Archives

Toe Curling Crutches – Insight Gleaned From Clients

We were exceedingly pleased when earlier this month several new ABR enthusiasts joined our group in Austria.  Special to this group is however that they are all talkative young men – both walking and in wheel chair.

From these adult individuals we could glean direct from the affected individuals themselves confirmations about many aspects of our basic ABR understanding and principles.

Those of you who have been following my blog for some months will have read the post called Hands and Feet:

https://abrdenmark.wordpress.com/2016/07/15/the-hands-and-feet/

This post is an illustration of the internal necessity for stiff arms/hands and legs/feet in children with cerebral palsy.

In that post, we expounded upon the idea that if any individual has a weak spine, the person will then search for the next best solution available in order to add more stability to his or her body.  If the neck is weak, then one can stabilize the neck by stiffening the arms.  The arms are of course not meant to be used as spine stabilizers.  When they are stiffened continuously in order to add stability to the spine, then they will of course soon “remodel” in a stiffer fashion.  This “stiffening” of the arms is then popularly termed “spasticity”.  One does not need to apply the typical neurological reasoning in order to find the direct cause of spasticity.

This month in Austria when holding the first assessment for a young man with cerebral palsy I asked him:

“Can you try to stand on one foot?”  His answer was nothing less that a direct confirmation of what is written above:

“Yes I can, but I need to curl my toes.”

 full_hd_wallpaper___franzi_toe_curl_by_foot_portrait-d6qnubt

Toe curling is a creative way to clench and to stiffen the body in order to add stability!  If I clench my toes, I feel it all the way up to my buttocks and the pelvis but also the lumbar area gets tense!  What geniuses these individuals are!
Their body tells them automatically that they do not have the spine stability needed to be able to stand on one foot, but that if they clench or curl the toes, then they will be able to mobilize more stability to make the standing on one foot possible.  They can
compensate for the lack of the central stability that the vertebral column needs to provide for by stiffening other areas.

 1315704

So, Dear Parents:  The ABR message to you is to please stop worrying about the spastic legs and feet and the spastic arms and hands!  Stop fighting with them by stretching them, cutting the tendons and lengthening the muscles, and by injecting them with toxins!  You need to understand that your child needs these spastic feet, legs, arms and hands.  Your child is an amazing genius who has been able to sense and to navigate within his own weaknesses and has been able to find an alternative for what he does not have intrinsically.

That which he or she is missing intrinsically is sufficient stability of the Connective Tissue Based Architecture!  This is the internal support system that we use all the time at a very low cost.  The healthy persons are so used to this internal architecture that we take it 100% for granted, day in and day out.

It is only when we do not have it that we notice:  “I need to curl my toes to stand on one foot.”

And now Dear Parents:  You can all re-assess your child’s movements and manners.  You can begin to see and to understand what is going on.

When your child opens his or her mouth wide each time he/she wants to lift or to move his head:  Now you understand why!  The wide-open mouth brings tension into the neck and the base of the skull and makes it easier for your child to control the head movement.

This is of course not the best way to do things, but this is what your child has figured out how to use.  Your child is not “brain deficient” but exceedingly smart.  If he or she has figured this out, then it is only a matter of diligence of application of ABR Techniques designed to strengthen the central core of the body, of the spine and of the internal connective tissue base that will in turn allow for him to find new strategies for lifting the head.  As soon as the central structures are strengthened internally, your child will not need to use his wide open mouth, or his arm stiffening to support the neck.

Before this internal strengthening is achieved, then any attempts to “loosen up” the arms or legs are not going to lead to positive results.  It is comparable to taking away someone’s crutches when he needs crutches for walking.  No one would do this!  But yet we as parents of Special Needs Children are lead to believe that we need to cut, to inject, to stretch the very structures that our children need as crutches for their own central and internal weaknesses.

As all families, parents and clients soon find out, at ABR we take time to listen.  We listen to your stories, your struggles, your successes, your difficult and intense problems, and your journeys.

Not only do we use the information you give us to shape your ABR Program, to guide you on a day to day basis with respect to general health based insights and suggestions, but we can then let the information flow from parent to parent.  What works for one family, will often work for another family, so there is no reason to keep anything to ourselves?  Each small bit of information can be given further.

This kind of information coming from young adults with cerebral palsy is precious.  It confirms our understanding that we are on the correct path in the promotion of the ABR Techniques and Methods which are all designed to provide for internal intrinsic architectural connective tissue based strength and stability.

Diane Vincentz

ABR Denmark

This entry was posted on 12 April, 2017. 1 Comment

ABR Grassroots

During the past months we have held many lectures about ABR for new and interested parents around Europe and in Africa.  I begin each of these lectures with the comment and observation that ABR has developed together with children or adults with special needs and their families.

Without these individuals who have been willing and enthusiastic about working with ABR during the last 17 years, ABR would not have entered into existence and would not have developed to the most effective means of addressing brain injury in the world today.  There is no laboratory where ABR is tested – far away from any patients.  There are no biopsies, MRI’s, or Ultra Sound tests fuelling ABR development.

ABR development has happened 100% in the field and this makes it specifically viable as a grass roots movement.

Especially in a world that is so dominated by the modern scientific methods, and the “evidence based” industrial medicine, it is important to remember how necessary the “Hands On” and “Real Life” evaluation of any phenomena is in order to attain the essential information for creating and developing anything new for addressing real life problems.

A cell culture or biopsy, an MRI or CT scanning can never give any information about how a child or an adult with severe muscular skeletal problems can improve, evolve or develop.  For this it is important to go directly to the individuals themselves and do an in-depth and as thorough an evaluation as possible.

We as human beings have amazing sensory abilities:  sight, touch, hearing, smell, taste – but more that the famous five we learned about in school – we have the sense of movement, we have proprioception, interoception, exteroception, nocioception – we can sense a thought, we understand speech, we feel warmth – our senses are amazingly rich and manifold!  How is it possible that mankind has gone so far astray, as to think that any invented apparatus for measuring some of the electrical activity in the brain or some device that is dependant upon magnetic resonance or an ultra sound light spectrum can tell us information that is more important that all we can gather ourselves through our own observation and thinking?  We can of course glean additional information through the use of such devices, but technical devices and laboratories cannot take the place of what the information can gain through our own sensory based facilities for observation.

It is here that ABR developed it’s own foundation.  Where parents and other affected individuals are willing to take the time, observe together with the ABR Assessors and Trainers – seek and find the limitations of the bodies of affected children and adults – and then to go further and to implement the techniques that have emerged based upon the observations of these weaknesses.  ABR Techniques have all developed as means of addressing “real life” and “hands on” tangible weaknesses and disorders.

Long years of application, trial and on the other hand the applied understanding of the emerging Fascia Based Research that has intensified globally during the last 20 years are then the practical results of the ABR Based Observational Methods.

The entire ABR Team is thankful for the hundreds of families around the world who are taking part in this new emerging science and understanding for addressing brain injury, cerebral palsy and other related disorders – based entirely upon observation and thinking and the application of the real-life ABR techniques evolving thereout.

 

ABR: Conferences & publications

 

header-logoDriscoll, M., Blyum L. (June 1st-4th, 2016) Can parents become generic therapist and administer high frequency therapies to their child with cerebral palsy? 5thInternational Conference of Cerebral Palsy (ICPC). Stockholm, Sweden.  28thAnnual Meeting of the European Academy of Childhood Disability (EACD). Stockholm, Sweden.   1st Biennial     Meeting of the International Alliance of Academies of Childhood Disability (IAACD).  

 

header-logoDriscoll, M. (Sept. 18-20th, 2015) Results of a 24 Month Prospective Cohort Study Investigating the Influence of Home-Based Therapy on Cerebral Palsy Patients on Intra-Abdominal Pressure and Spinal Stability. 4thInternational Fascia Research Congress, Washington DC.   

 

header-logoDriscoll, M. (Sept. 3-5th, 2015) Can a home based rehabilitation therapy be beneficial for cerebral palsy patients? 1stAsia-Oceanian Congress for Neurorehabilitation, Seoul South Korea  (oral communication, International).   

 

header-logo
Driscoll, M.
, and Blyum, L. , (Sept., 10-13th, 2014) Results of a 3 year prospective cohort study investigating the influence of home-based therapy on cerebral palsy patients GMFCS types 4 and 5, 68th Annual meeting of the American Academy for Cerebral Palsy and Developmental Medicine, AACPDM (oral communication, International).   

 

 

22Driscoll, M., and Blyum, L., (2013), Investigation of the influence of a home based therapy on the health and well-being of cerebral palsy patients, 2nd Singapore Rehabilitation Conference, Singapore.

 

 

 

pisa

Driscoll, M. and Blyum, L. (Oct. 10-13th, 2012), Results of a 2 year study investigating the influence of home based therapy on cerebral palsy, 4thInternational Cerebral Palsy Conference, Pisa, Italy.

 

 

brussel

Blyum, L. and Driscoll, M. (Oct. 5-7th, 2012) Dynamic anatomy, a new approach to functional anatomy, 1st Annual European Fascial Congress, Brussels, Belgium.

 

 

fasciaBlyum, L., and Driscoll, M*.(March 28-30th, 2012), Mechanical stress transfer – the fundamental basis of all manual therapy techniques, Third International Fascia Research Congress, Vancouver, Canada.

 

annual pacificDriscoll, M. and Blyum, L. (April 18-19th, 2011) Home based and family centered treatment of cerebral palsy. 27th Annual Pacific Rim International Conference on Disabilities, Honolulu, Hawaii.

 

 

chypreDriscoll, M. and Blyum L. (Sept. 29-Oct. 2nd, 2010) The offset of mechanical homeostasis in cerebral palsy.8th Mediterranean Congress of Physical and Rehabilitation Medicine, Limassol, Cyprus.

 

boskDriscoll, M.*and Blyum, L. (Nov. 5-7th, 2009) Stress Allocation in Cerebral Palsy: A Process Governed by Physiological Properties.  A global status quo on Cerebral Palsy, with a view to the future, Utrecht, Netherlands, Het Vechthuis.

 

 

Untitled-3Driscoll, M.*and Blyum, L. (Feb. 18-21st, 2009) The Presence of Physiological Stress Shielding in Load Bearing Articulation of Patients with Cerebral Palsy.  3rd Inter-nation Cerebral Palsy Conference, Sydney, Australia, Sydney Convention and Exhibition Centre

 

netherlandDriscoll, M. and Blyum, L. (Oct. 27-30, 2009) The Influence of Altered Mechanical Properties in Hypertoned Fascia on Muscle Activational Strategies.   Second International Fascia Research Congress, Amsterdam, Netherlands, Vrije Universiteit.

 


 

OUR PUBLICATIONS

Publication 1

Driscoll, M., and Blyum, L., (2014) Investigation of the influence of a home based therapy on the intra-abdominal pressure and spinal stability of cerebral palsy patients, Journal of Back and Musculoskeletal Rehabilitation,  (Under review)

 

 

 

Publication 2

Driscoll, M., and Blyum, L., (2014) Investigation of the influence of a home based therapy on the health and well-being of cerebral palsy patients, Journal of Bodywork and Movement Therapies. (Under review)

 

 

 

Publication 3

Driscoll, M., and Blyum, L., (2014) Results of a 3-year prospective cohort study investigating the influence of home-based therapy on patients with cerebral palsy in GMFCS levels IV and V, Dev Med Child Neurol: 56 (s5), p67

 

 

 

Driscoll, M., Eng., Ph.D. and Blyum L., “Mechanical Stress transfer – the fundamental physical basis of all manual therapy techniques”, Journal of Bodywork and Movement Therapies, Vol. 16, Issue 4, p520. Published in issue: October, 2012

Driscoll, M., Eng., Ph.D. and Blyum L., “The presence of physiological stress shielding in the degenerative cycle of musculoskeletal disorders”, Journal of Bodywork and Movement Therapies, vol. 15, Issue 3, p335-342. Published in issue: July, 2011

ABR Techniques as Meso Anatomical Movement Inductions

What does the ABR Team refer to,  when they speak about the “Meso-Anatomical Techniques” which we teach in the ABR Program?

“Meso – Anatomical” is the term given by Leonid Blyum to precisely describe what all ABR families do when working with the large variety of ABR manual techniques shown at each course.

“Meso “ is a term that many of our ABR parents should already be familiar with.  Meso comes from the Ancient Greek language and means: “in between – related to the middle – intermediate”.  In many lectures with ABR parents we spoke about the Embryological Mesoderm or Mesen-chyme as being the origin of connective tissues in the early embryological stages.  In this respect the “meso”-derm refers to the tissues that are developed between the two polarities of the ento (inner) and exo (outer)- derm’s.  The entoderm later develops into the tissues that become our metabolic system – whilst the exoderm develops further into what becomes our skin and nervous system.  These two systems are so far away from each other in their basic and fundamental dynamic, that they require a “middle way” – a “meso” in order to bind and connect them to one organism.  Dr. Jaap van der Wal – a world leading Embryologists says:  “The meso is not a derm! – It is a “meso”! – meaning that the meso is not a “skin” or a tissue – but it is that system which is able to live between the two extremes and at the same time creates a basis for all the various life functions – and for the inwardness of perception (proprioception, interoception)  and being as well.

By adding the prefix of “meso” to the word “anatomical” another meaning for “ in between – in the middle – intermediate”  is brought to light.  This term describes the specific qualities of ABR Techniques.  In this context “meso” designates  a quality of anatomy and movement that is not “micro” and not “macro” – meaning not on the cellular level (microscopic) and on the other hand not on the level of macro- anatomical either as would be in the case of an entire organ or a specific muscle, or muscle chains.

14358646_10154650115096454_533996977415807292_nWith ABR techniques we create movements within the child or adult that are within a very small range – the range of about one centimetre.  This range is much higher than the microscopic level, and on the other hand – if one thinks about long chain movements like taking a step or throwing a ball – these ABR movements at first seem minimal.

But these movements only “seem” minimal as long as one has not yet understood the magnitude of the importance of these movements.

 What is so special about the “meso” range that we utilize, explore and promote with the manual techniques being taught in ABR and being used in the variety of PAVES exercises shown?  The answer to this is manifold, but we can start by identifying two or three main elements:

  1. When we implement these movements by utilizing our various ABR tools such as balls and mats then we are able to help the child or otherwise affected adult to begin to implement movements that he or she cannot initiate himself. These movements are for example the movements belonging to the deep myo-fascia of the trunk and spine.  Buried within the structures of our vertebral column the nerve endings are located that are the primary communication links about any changes in our body –whether changes in posture or any positional changes requiring counter balancing reactions, stability, etc.
  2. By using meso – anatomical techniques, one is able to “induce” movements that are a part of the primary dynamic repertoire which one normally learns in the first half a year of life. At this time an infant develops this primary dynamic repertoire.  This is a repertoire of movement that can no longer be learned consciously at a later time of life.  After about six months of age the door for learning these movements closes.  At this time the length and the weight of the arms and the legs changes sufficiently in proportion to the size and weight of the trunk.  This change in proportion makes it even more difficult for a person to “learn” to execute these movements later in life.  One cannot “teach” the primary dynamic repertoire!
  3. Through “induction” of these movements to the child or adult, one can “re-train” the system to be able to carry out and to integrate these movements into the movement repertoire. Through having access to these movements, then the child is able to “balance”, to “stabilize” to control the movements.  The door to movement development is opened for the child.
  4. Here a robot example of what happens if the primary dynamics of the deep spine structures are not working can be seen here:

https://www.facebook.com/permalink.php?story_fbid=1001882553253264

At the same time this short video clips gives illustration to the spinal mobility condition of many ABR clients pre -program.  Whenever the child needs to adjust with the spine, the spine does not move.  The result for our children is that they “cannot sit”, “cannot stand” and cannot maintain weight-bearing positions.

ABR Meso-Anatomical Techniques are an unbeatable tool for getting to these deep Primary Dynamics and improving the mobility and repertoire of usage.

 

Diane Vincentz

ABR Denmark

Director

 

ABR Global Developmental Enhancement – Global Developmental Delay

 

captura-de-pantalla-2016-10-01-a-las-10-26-58

Children with special needs will all in some manner be affected with what is termed “Global Developmental Delay”.  This indicates that the entire development of the child is affected to such a degree that all the defined major developmental areas (officially at least two of the areas) are affected, specifically:

  •  Motor development
  • Speech and communication
  • Cognitive
  • Social and emotional development

In reality however these developmental areas are not disconnected and disengaged from each other.  In any organism, and in the human being at a much higher level, all of these different developmental areas are highly intertwined and decidedly connected.  In fact, as our developmental hierarchy graph below attempts to illustrate, the different areas of development are not only interwoven with each other, but the developmental potential of the so called “higher and cognitive levels” is dependant upon what happens at more basic and fundamental levels.

ABR Paradigm Shift Diagram

One example that illustrates the difficulty in attempting to disconnect the developmental areas from each other can be understood when one observes the case of human speech and communication development.

Within the world of the Speech Therapy specialists it is known and widely accepted that a child who cannot adequately swallow and chew will not be able to learn to speak. This shows us how in the human being so called “higher functions” such as speaking are dependent upon at least a minimal level of basic life functions.  In effect it is so that if a child cannot chew and cannot swallow, and – in addition – has a sufficient weakness of the respiratory level, then any attempts to “teach” the child to speak with speech intervention methods will be in vain.

This does not mean that the child cannot learn to communicate, use a computer-based program or learn some basic skills in this fashion.  But, speech as a skill involving our enter speech organism, will normally be closed for the child due to the fact that the human speech is dependant upon a finely tuned motor coordination between:

  • The respiration – coordination of the air flow through the larynx and trachea
  • Epiglottis as articulator
  • Pharyngeal coordination
  • Mouth floor control
  • Tongue
  • Hard and soft palate coordination
  • Mimic muscles of the face
  • Lips
  • Jaw
  • Sinuses and skull as resonators, etc.

The list of the structures that need to be fine tuned and well coordinated to speech function is long and exceedingly complex.  Yet a healthy child between the ages of 0- 3 years – through an intense ability to imitate the activities of the people close around him – begins to utilize these structures and to coordinate them in a highly complex fashion in order to be able to use speech as a means of both emotional and later intellectual communication.

A child who suffers from Global Developmental Delays will have difficulties related to all four of the main accepted developmental areas.  There is almost nothing in his or her own development that will not be touched.  From the side of the rehabilitation it would make sense if the child could be sent to a Global Developmental Specialist.  But this professional does not exist.  The typical result for the child and family is then that the child will be dutifully sent from one specialist to the next:

  • The speech therapist
  • The occupational therapist
  • Riding therapist
  • Swim therapy
  • Eye Doctor
  • Neurologist
  • Orthopedic specialist
  • Physio-therapist
  • Special Education teacher

And the list goes on and on.

ABR Program and Method has shown that for children especially, all development is “Global”. One cannot disconnect one area of development from the other – in the human organism development of one “area” is dependant upon the stability of other areas.  We cannot dissect the developmental regions and place them on the floor of some workshop as one can do with a car – put the brakes in one corner, the carburettor here, the engine there, the starter motor on another spot!  This does not work with the human being.  Activities and capabilities rest upon each other – are interdependent and co-exist.

The parents and children in the ABR Program have found a fortunate means of global developmental enhancement.  ABR is a Program that promotes transformation of all developmental levels respecting the inter-connectivity of processes within the human being.

If as an ABR Parent one comes to work on the neck or the throat of the child one will be promoting a wide variety of functions all at one time.  ABR neck applications typically help the child with:

  1.  Stability of the upper respiratory tract
  2. Swallowing
  3. Neck stability
  4. Head control
  5. Eye stability – even vision
  6. Sound production and variation of tone
  7. Inner coherence of the proprioception – body map
  8. Connectivity in respect to the surroundings and environment

In this way we can see that the soft tissue remodelling achieved through ABR applications work as a foundation for the child’s higher development – whether it has to do with basic life functions or higher capabilities such as speech and understanding.

ABR works as a Global Developmental Enhancement tool, allowing parents and caretakers to dramatically change the life and life quality of mild to severe handicapped and special needs children.

Diane Vincentz

ABR Denmark

Director

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.

foto-estudio