de antaño.

 

Dolores de garganta: Generalmente no es fácil detectar el dolor de garganta en un niño no verbal. Incluso un niño saludable que habla no siempre les dirá a los padres que experimenta dolor de garganta. A veces, uno puede oír su voz un poco más ronca, pero no siempre. La detección temprana de un dolor de garganta es importante porque comúnmente puede llevar a bronquitis o neumonía, y es mucho más fácil despedirse de ellos si uno los detiene temprano al nivel de la garganta.

 

El ejercicio 3Q básico con forma de U es una excelente aplicación para los dolores de garganta. De hecho, uno siempre debiese tener la construcción para el ejercicio en U preparada y lista para usar en los meses de invierno. Si el niño llora por un dolor de garganta, o si miran la garganta con una pequeña linterna y ven que la parte posterior está muy roja, entonces debiesen hacer transferencias frecuentes con el ejercicio en forma de U para detener el resfrío a este nivel antes de que se vuelva un problema respiratorio más abajo.

 

Si uno mismo tiene un dolor de garganta es posible tomar la construcción para el ejercicio en forma de U y aplicar el ejercicio por 10 ó 20 minutos hasta que el dolor se calme. Largos movimientos mezclados con movimientos de oscilación rítmicos funcionan mejor.

 

Bronquitis: es importante detectarla y tratarla en un niño con Parálisis Cerebral lo antes posible debido al peligro de desarrollar una neumonía. Muchas familias escogen ir rápidamente al hospital cuando aparece una bronquitis, dejar que el niño reciba altas dosis de antibióticos, que cuando se dan repetidamente, sirven para debilitar más el sistema inmunológico del niño. No todas las familias tienen acceso a un buen médico homeopático, naturista o antroposófico que los pueda aconsejar y dar apoyo a los padres en el tratamiento de estas enfermedades sin el uso de antibióticos.

 

El primer tratamiento para la bronquitis con ABR consiste en aplicaciones frecuentes en el Pecho tanto de 3Q como de Rollado (SSBR).
  • 3Q: usando una construcción tipo melón grande. Se puede trabajar la parte superior e inferior del tórax por varios periodos cortos durante el día. Utilizar movimientos largos y también periodos de movimientos oscilatorios rítmicos.
  • SSBR: debiese hacerse en el tórax anterior y posterior. Adicionalmente, especialmente si el niño no puede toser o no lo hace exitosamente, debieran agregarse las técnicas “palmoteo”. Esta técnica se ha hecho por siglos y uno puede aumentar su efectividad de simplemente palmotear el pecho, poniendo unas capas de napa/guata y toallas entre la palma y el pecho del niño. La muñeca está relajada y la mano puede caer con todo su peso sobre el pecho. Este palmoteo debiese hacerse frecuentemente, al rededor de todo el tórax: frontal, lateral y posterior. También ayuda a soltar mucosidades que están alojadas en el sistema bronquial.

 

Padres que han aprendido los ejercicios PAVES también pueden combinar lo anterior con breves intervalos de posicionar al niño en el balón de gimnasia o el maní (physio roll) junto con una almohada de memoria suave. Las aplicaciones oscilantes se pueden hacer con el niño en varias posiciones descansando en su tórax sobre la almohada y el balón. Entre las manos de los padres y el niño, se pueden poner algunas capas de guata/napa y espuma de respaldo.

Oscilaciones:

  1. Pre-compresión, un profundo volumen de contacto.
  2. Pausa.
  3. Rebotes pequeños, cortos y oscilantes que comienzan desde abajo.
  4. Entre 50 y 100 oscilaciones en cada posición.
Si a pesar de todos los esfuerzos el niño tiene neumonía, las aplicaciones anteriores también son recomendables.

Infecciones de oídos:

  • 3Q: usar un melón de tamaño mediano que cubra un área suficiente del oído.
  • SSBR: usar un estuche relleno con espuma de balón y una pelota pequeña como el kiga overball para rolar el área, especialmente hacia arriba y abajo hacia la cara.

The relationship between ABR and other Bodywork or Manual Therapies.

Parents have asked me to comment upon the relationship between ABR and other Bodywork or Manual Therapies.

The last 30 years has witnessed an sudden increase in the development of manual and body work therapies. Whereas in the Western part of the world the chiropractic and osteopathic methods were known, today’s body workers offer therapies that range from Rolfing, Feldenkrais, Myo-fascial release, Stecco Method, Cranial-Sacral Treatment, Bowen Method,. – and the list goes on and on. None of these methods were developed with the specific needs of special needs individuals in mind.
ABR was developed exclusively with and for special needs individuals and their parents and caretakers.
More recently however, all of the various manual therapy methods have become united under the umbrella of the “fascia based research” that supports the clinical results that therapists have been experiencing under their own hands for years.
At the same time this research reveals the magnitude of the potential that can be tapped into when one to takes seriously the properties for renewal that each and every person has within his own connective tissue or fascia system.
In tempo with the research being done with the connective tissues, ABR is transforming its own techniques and rehabilitative reach. This is something unique to the ABR method. ABR is in a continuous state of development, creating new techniques that integrate the findings brought through the fascia research.
The human bodies own system of connective tissues is a system with characteristics and properties that are entirely different to those of more highly developed structures – for example the muscles and nerves.
Below is a list of a few of the traits that are unique to the connective tissue system of the body. Following each quality I have given an example of how ABR has integrated these scientific understandings into the development of the ABR method.

– A Basic System – The connective tissues build the foundation for more complex and more highly differentiated systems. ABR knows and shows that by building the foundation of the body as seen in the connective tissue system, one can achieve improvements at all of the higher levels.

– Transanatomical – meaning that connective tissue structures are not limited to one anatomical structure but cross unlimited anatomical boarders. ABR confirms the transanatomical quality of the connective tissues which allows one to work in one area of the body and achieve global effects. The collected knowledge of the transanatomical fascia based connections are actively integrated into ABR strategy.

– Energy neutral and Energy thrifty – meaning that working with these structures is an energy thrifty choice and not energy expensive for the organism. Other structures such as muscles and nerves consume massive amounts of the bodies energy supply. The connective tissues do not consume much. They are self sustaining and energy efficient. This knowledge and understanding forms a basis for the entire ABR Strategy that incorporates the idea that anything we do with or for the child either presents a Gain or a Drain.
The E-ABR concept allows a comprehensive assessment of the child’s daily environment. Together with the families we can assess and lay a plan for an energy usage reduction for the child that will then in turn allow the child to make the necessary improvements and reconstructions at the level of growth and tissue differentiation, that in turn lead to improvements in both structure and function.

– Bio-tensegral construction. The ABR techniques are bio-tensegral in nature. They work actively by applying stress within a bio-tensegral range and are able to achieve a magnification effect through respecting the bio-tensegral qualities of the tissues. At the same time the bio-tensegral concept of connective tissue construct allowed for ABR to discover techniques that administer effective reconstruction to all layers of the body – from the visceral (inner organs) to the muscular skeletal levels.

– Embryological Based – The origin of the connective tissues is the embryological mesenchyme. This name points to the fact that the connective tissues maintain embryological characteristics throughout the entire life of an individual. ABR actively integrates knowledge attained from the study and understanding of embryology into the development of its techniques and strategies for application.
The body of a child or individual with cerebral palsy has “fallen several levels” as it were. The tissues of the child have returned to earlier less differentiated stages. An understanding of how the tissues can progress and metamorphose from the less differentiated to the more differentiated state builds one of ABR’s basis of reasoning and works into the strategical development.

The thorough endeavor to understand and meet the needs of the mild to severely affected individuals, has led ABR to the development of a distinctive comprehension of connective tissue degeneration. This elaborate clinical diagnostic tool would take several hundred pages to describe. Having mastered the ABR Assessment however allows the Assessors to determine and prioritize which ABR applications will bring the fastest and most effective improvements and act as developmentary drivers.

This clinical diagnostic tool, that was developed side by side with the ABR techniques, is unique to the ABR Method. It could then, in turn lead to the development of the varied and exclusive ABR Techniques that differ both in the scope and applicative format to all of the other existing manual therapies.

In spite of the fact that the ABR Techniques themselves – when compared to other manual techniques that can take anywhere from six years to a series of many weekends to learn – the ABR techniques are so devised as to be teachable to parents and caretakers. One can become proficient enough to apply the techniques with great success to the children and adults in the program in an initial teaching session of about eight hours duration.

The ABR techniques can then be applied on a daily basis – this in itself differs from most of the other manual techniques that are devised to be applied on – at most – a weekly and even then – only on a limited basis of up to 10 sessions.

Neither is the effectiveness of ABR Techniques comparable to other manual techniques. Parents and caretakers alike can achieve heretofore unheard of reversal of severe structural deformities and even life function weaknesses through their own work in their own homes.

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Diane Vincentz
ABR Denmark

ABR Paradigm Shift – Hierarchical Development Analysis

The inserted graphs show how ABR has achieved a radical shift in focus in respect to rehabilitation and why this shift in focus is so successful.

ABR Paradigm Shift Diagram

In the human being higher function is generally dependant upon more fundamental functions.  The diagram illustrates the fact that – if the strength of the connective tissues is weak, then there is no firm foundation within the body for the life processes.  The respiration will be weak – the metabolic processes are constrained.

The life processes rest upon a firm connective tissue base. In the case of CP as well as a wide variety of genetic and chronic illnesses, the child is challenged at this level.   Challenges at this level, can make it almost impossible for him or her to develop the next level seen in the diagram.

There will inadequate weight bearing; the compressional strength of the body is impaired.  Proprioception as well as internal “interoception” is indistinctly defined for the individual.

When deficiencies such as these are present, the primary movements that are normally developed within the first six months of life do not unfold.  The child does not learn to move the spine in the undulatory fashion.  He cannot “worm” himself around on his back, cannot rotate the spine or flex it to the side in a snake like fashion.   This huge variety of spine movement is dependant upon the ability of each single vertebra to move in respect to each other.  The single vertebras of a child in this condition do not reveal much movement in respect to each other.

The primary dynamic repertoire belonging to the first six months to one year of life does not unfold.  This will result in the child being locked in respect to his own development.  Gross and fine motor function in this condition will definitely be impaired.

The primary dynamic repertoire belonging to the first months of life cannot be “taught” and “learned”.  Imagine yourself trying to improve the movements between the sixth and seventh spinal vertebrae or between the fifth vertebrae and the sixth rib!  This is fully impossible.

If the child has not learnt it in the first six months, he can no longer learn to do it alone.  He needs the help that ABR brings to “learn” to develop and to utilize the spine movements.

This does not mean that a child cannot “jump over” the purple and the blue levels shown on the diagram.  He can jump over and develop communication skills, make cognitive advances, etc.  But what can never happen is that the higher levels of development can bring up lower levels.  No matter how clever a child becomes, weaknesses at the lower levels will not be alleviated.

One needs the improvements of the lower levels for true developmental flourishing.

Therefore ABR work means going down deep and restoring the foundation of the internal stability and tensional connectivity of the body.

When these levels are improved and restored, then development appears in a blossoming and in a “sprouting” like manner. The child begins to flourish at the higher levels without extra work – attaining the ability to focus, be attentive, communicate – even speech and thought process are possible in severe children.

For children and adults with cerebral palsy and a wide variety of disorders, ABR restores the base, the fundament, the foundation allowing for higher functional development in mild and severely impaired individuals.

 

Diane Vincentz

ABR Denmark

Director