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Therapies for cerebral palsy- the clusters approach. ABR Workshop at Pac Rim Video Part 1.

Well, dear friends,  the summer is almost over – and it is time to get back to the ABR matters.

I didn’t bug you during the last few weeks with ABR-related food for thought – as parents you deserve some vacation as much as your kids… without me bugging you with large chunks of information to process.

Historically ABR calendar follows the division into the academic/ shool years rather than the calendar ones – so I guess I need to congratulate you with the beginning of the new school year.

More studies are coming your way!... I hope that makes you excited rather than grumpy… :-)

I am not really sure whether my teachings make your favorite subject but hopefully you find my ramblings helpful at least to certain extent. In other words, hopefully the reading of this blog translates into  improved  clarity about your special kids development rather than into increased confusion.

I do strive to express my views in language that is easily understood even for a person who is far removed from medical and biomechanical terminology, however, sometimes – there is no other way around it.

My goal is to help you with the understanding of Cerebral Palsy kids’ development and to give you the information that allows you to make intelligent choices.

Well, often enough the real ‘insider’ information is coded and wrapped in the cocoon of special terms designed to scare away the outsider and to preserve the monopoly of medical profession on decision-making about your kids treatments and care. Hence, unwrapping it requires some thinking and intellectual effort of being ready to face the ‘fancy words’.

I started with this preamble as a way to introduce the 5-part series of videos that contain the extended Workshop presentation that me and Mark Driscoll did at the Pacific Rim International Conference on Disability on April 18, 2011 in Honolulu, Hawaii.

I published the abridged version earlier but I am pretty sure it is well worth your time to study the full one. Not only the sound clarity is much better but there is a proper pace of presentation with the smooth transition through elementary logical statements.

This workshop was designed for the professionals – most of the audience were PTs and OTs as well as a few of the MDs specializing in rehabilitation. However, you shouldn’t worry about the presentation being too high-brow.

I do believe that the language is accessible enough for a parent – although sometimes you might need to pause the video and look the words up in Google.

The first video covers the introduction/overview that presents ABR in a somewhat new light. My goal was to make sure that you get the big picture of what is the specific place that ABR has among numerous treatments, therapies and rehabilitation methods that you hear and read about.

Often enough, parents as well as professionals, are label-oriented – every therapy is looked upon as another entry in a list where your mindset is set on: “Ok, now we are trying this therapy; if it doesn’t give me the results I want for my child fast enough – I am going to proceed to the next one on the list.” This linear view is unfortunately misleading because by focusing on the individual therapy labels you lose the perspective of therapy clusters.

Let me use and example to clarify this idea. For instance, on the surface, say, Bobath, Voita and Doman are all different labels associated with different personalities and techniques, however, it is essential to realize that all these therapies belong to the same cluster.

They are based on the same underlying idea that it is “all about the signals”. These therapies employ different techniques but the essence is the same: “Send “better” signals to the brain of a child with Cerebral Palsy by imposing the specific movements onto the child’s body”. These therapies imply that the brain injury caused the loss of the “right” signals so enforcing the signals from outside is set to “re-wire” the brain and translate into the improved functions. What is then the common ground underneath of all these therapies? – It is a firm belief that the ‘biomechanical body’ is no more than the passive arena where the electrical signals run the show.

What is the result of such beliefs? – Complete disregard of the direct biomechanical effects that “imposing signals” does to the body. In other words, these therapies share the same underlying principle – the only one who matters is the ‘driver’ (i.e. the brain) – which translates into inevitable abuse of the ‘car’ (your child’s body). Imagine that your house was designed by the electrician who only cares about the electric  wires and the easiest access to them. Would he ever care about the walls? – Not really. What about heating? Water installation? Mechanical robustness? Elevators? – none of that matters for a person who looks for signals only.

That’s what I wrote about in the post on “Giving the boot to Neurological Dogmas” – that the focus on the ‘signals’ results in parents doing horrible things to their child’s bodies all in the vain attempt to impose “better signals” by some type of forced movement or positions.

I hope that you are beginning to see why the ability to realize clusters of therapies is really most important for you as a parent who is on the constant search for the better therapies for your kids with Cerebral Palsy.

Without understanding, which cluster does the therapy belong to you end up going from one electrician to another one pulling the wires in different fashions and drilling for them whilst missing the house construction altogether.

Again – the final  choice is always yours but you are in a much better position to make an intelligent decision when you see just a few clusters of therapies rather than the endless list of individual labels where the new ones pop up all the time.

This ability to think in clusters is helpful for you not only when you make the “OR” choices: this therapy OR that therapy; but also when you decide upon the “AND” choices of combining different treatments together. In other words, when you are looking for a wholesome comprehensive meal you want to have the entrée, the main course and the dessert instead of ending up with three different fizzy drinks, right?

That’s the context that you’d want to watch this video in: What clusters of therapies exist for Cerebral Palsy children? What clusters have been well drilled in the past with what results? What are the true novelties introduced rather than a camouflaged old serving? And so on…

To help you with creating this map of the Cerebral Palsy therapies field –

I introduce a very simple concept: “Thrifty” rehabilitation/therapy methods (probably “Prudent” is an even better word – but I kind of missed it back then) vs. “Lavish” ones.

  • Lavish” rehabilitation/therapy methods are the ones that recruit the most ‘expensive’ structures within your child’s body, the tissues that are extremely demanding on your child’s limited metabolic resources being the ‘luxuries’ of human development.
  • “Thrifty/Prudent” methods – are the ones that engage the cheapest  biological tissues that do not exert a heavy metabolic toll on your child’s body, that contribute to better functions at no extra costs.
  • Lavish” /spendthrift methods – “suck the juice” out of your child’s biological batteries sacrificing the long-term sustainability for the sake of a short-lived boost of action.
  • “Thrifty/Prudent” methods of rehabilitationcharge your child’s biological batteries creating the ability to develop consistently and progressively in a metabolically sustainable manner.

What are the :”Lavish” and the “Thrifty” methods? – Well, I am not much of  a thriller writer but hopefully I have managed to create just enough of suspense and curiosity to make the viewing interesting…

P.S. As always I encourage you to leave comments and Facebook likes – the beginning of the school year is always kinda slow – so some kindling is always welcome.