Breathin'....Sustaining Life Forces

 

 Breathing, respiration, oxygenation, the movement of chi, the life force which sustains, resides in a small set of paired organs.  The breath of the outer and movement of the inner....it is that which sustains every vital process in the body.  The simple exchange of the most basic molecules enables the body and soul to sustain connections to the universal process of life.
      In the world of disability, respiration is perhaps among the most vital and sustaining forces of life.  In the expanse of disability, mucus, stickiness, shallowness, lowered blood saturation levels, hyper or hypo ventilation, compromise the body healing and curing itself.  This exchange between the inner and outer worlds enhances, inebriates, defeats or compromises living.  To me, the lungs are paramount for my son; this organ and its process physically and spiritually maintain the force of life.
      If you not severely compromised, you can learn deep breathing, yoga, various respiratory protocols which enable a decrease of stress, a hyper-oxygenation of the blood, a rhythm of interaction with the outer and inner and an enhancement of immunity.  There are many conscious adaptive approaches.  BUT, what if a child or adult is so fragile, medically complex that conscious controls are not available?  So, so many of our friends have disabled children or adult/children who are challenged by forces of the body and the environment and they develop respiratory issues which make them vulnerable to a diminution of life force, to pneumonia, to shallow breathing, to airways and bronchi clogged with mucus, to.... are there interventions which strengthen the most vital of systems?
      One ABR (Advanced Biomechanical Rehabilitation) protocol which has significantly assisted my son is noteworthy;  it's a modification of a older protocol.  Posted a while ago on my Facebook page, I wanted to share this protocol for parents to assist in strengthening that which is so vital.  I know it is not the only intervention; I am sure others could add various techniques.  Breathin' is so very important.
       Here is our exercise explained by Leonid Blyum, founder of ABR , on Adam in April, 2013.

2013-04-22 Chest Exercises from Phil and Sharon Dzialo on Vimeo.

ABR redux....

     We are approaching ten years of ABR (Advanced Biomechanical Rehabilitation) in our daily effort to allow Adam the maximal amount of comfort in a body riddled with spasticity and contracture.  We make progress:  the scoliosis resolves, the space between vertebrae increases, the rib cage becomes even, the pelvic floor shifts to a normalized position.  Adam can again sit comfortably in a wheelchair.  These strides have developed slowly without a need to resort to any allopathic interventions.

      People often wonder if the theory of fascial collapse, the need to strengthen the core and the methodical process to move from spasticity to weakness to normalization is real.  Underneath spasticity is weakness and the journey is filled with what I consider "healing crisises." Things never simply just get better, nor is healing a purely linear process, without crisises along the way.  Change produces challenges that you work through...as spasticity gives way to weakness, challenges develop until strength of the core and the supportive fascia returns.  Crisis occurs in many and unique ways.

      Below is a new five minute video from the Denmark ABR Center which traces the real effects of ABR on hip subluxation.  This subluxation is often a function of pelvic and core weakness.  It's a common condition in CP and other syndromes characterized by a manifestation of low or high tone, spasticity or floppiness.  This video traces the effect of ABR through x-rays over years.  Surgery, muscle releases, casting, etc can and are avoided.  Surgery is an intervention which often needs repeat and ultimately weakens the fascia.  Seeing is believing.

       ABR is a slow, intentional methodical parent directed process which can normalize hip subluxation.  The alternative in more severe cases is surgery and casting....

Pins and rods

Like ABRCanada on Facebook...a great, great resource.

ABR Egg Rolling on Adam's Back...Fixing Lots of Stuff

       Well, Adam has scoliosis (which has improved dramatically); a depressed vertebral column; insufficient space between the vertebrae, and intercostals which seem to fuse ribs together. Also the illiacs and the sacrum need to be shifted forward. These issues are common to the collapse of the myofascia which often are a result of Traumatic Brain Injury and a near drowning.    
         And so, here is a video in which Leonid explains how to use the egg and the "blob" to roll on Adam's back and extract the dural column and "unglue" the intercostals. The instruments and the technique have been further developed since our last visit six months ago. We expect clearer and deeper respiration and increased flexibility as well a strengthening of the core.

ABR Egg Rolling Demonstration on Adam ..Separating Upper Ribs from the Clavicles

The New, Improved Egg Rolling Exercise...a demonstration of refinements to the egg rolling exercise by Leonid Blyum. This video focuses on selection, hand technique and work on separation of the clavicle from the 1st and 2nd ribs and their connection to the manubrium.  The fusion of the myofascial fibers  result from their collapse during the aftermath of a traumatic brain injury, This separation is vital for the improvement of respiratory processes in the upper thoracic regions of the upper anterior portions of the chest wall.

 

ABR Evaluation, April 2012

       We were able to participate in a two hour evaluation of the history of Adam's progress over the past year of ABR (Advanced Biomechanical Rehabilitation).  Leonid Blyum, through a pictorial history of Adam's body was able to demonstrate the changes in his core stability, thoracic expansion, vertebral lengthening and pelvic floor adjustment. Positive changes in the strengthening of the myofascia, which supports all structures in the body, also presents future  challenges which need to be addressed.
        We were fortunate to share our evaluation with the many members of the ABR international team from South America, Europe, Canada, Hong Kong and a guest and friend from Hawaii.

Sharon Dzialo, Leonid Blyum (developer), Annie LaChaud (Director ABR Canada),
Sarah Lee (Director ABR Singapore), Diane Vincentz (Director ABR Demnark),
Gavin Broomes (ABR , Argentina) review Leonid's photo records from
the past years.

Leonid explains how Adam's respiratory compartments have expanded from the upper thorax
to the lower thorax...a deeper breathing, which also brings up and out years of
accumulated "gunk" in the lungs.  Not pretty to look at, but it's a transformational landscape
based upon excavation of submerged and rigid structures.  This "archaeological dig" takes
years to extract the vertebral column and unglue intercostals, but it is working its magic.

Ball rolling along the vertebral column and also along the illiac-sacral triangle
has allowed Adam to sit more squarely in the chair for longer periods of time.

Gavin Broomes (Argentina) and Sarah Lee (Singapore) video
Adam's evaluation by Leonid for training purposes at  their respective
ABR centers

Leonid examining upper thoracic division developing in
Adam's C-7 and shoulder blade areas which need further
"excavation" and extraction for core stability

        The evaluation highlighted many positive changes in Adam's core strength, head stability, respiratory capacity (especially in the lower thoracic areas), increases in the spaces between the vertebra in the dural column, and a stabilization of the pre-existing pelvic tilt.  

        Also the evaluation indicates that work needs to continue on the intercostals, dural tube, area between C-7 and the shoulder blade, the occipital area, and the space between C-7 and the should blade.  Much emphasis will be also placed on the anterior thorax and continuing work on the illac-sacral triangle.  

        Interesting to note is the fact that in a traumatic brain injury the body loses its motor map, which needs to be regained.  Two legs are treated as one because of the loss of a motor mapping; two arms lack differentiation and compartmentalization...many projects to work on.  The latter notions seem to be consistent with the theory and work of Anat Baniel who trained with Moshe Feldenkrais.  This is another piece of the complexity of Traumatic Brain Injury: the body needs to re-learn its motor map.

        The following post will focus on the prescriptions and exercises for the next six months.

A Day in the Life of an ABR Kid

       ABR (Advanced Biomechanical Rehabilitation)  is an intensively parent involved therapy that is guided by scientifically based biomechanical principles which attend to the structural collapse caused by brain injury (CP, stroke, near-drowning and many other brain assaults).  The techniques bring about predictable musculo-skeletal changes by strengthening the myofascia of the body.  Complex science is applied through simple principles and applications.  The theory is expounded upon by the developer Leonid Blyum on his blog. Research validation is underway.  The approach is very parent intensive and this post details the various hours of applications required to produce change.  Parent training and evaluations occur four times a year initially, then are reduced to twice a year.  Time and effort are crucial factors to reverse the myofascial collapse of a brain assault.  Here's Adam's typical ABR day:

6:00 AM to 7:00 AM (hopefully while he sleeps)

Soft egg rolling on foam along the lumbar vertebrae

Soft egg rolling along the sides of the upper sacrum with Adam on his side

9:00 AM TO 10:00 AM

Soft ball micro rolling on lateral neck up to but not over the SCM

Super soft mini ball rolling on cranial apex with foam platform

Soft egg rolling along clavicle

Soft egg rolling along the pectoral muscle

10:30AM TO 11:30 AM

Soft ball rolling along the upper vertebral column

Soft egg rolling along collapsed area on sides of  lumbar vertebral column

Soft egg rolling along fascial collapse on sides of lumbar spine areas

Soft ball rolling along lower lumbar and upper pelvic floor

3:00 PM TO 4:00 PM (While watching Dr. Phil)

Placement of soft egg on arms for short rolls to reduce spasticity and increase fascial strength

Rolling the soft egg on the arms...both arms per session

8:00 PM TO 5:00 AM

My invention:  three inch memory foam topper with cut-out for
pelvic and upper posterior thorax bladders

Adam strapped up for the night: bladders, platforms and foam on
posterior thorasic and pelvic areas on back and similar set ups on chest, stomach and hips
from the front.  Happy as can be...no?  But he sleeps well.

ABR Machines (we use two) which rhythmically inflate and deflate bladders to
strengthen certain myofascia areas where we place the air bladders.

Conclusion

Ollie, provides professional supervision.




In between ABR treatments, Adam also gets fed, watches tv, and does other stuff, every day.

CONCLUSION:  It works! No doubts on our part, none at all! No surgeries, no braces. no spinal fusions or rods,

no AFO's, no medicines of any kind, no baclofen pumps, no botox, just ABR. The best part, no

PT's or orthopedists. Just a kid who smiles every day!

ABR: New Protocols, New Directions, Changes: Fall 2011

Adam sleeping though an egg-rolling demonstration
on the shoulder pocket below the clavicle

       Well, we're back from Montreal ABR (Advanced Biomechanical Rehabilitation) and our latest evaluation and training!  Actually, we've been back for two weeks and we have finally integrated the exercises into our continuing bodywork with Adam.  Leonid, via video evaluation, noted that Adam's upper back is straightening and our work on his pelvic platform  is shifting his pelvis into the proper position.  His vertebral column is demonstrating a higher degree of flexibility.  When sitting, if he is allowed to tip to the side, his butt (can't think of a technical term for ass) stays flat on the chair and no longer tilts and follows the spinal column as if it was fused.  This vertebral flexibility is allowing him to sit more comfortably.

The lateral neck super-soft ball rolling exercise.
Remember, Phil, do not roll on the SCM  as Fehim
emphasized numerous times because its painful for the kid.

       So what's next?  We are focusing on his upper body, clavicles and shoulder pockets to bring volume into that area which should allow for a greater release of the arms.  Also, exercises focus on the top of the head and SCM ( sternocleidomastoid ) triangle.  This area of application had greatly improved his swallowing in a brief period of time.
       Additionally, we have applications in the lateral thoracic area (L1 thru L5) and across the lower lumbar area.  Working on his lower back will hopefully strengthen the fascia in this area and straighten the lower spine.  We are now up to 3-5 hours a day of ABR and finally decided to vacation one day a week.  

Placement of "egg" on the platform
behind the mastoid.

       The incorporation of the "egg rolling" has quickened the pace of change and 5 out of the 7 new exercises deal with egg-rolling.  We are amazed at the role of the fascia in the normalization of a structure which has been severely impacted by a brain injury.  Muscles and bones mean so little to functionality and mobility; the fascia holds the totality in place and the "fascial trains" integrate body systems into movement systems.  Amazing stuff!

Egg-rolling on the lower lumbar (L1-L5)

      Needless to say, we are excited about the changes which we can more readily visualize and we continue work to produce more change.  Adam is more comfortable in his body and we work to make him more so each day.

Coming Attractions:  A New Frontier....

       Equally exciting is a new clinical trial we have explored called a brain-computer interface where researchers have created a model in which a small aspirin sized chip and electrodes communicate energy across portions of the motor cortex.  The energy differentials are calculated by computer to determine intention to move arms and the intention is completed through computer interface.  If you think that you want your hand to turn TV on, the electrical charge in the brain is measured, translated by a computer algorithm to a computer to turn it on.  A robotic arm nearby can be controlled by simple thought!  Bizarre?  More in my next post!  Clinical trials have been underway since 2005 at Massachusetts General Hospital with people with ALS, MD, spinal cord injury and brain stem stroke.  Brain Gate is becoming a reality!
The same team is researching epilepsy which is unresponsive to medical management.

Neuronal sensor (size of a baby aspirin)

Adam's Back, Eggs and Super-Soft Balls...

       The biomechanical changes in the body of a spastic young man (Adam, in this case) resulting from many hours of daily ABR (Advanced Biomechanical Rehabilitation) are never simply linear and even.  Changes happen from the top (head) and cascade throughout the body.  At times, as parts of the myofascial membranes and supported structures normalize, other areas demonstrate their inherent weakness from the original collapse caused by the brain insult, either acquired or present from birth.  As we know, underneath all spasticity is weakness.  The "getting better" part of the process is neither smooth nor linear.  Transitions arise and changes in ABR protocols are necessitated.  ABR produces releases in the myofascial layers which reveal further weakness which must be strengthened.

Our present ABR project: differentiation of
sacrum and illiacs; mobility in sacroilliac
triangle to prevent pelvic tilt when
seating.

      We have now resolved the issues concerning excessive mucous production because of releases in the thorax and increased lung function. And we have fairly effectively removed restrictions in Adam's vertebral column through the mid thoracic area.  Prior to ABR his shoulder blades were rotated high into the clavicular areas and there was little differentiation between upper thoracic and cervical vertebrae.  These areas have greatly improved and alligned.  On the heels of this positive progress, we are now confronted with Adam's inability to sit in his chair for periods of more than an hour without discomfort.  Now, we need to confront the rigidity and lack of differentiation of the sacrum, illiacs and lower veterbral column.  This rigidity causes pain when loads on the column come from below and cause the pelvis to tilt.  Now begins the process of ungluing these structures from each other and strengthening the lower end of the vertebral column.

The EGG...actually we use the orange very soft
version by eggserciser and the red soft by theraband.

         After a video consult with Leonid, we are using the new "egg" rolling technique along the illiacs and the sacrum while Adam is prone so as to release the rigidity which produces the pelvic tilt when seated.  Also, we are using the egg to roll from along the hip bone to the pubic bone to strengthen the lower abdominal wall now that previous exercises have produced needed space.  Parents need to be trained to use this new tool and, most importantly, the necessary targets will be prescribed for them based on each child's physical challenges.

Since ABR, the rib cage evened out, abdomen strengthened
and expanded, shoulders moved to proper position and intercostal
spaces greatly expanded.

         After several weeks of the new protocols, we are noticing more changes in the sacro-illiac triangle and a greater division between the lower rib cage and pelvis on the right side of his body.  All good things!   Our belief in the success of ABR maintains our determination and we do the techniques daily for 3-5 hours and use the machine in the evenings for about 10 hours a night.  While Adam's body is not a pretty sight, it is getting prettier and more comfortable.

Note the finger pointing to the increased division between the lower portion of the rib cage and pelvic area.  For many years these structures overlapped and ABR has allowed for differentiation and production of space which will allow the hip bone to move into its rightful space in the abdominal wall.  No, by the way, Adam doesn't have two navels.  The upper one is the old g-tube stoma which held the mic-key that Drs. Phil and Sharon removed and got the old boy eating via mouth.


Again, ABR is a singularly effective therapy to normalize structures which collapsed as a result of brain injury...it's a parent intensive long haul, but changes develop along a predictable, yet non-linear, uneven path.  Nothing is simple in the world of severe disability.

Prior to ABR, you could not differentiate scapula nor
any of the cervical or thoracic vertebrae...now they are visible and
aligned.  Next project:  mid thoracic to sacrum straightening and
strengthening.  We're getting there!

A Primer on Bringing Out the Worst in Me.....

It is a consolation to the wretched to have companions in misery.

Publilius Syrus (1st century BC) 

Maxim 995 

       I feel a great dissonance when I am out of sync with nature (just another brilliant intuitive insight).  In the winter, we hibernate, slow down. lay low and decrease expectations of self...just like a gluttonous behemoth in its cave.  In summer, we bask in the sun, taking in the richness of the rays of light and warmth.  In the fall, we slow down and prepare for the hibernation by participating in the changes nature brings.  In spring?  Well, flowers bloom, trees bud, the soil is prepared for planting and the effing Canada geese return to crap all over your lawn. I suppose these vile creatures are ingesting all that lives so that they can effectively breed and make more genetic copies of themselves.

       Well, what do you do if you are out of sync with nature and plain out of valium?  What do you do if (of course, in the land of disability care-giving) things are not green, pliable, sunny, warm and fuzzy?  What do you do if one day is like the past 4,378 days?  Wake the boy, shower the boy, change the boy, feed the boy, ABR the boy for hours, laser him for a bit more, feed again, make faces, entertain and "flip" him off so he laughs.  Change and feed; change and feed; clean stuff up; gag him so he gets the crap out of his throat otherwise he freaks and hyperventilates.  (I would freak if I almost drowned and died and had a hard time breathing).  Anticipate needs which may not even be there.  Each day the same, and it's spring...a new beginning, refreshing new life, propagation of the species (as if I could care and have the energy for that!).  Simply, the outside is not in sync with the inside.

And I think I have it hard?

       This is not the way it should be...I should be grateful for what is, for Adam's life, for his health, for my health (dubious), for being the beneficiary of a gift ( a handicapped son) from god which brings out the best in me?  He/she/it knows what's best for me and what will purify me of my past sins or perhaps, allow me to put some karmic points in the bank so the next time around I will be rewarded with riches and a 1000 virgins.  Sorry, this is my last time through, and I was pretty adamant about that with the guy upstairs.

       I have to accept that life is what it is...a balance of a bowl of cherries and a bowl of turds.  Eat and flush!  I think that was a movie., something like "Eat, Pray, Love"... probably the worst movie I ever saw and I'm mournful that Adam had to sit through it with us...at least there were burgers and beer at the movie theater, but no discounts for kids in wheelchairs...you don't get a discount because nobody notices.  Someone who sits in a cafe and drinks strong coffee all day in France would label these periods "existential ennui." 

      When you care-take a pretty complex kid, you, unfortunately, don't have the luxury of much time to wallow, although I think that wallowing could be somewhat good for the soul.  St. John of the Cross wrote a lot about the "dark night of the soul."  He had a lot of time to wallow and was made a saint...do you think I have a chance at making a canonization?  Will you write to the Pope on my behalf?  Probably not, because if you're reading this crap, you are probably a lot like me.

       You do what you have to do, you fight for what is important, you get up every day, even if you don't want to.  You smile when you aren't happy, you eat only that which brings you joy, you drink what pleasures you.  After all, we are entitled to these fruits of the springtime earth.  Above all, you NEVER,  EVER consider doing something different from what you are doing.

        The positive to this life is that you lose your censor...you say things as they are, you see people as who they are, you envision possibilities, like real friends and parties and cruises,  which may never exist...you live and you do not have the luxury of dying because there is a job to be done.  You do the job because you love your child; not because he/she is an angel, a special person (I hate that f....in' phrase), a gift from above.  Because he/she is your child...your blood, your spirit, your life....that is unless the stork dropped the kid off at the wrong house.  That is always a possibility...

       I am happy now, because I know that I am not alone.....or, so I assume?

Guest Post: Maribeth Dawkins...Hope Springs Eternal

        Maribeth (Meb) Dawkins is Adam's longstanding ABR therapist and shiatsu practitioner.  She has often traveled with us for trainings in Montreal and has provided Leonid with a wealth of information about baseball and ornithology, neither of which are the hotspots of Russian culture.  Meb has passionately cared for Adam and has been a stable force in his life for 12 years.  They are on the same page in life, in all areas, except favorite sports teams.  Thanks, for sharing this guest post and your gifts with Adam!

Hope Springs Eternal

      According to the calendar, spring is officially our current season.  It hasn't felt like it here in the Northeast yet, but there have been occasional signs.

Maribeth (Meb) Dawkins

       I drove to the Cape, to work with Adam, the other day during a sleet and snow event.  The temperature was hovering around thirty degrees, yet there were crocuses popping their hopeful heads through the snow.  It's hard to be full of hope when nature keeps throwing conflicting messages at you.  Even when your body, mind, and spirit aren't feeling the presence of Spring, you KNOW it is inevitable!

       One of my favorite things about the advent of spring is the return of baseball.  New York Yankees especially! (Apologies to the Dennison's)  What is more hopeful than a fresh start, a clean slate, a good long Winter's rest and six months of PLAY!

      Adam joins me in being a true baseball fan, though our allegiances lie on opposing sides of the best rivalry in sports.  Before his accident, Adam had, and I hope I'm quoting this correctly, "the best day of my life" in response to his first experience of a Sox game.  Sharon, Phil and I have spoken for years about how great it would be to get Adam back to Fenway Park.  Unfortunately, due to Adam's physical state, lack of mobility, and extreme reactions to overstimulation, this hasn't been feasible.  Adam's comfort zone is not something to compromise.

       To return to my theme of hope, how about Adam finally being ready to go to a game after all these years!  We have ABR (Advanced Biomechanical Rehabilitation) to thank for this, in addition, of course, to the constant love, support and healing he has generated, and received.

       The tickets are in hand, and Sharon and Phil will be taking Adam "out to the ballgame" in July.  I won't be there for this momentous occasion, as much as I would love to, but I hope and trust there will be many more opportunities to come.  Who knows, we may even get lucky enough to score some Yankee vs Red Sox tickets!! (Notice which team I put first?)

Meb's favorite pic!!

Adam (kind of)  at ? years old ( added by his dad)

New ABR Exercises . . . Onward and Upward

              Advanced Biomechanical Rehabilitation (ABR) is our primary therapy used in Adam's rehabilitative journey.  It is supported by a host of other complimentary approaches as we we continue on this long journey.  The previous post focused on Adam's evaluation in Montreal which informs the exercises described here.

Intense, super soft ball mini-rolling on Adam's head

     Two full days of training, after a comprehensive evaluation,  provide us with the next six months of body work on Adam.  The theory which underlies ABR continues to unfold, it is never static.  The applications also unfold; there are new techniques and new targets to focus upon.

Application to Adam's ever expanding thighs

      The changes in application are significant as two new theoretical constructs are explained.  We will, of course, continue to support and reinforce Adam's hydraulic structure and numerous applications are targeted at the head because the head is the nexus of the hydraulic system which supports the myofascial layers...strengthening of the layers lead predictably toward mobility and eventually function.  Even in the tiniest embryo, you see a head and a rudimentary structure which develops...the remainder of the body develops from the head in the womb.

Leonid supervising Sharon's back of the head technique

       Two new constructs;  intense ball rolling and super-soft balls.  We learn a targeted ball rolling which is much more intense with a greater manual force exerted .  It goes deeper, it allows a penetration of the stress shielding layers of the body and above all it accelerates the rates of myofacial strengthening and change.  Change actually accelerates.  Super soft balls are actually the same structures which are further deflated and allow for greater coverage of the target areas.  This technique is especially applicable to the head.

Leonid demonstrating the positioning of head applications with the super soft ball

      Again, the applications provide for compression without distortion...intense compression of ball with mini rolls and a solid transfer medium...the energy of the process is transferred while bypassing the stress shielding factors of the outer body.  Strengthening the core ...structural change, mobility and function...a predictable course of change.
       And of course, ABR would not be complete with the more traditional 3-Q technique (quasi-static, quasi-spherical, quasi-isotropic).  We have three new 3-Q applications which target specific areas of the head.  These are targeted applications which are very specific to areas which need to extracted.  We are working on areas below the occiput and on both platforms behind the ears.  Intense ball applications focus on the head (both top and back); three areas along the vertebral column, the sacrum, fifth - eighth vertebrae on the thorax, shoulder apexes,and  both thighs.  We usually work on Adam several hours a day; Maribeth usually does 5 hours of applications every week.  Changes are definitively happening and at an increasing pace and in a very positive direction.

Maribeth employing the 3-Q technique on the lower lateral neck platform

     Oh, yes...Adam also has two ABR machines with 8 bladders inflating throughout the night..sacrum, abdomen, hips, thorax and mid vertebral column...also a set of high quality ear plugs.  He sleeps like a baby.
     Before you feel bad for Adam because of all the ABR, please remember that we usually give him one a week off from all therapies.  Really nice of us, no?

      For my adventurous readers, Leonid will be presenting and doing a live assessment at the Pacific Rim International Conference on Disabilities on April 18 in Hawaii ... still time to sign up...LINK to brochure.   It would make for a nice vacation on short notice!

ABR (Advanced Biomechanical Rehabilitation)...Evaluation: Spring 2011

       ABR is a biomechanical approach to cerebral palsy, brain injury, stroke, near drowning and other brain assaults.  With such an injury, there is a progressive collapse of the myofascia which supports the musculo-skeletal systems.  The myofascia are bands of interconnected tissue which allow systems to function as a whole.  This collapse is evidenced in scoliosis, hip subluxation, spasticity, dystonia, contractures and numerous motor impairments.  ABR believes that parents, with training, can bring back volume to the collapsed structures.  With a functional body hydraulic system, normalization of structure through the strengthening of the myofascia produces mobility and function.  All change is a function of non-invasive procedures: traditional physical therapy, orthopedic procedures and surgeries are avoided, and the use of botox is eschewed.

Adam and Leonid, sitting with some support

       All sessions are preceded by an evaluation of all the structural components of the body.  Skin quality, tone, volume, function, change are considered in the development of individual prescriptions of various activities.  Evaluations usually last one to two hours and are video-taped and photographed so that long range change can be plotted both for personal and science based reasons.  Change is evidenced in photos over the years.
       We have just returned from Adam's evaluation in Montreal by Leonid Blyum, the developer of ABR.  It's important to note that Adam is among the most compromised ABR clients given the extent of his brain assault:  25 minutes under water.  Numerous children and adults have lesser structural issues.

        In the last six months, Leonid noted that the skin quality of Adam's upper arms and volume in his thighs has significantly improved, making room for muscular expansion.  He is eating better as his jaw is more properly aligned.  His thorax is now level (originally the left side was higher and the right sunken). The space between his vertebrae has expanded and the ribs are rotating toward the proper positions.  His spine is gradually straightening and the pelvic floor is moving into a more proper position.  We are very pleased with evaluation, the observations and ongoing predictability of change.

Sharon, Adam, Leonid...thoracic evaluation

        Over the next two days, Leonid introduced parents to further refinements of ABR theory and applications and we were trained in new specific applications to continue the change.  Despite the severity of Adam's injury, his health is superb, spasticity lessening, and his body normalizing.  It's a marathon, over seven years so far, and probably many more.  The change has always been unidirectional and that is in a positive, predictable direction.  The following blog will examine some of the new prescriptions and and areas we will work on for strengthening.  Underneath all spasticity is underlying weakness of the myofascia layers.

Leonid, Gavin, Sharon..examining new folds as they emerge

ABR . . . Returning Home Again

Leonid Blyum, ABR developer

“The soul of man with all the streams of pure living water seems to dwell in the fascia of his body. When you deal with the fascia, you deal and do business with the branch offices of the brain. That is as under the general corporation law, the same as working with the brain itself, so why not treat it with the same degree of respect?”  (Andrew Taylor Still, Founder of Osteopathy, 1899)

     Within the many layers of myofascia, we find the muscular and  the skeletal systems normally supported.  With anoxic brain injury ,CP, stroke, etc., there is a collapse of these layers of supportive tissue wherein the whole no longer functions with integrity and mobility is lost or compromised  Fundamentally, there develops an inherent weakness which lies underneath the spasticity and contortion of the body.  Given the fact that motor neurons do not regenerate, there are alternative pathways to mobility and function.  The ABR techniques (Advanced Biomechanical Rehabilitation) reach into the visceral core and strengthen this tissue layer  which in turn normalize structure and brings mobility and function.  ABR is scientifically researched and supported through the science of tensegrity study.

Rotation of scapula above collarbone, common evidence of collapse  which is treated by ABR   protocol; Adam had a similar rotation which was resolved.

      ABR is not a quick fix, but a long term therapeutic process carried out by parents as a result of regular evaluation of progress and application of new techniques.  It does work and this is scientifically documented and research continues as progress of clients is measured against the expectations of  the GMFCS scale.  We are starting year 8 of Adam's journey in the ABR process.  It has reinforced good health and strengthened respiration (vital in all cases of brain injury), radically changed his thoracic landscape, clearly improved his scoliosis (by expansion of the volume between vertebrae) and reduced his overall spasticity.  Adam is also among the most compromised and complex of the ABR population.  The progress in the normalization of his structure has been marked, and this is a common reflection of many ABR parents. In the past 8 years, there have been no surgeries, no medications of any kind, no orthotics, no hospitalizations, no emergency visits to the doctor.

      It does take commitment, a minimum of 3 hours of manual application per day and can be supplemented by machine applications while children sleep.  Manual applications target specific areas, machine applications are wider and supportive but do not replace the manual.  Each series of exercises are developed and prescribed by Leonid Blyum, the developer, through either a personal evaluation at the center or by video.  In the initial years, four sessions of training are required either in Montreal or satellites across North and South America.  After a number of years, the evaluations are reduced to bi-annual.

Leonid Blyum, hands on evaluation

       We are looking forward to Montreal March 30 to April 3.  Leonid will skillfully point out changes in Adam's structure, he will prescribe a new set of applications for manual and machine work, and the trainers will develop the materials required and provide training in the specifics.  Above all, we look to Leonid to be our cheerleader as he recognizes a predictable pattern of change...change is predictable.  ABR is a backdoor to mobility and function.  It is based upon pure research and science.  This blog contains many links to ABR theory, application and work of the centers around the world.  ABR makes rehabilitation and progress in the area of brain injury possible.  Parent blogs are replete with stories of significant change.

Fehim Medinic, a trainer, observes Sharon's technique on working to  normalize the pelvic floor.

        So, next week marks year 8 and it marks a re-dedication to our commitment.  After the sojourn in the big city, I'll have an update of changes, improvements, new techniques and pictures galore.  While we have tried almost every available realistic therapy, this is the only one which produces positive structural change which is permanent.  ABR eschews any orthopedic surgery, DAFO's, standers, and poisons (botox, intrathecal baclophen pumps), traditional strategies of physical therapy which are all contra-indicated.  Scoliosis, hip subluxation, contractures are non-surgically and non-invasively treated.  It works, it's tough, it's a long commitment, but it's a true expression of love of your child as he/she moves to a normalized structure.

www.blyum.com