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

 

How ABR Nutures a Proper Trunk – Limb Coordination

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We are supplying this link so that all can see a great illustration of how the proper body – limb coordination works.

This is the example salamandra shows us on the left. The body starts with the undulatory motion, and the limbs follow the undulation of the body. The example in the middle has a blocked undulatory motion, but she still can come forwards. On the right however we see an example of the inverted coordination. When the limbs react first and try to impose this movement to the central connections (spine) – then the complete chaos occurrs. This shows us the fundamental issue with any training based upon a method that starts with the periphery – limbs, through imposing movements on to the child from without through devices, splints, commands, standing frames, etc. Then one imposes the movements from without through the limbs. In this case, a child with a weak core needs to stiffen with his central connections and becomes at the most more like the middle salamadra.

Watch the clip several times, to get a feeling for how the undulatory motions initiate our movement. The human being of course has the undulations in all three planes: sidewards, forwards/backwards and rotations – and all work together at once.

ABR techniques are designed to help the child to develop and to initiate the undulatory motions at ages and stages where it is normally no longer possible. In fact the establishment of these movement stages belong to the earliest development moments from 0 to six months. After the age of about six months, the child can no longer initiate and establish these movements on his own.

The sequences of activation not only relates to the trunk and the limbs, but also corresonds to muscle types belonging to the trunk and limbs respectively. The muscle types that react first 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 reaction.
Training through normal exercises can only 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 belongs intrinsicly to ABR work which is desinged to install the “baby stages” of deep intrinsic undulatory movement in children and adults who have long left the baby stages – and also in those that at this young age are too weak to initiate the proper coordination between the deep intrinisic muscles of the trunk and those of the limbs on their own.

Diane Vincentz

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

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:

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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

 

This entry was posted on 13 October, 2016

ABR Global Developmental Enhancement – Global Developmental Delay

 

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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 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 entire 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 for 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 profession 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 – improving respiration flow
  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 having to do with basic life functions which are depnedent upon a stable intrinsic strength of connective tissues, –  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

This entry was posted on 1 October, 2016

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

trimilin-trampolin-vario-5f54b442 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 to trunk coordination, which becomes obvious both when the children attempt to move or when movements are initiated with them 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.  This deterioration in function is evident in the GMFCS motor score curves seen clearly with the GMFCS Levels III, IV, and V:

Typical of this lack of a sufficient trunk limb coordination is also a tendency to carry out “robotic” movements, to use excessive muscular effort and also to require a high level of  concentration for carrying out movements.

Older and 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, pains and discomforts, 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 rquired for creating the proper trunk limb coordination. ABR applications achieve this at ages and stages where it is normally no longer possible for the person to establish this coordination themselves. In fact the integration of these primary movements and  stages of movements connected to the spine,  belong to the earliest motor developmental moments of life  – which normally are completed between birth and  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.

ABR Techniques  open 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 are most highly integrated within the trunk (type one) and those that have a higher reaction threshold (type two) are more highly integrated within the superficial muscle layers  of the limbs.

Whe persons with Cerebral Palsy, or other illnesses affecting the motor skill function go through training or ordinary rehabilitation and other exercises – this out of necessity 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 children who may be  at this young age and are too weak or too stiff to initiate the proper coordination between the deep intrinsic muscles of the trunk and those of the limbs on their own.

ABR Techniques for the spine and trunk are based upon a re-integration of a proper trunk-limb coordinatinon.  To further support the active integration of these movements we have a variety of specialised techniques:

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.

TheraTogs Usage is in itself a great way to promote a healthy coordination of limbs and trunk.  The TheraTogs is a specialized garment that helps children with special needs to stabilize their trunk.  When trunk stability is present and the child is not so highly dependant upon muscle tension for creating this stability, then the trunk can react in a more appropriate manner and it is possible to establish the proper sequence of activation of the limbs in respect to the trunk.   This garment can easily be integrated into daily routines. It will add a significant advantage to all movements performed by the users. It adds  tensional uniformity and 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

This entry was posted on 27 September, 2016

Osteo- Tapping

Why Osteo-Tapping?

In children with cerebral palsy and other related disorders, as well as in  individuals with reduced muscular skeletal function, one is dealing with widespread degenerative processes that have a spiralling 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 properly bear and carry the weight of the child.  Problems such as hip-subluxation, scoliosis, contractions, spontaneous fractures are only the most obvious problems which show 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 positive 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 fewer cases but also present,  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. These need to start to appear and are the sign of  the necessary  connective tissue attachments to the deep skeletal levels.)
  3. Improved “enthesis” or attachments between the muscles and the bones. The enthesis is the connective tissue arrangement between the ligament/tendon and the bone. When the tendon to bone attachments are weak, then the muscles do not have the needed stability for the muscle contraction.   Then the motor function happens in a disorganised manner.
  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

This entry was posted on 23 September, 2016

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.

This entry was posted on 15 September, 2016,

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 the chiropractic and osteopathic methods have long been established in the Western world, 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. Although each of these methods can have positive effects on pains and other ailments, not one was developed with the specific needs of individuals with special needs or specifically cerebral palsy 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  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 scientific research being performed  with the connective tissues, ABR is developing its own techniques and rehabilitative reach. This is something unique to the ABR method. ABR is in a continuous state of transformation – 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 or the 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 most of the higher levels.

– Transanatomical – meaning that connective tissue structures are not limited to one anatomical structure but interpenetrate and 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 or even the 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.

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 –  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 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