April 2017 – abr-denmark.blog

12/04/201721/09/2017

Toe Curling Crutches – Insight Gleaned From Clients

We were exceedingly pleased when earlier this month (March 2017) 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 a wheel chair.

From these adult individuals we could glean directly 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. Stiffness of the arms and legs, hands and feet – or even of the stiffened open mouth – these are all natural reactions!

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 the spine. 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 who is studying to be a teacher 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.”

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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 and intrinsically 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 should be providing for by stiffening other areas.

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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 in order to be able 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, to feel yourselves within, 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 or raise an arm: 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 longterm 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

06/04/201710/09/2017

U-Turn Approach to Independent Sitting

A mother has asked us to elaborate on what ABR calls the “U-Turn Approach to Independent Sitting”.

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ABR is a technique that addresses weaknesses within the connective tissue skeleton and brings architectural and structural improvements to children with muscular skeletal and movement disorders. The following explanation is given in order to create a basis for understanding how these structural improvements translate to improved function.
The child cannot sit independently. What stages does she have to go through to attain independent sitting? How will we be able to mark and to notice the improvements when they start to appear?

The speed of transitions from one step to another will depend upon the severity of the child. A mildly affected child will progress through these stages in such a way that the parent may not even notice it. The parents will notice the appearance of more dynamic functions like rolling and crawling and creeping, as well as the emergence of transitions from one position to another. In the case of a more severe child, these stages will show up more gradually.

In the description given below, sitting is used as an example, but this example could equally be applied to most other movements and functional complexes as well.

What ABR demonstrates repeatedly is that, when the direct road to the achievement of independent sitting is closed for the child, one can take the U-Turn approach and still come to independent sitting.

On the other hand, if the child does not show any spine movement, if the thorax is excessively weak, and the entire body responds as one block in respect to changes in positioning – the child will not learn to sit independently, regardless of how much external training and brain stimulation the child receives.

The U-turn approach describes the functional steps that will show up along the way that lead the child to the attainment of the function of independent sitting.

Normally the problem is analyzed as follows:
If we were to put the child into a sitting position on a stool and go away the child would fall. One could say: “Well her brain is damaged and the brain is sending poor signals to the body. Therefore she cannot sit.” One then goes on to try to train her to sit anyways – and this is the basis of most training programs.

But this will not help the child to come further. We need to look deeper to find the elements of independent sitting that the child is missing, and then make a strategy as to how to attain them. We can see that she seems to initiate the fall often through some kind of full body stiffening or protective reactions. Many children appear to “throw themselves backwards”. But, if she initiates a fall she is not able to stop or to brake the fall. Movement in the healthy person is not only constituted of the ability to initiate a movement, but a controlled movement is also made up of the ability to stop or brake the movements in any and every position and at any and (almost) every acceleration.

Initially, if the child starts to fall, she will do this with the accelerated fall. She does not have a simple fall that follows the gravitational pull, but will fall with an increasing velocity. This is due to the fact that when we put her into a sitting position we do this against inherent bodily resistance. This resistance is a result of a combination of factors such as backline spasticity and fascial shortening – which are brought into an elongated tension when she is put in sitting position. As soon as the external support is taken away, the tightness along her back re-contracts and returns to the neutral position, making the velocity of her fall accelerate. We can observe the “snap back” reactions.

At the same time the child has not been able to “index” the variety of positions which a healthy person has in respect to the sitting position. This huge variety is an “unknown unknown” for the child. The bottom of the child cannot grip the surface she is sitting upon and then the entire body goes into a protective reaction. When the full body stiffening occurs, the child shoots.

When she does this, she is simply unable to brake the fall.

If we want her to improve we need help her to go through several phases.
The first thing that needs to happen is that she can begin to fall with a simple, floppy and loose fall. This will appear when spasticity and fascial tightness in the trunk begins to release and is – never the less – a result of connective tissue strengthening and remodeling. This is a deep and important improvement, but not necessarily yet a functional improvement. The parent may not even notice when the child goes through this stage.
The next step is that she will be able to begin to slow down the fall. She may not yet have achieved the strength needed to brake the fall entirely, but if we – for example – initiate a change of position, the child will begin to show us that she is trying to slow down the fall.
Thereafter the child will move on to having control of the fall in some positions, but not yet in all of them. The child still cannot really sit alone, but if we change the sitting position, the child will not helplessly go into the falling mode, but will be able to stop the fall at some of the positions between being upright and being completely horizontal.
After arriving at this stage, the next really big step is when the child begins to perform the counter balancing movements. A counter balancing movement is a movement that balances out another bodily movement in order to avoid distortion of the body or the loss of balance. We make the stages of counter balancing development visible by initiating a movement through the utilization of one segment – for example the head or the upper trunk or pelvis for this. If the child can start to return part of the body towards the initial position whilst another bodily segment stays or still moves in the counter direction, then the counter balancing movements are starting to appear. In effect all of our changes of positioning and especially walking involve a highly developed complex of counter balancing movements. With respect to a child who has not yet attained free and independent sitting, the achievement of some counter balancing movements show us that the child is getting close to being able to sit without support. Often at this stage the child can begin to sit alone or with support on his or her arms when placed in the sitting position.

On the way to achieving the counter balancing movements, the child will of course have improved significantly in respect to trunk strength and stability, pelvis positioning, the strength and mobility of the vertebral column as well as to increasing bodily segmentation. The child will begin to show mobility in the upper body that is independent of the movements of the extremities, i.e. arms and legs. The head will have to become independently mobile with respect to the trunk, and the thorax needs to be independently mobile in respect to the abdomen, etc.

In this way one can understand how the ability to perform segmented movements of bodily parts in respect to each other is essential for the attainment of independent sitting. As long as the different segments – be it head, neck, chest, abdomen, arms or legs – are all fused together as one movement unit, then the possibility for both “braking” a movement and also for the counter balancing movements are not available to the child.

In order to summarize one can say that the child will go through the stages of:

1. A simple and loose fall
2. Slowing down of the initiated fall
3. Stopping an initiated fall
4. Counter balancing movements
5. Maintaining the sitting position for shorter or more extended periods – on the way to the attainment of a free and independent sitting.

This describes the “U-Turn” approach that is possible to achieve through ABR work in conditions where the progress has otherwise shown to be impossible.

Diane Vincentz
Director
ABR Denmark Aps

02/04/201713/09/2017

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.