Having started this blog I guess I need some sort of foreword and introduction of myself as well as outlining some narrative of the ABR story.
I always felt that they simply gave up too soon, admitting defeat before even starting, being all too ready to hand a child to a surgeon. Hard to explain why but everything in me protests against the very idea of a ‘planned’ surgery done on a child with brain injury. I don’t deny that occasionally it ‘works’ -- improving comfort, maybe even giving better function sometimes but still such a forceful intervention for such a weak child -- it really doesn’t feel right for me and, should I say, it affects my sense of harmony, my basic perceptions of the ‘right’ and ‘wrong’.
So when I run out of steam, I just open a surgical book and re-charge myself because every page makes my blood boil from an injustice and what I perceive as a dead-end avenue of reasoning.
So naturally, my personal opinion is – time and efforts is not a factor if it ‘allows to avoid surgery’ – That’s why my focus has always been very clear – how to achieve maximum results without surgery or any other invasive tools like botox, baclofen pumps etc.
In the beginning my father’s clinic operated under “No pain – no gain” principle– there were very intense monthly courses of various skeletal adjustments, manipulations and vigorous stretching etc.
Resulting posture and mobility improvements were often quite impressive within a short space of time but we faced a challenge – results were often short lived. We were very effective in releasing the rigid joints and muscles but were often defeated by accompanying weaknesses in the long run.
That’s why the next natural move was to add some strengthening exercises to our program – that happened around 1997 and I was put in charge of this project as a person diligent enough to deal with micromanagement of teaching parents from scratch.
- Strengthening is extremely labor intensive. In comparison to any form of release, that shows a response quickly, effective strengthening demands some really significant hours of work in order to achieve any tangible progress.
- Strengthening had to be passive – done by ‘external’ person – because a CP child or any other person with severe motor impairment doesn’t have much of a voluntary control of his own in the areas where they need strengthening the most.
That’s how it all evolved - from ‘no pain, no gain” super intense release, manipulations and adjustments of the early days to the recognition of the fact that strengthening of the weakest links was the key; and from a mindset of a maximum visible effect from a single treatment session to a mindset of a best long term step-by-step transformation.
There was another natural selection that happened along the way – to start with I had pretty much an equal interest in SCI, TBI, stroke and CP. But it turned out that the parents of CP kids were the ones who are willing to work the most and that determined my focus for the future years.
And I must admit that transition from relying on professionals to teaching the parents wasn’t easy. It takes a lot of change of both one’s mindset and one’s tools. One can’t just take a method that demands a professional 1000s of hours to master then dumb it down and teach it to a parent. In such a case – one shouldn’t wonder that results are very limited but, unfortunately, that’s exactly the way the parents are taught to do home exercises today by most professionals.
For a change – just have a look at any body-building magazine – you’d be amazed with the attention to detail. Every little aspect is being addressed – how to isolate a muscle; how to adjust an angle and a range, how many repetitions to do and how often and so on. There are exact protocols and heated discussions about every little nook and cranny. And what is the goal? – To gain another half-inch to a biceps size… And I am yet to meet a parent, who was trained in a home exercises routine by his professional supervisors even remotely close to such a precision.
It’s a pity but at the same time it spells opportunity and just confirms what I said earlier – non-invasive methods in a professional setting are not addressed seriously enough.
I said it before and will repeat it many more times – I believe that non-invasive methods were never given a really fair chance because healthcare professionals can only deliver very limited hours per child, but at the same time they are neither ready in their mindset nor methodologically equipped to pass the key role to a parent as the only person with sufficient time and enthusiasm reserves necessary to address the weakest links by strengthening. A parent is the only person who has time, dedication and true knowledge of a child. No professional has this combination.
Unfortunately medical professionals are ‘too professionally centered’ -- they can’t realistically ‘let it go’ – give the leading role to the parents.
As a result, I feel that today’s rehabilitation field is too slanted towards invasive protocols – surgery, drugs, forceful stretching etc.
Many years ago I’ve read a statement by a retired surgeon: “Hopefully one day the non-invasive methods will improve to such an extent that a surgeon would roll up his tent and leave. I am not sure whether he sincere or not saying that but I took that statement to heart as a personal mission.
I started on my own 8 years ago. The road hasn’t been always smooth but I’d dare to say that ABR made a lot of progress.
have grown to quite significant numbers by our standards. ABR centers look after about 500 kids
worldwide through Canada to
Europe and to Singapore
Nonetheless I am optimistic.
We do focus a lot on mathematical modeling for better understanding of CP child’s biomechanics and you will see it later in the theoretical part of this course.
So I am having a positive look at the future. And the main reason for that is not even the hard work and expertise built by ABR centers but the main reason is YOU. You, th parents of children with special needs.
That’s an honor and responsibility at the same time and me personally and all the ABR teams worldwide we try to live up to these standards.