ABR JOURNEY -- THE STORY SO FAR...

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.

 Truth to be said, I’ve always found self-introductions to be somewhat unnatural thinking that people should judge what I do at face value regardless of who I am of my personality flaws.

 However, on the other hand, I do realize that anything related to rehabilitation of special needs children is a sensitive area and parents indeed want to know more about the person they are dealing with.

 First of all, “Yes” -- I have been fully immersed in the rehabilitation field for a good 16 years now; but: “No” – I am not a medical professional.

 To begin with I studied math and economics models and I never ever planned to become a hands-on practitioner even though my father is a professor of Physical Rehabilitation being one of the most prominent manual therapy figures in the country, but I grew apart from him without ever having a slightest interest in medicine. 

 However, after graduating I spent a summer with him and was captivated by the complexity and the beauty of biomechanics through his crude yet very vivid explanations and demonstrations, first of all, in a pure theoretical way. 

 Well, I wanted to learn more so I joined him still expecting a theoretical focus only.. 

 But my father was smart enough to present the hands-on work as an applied biomechanics being the necessary condition to develop a really deep theoretical knowledge. As a result I immersed myself into absorbing a vast arsenal of his bodywork tools ranging from various massage techniques to chiropractor–like manipulations to home exercises programs… As the years went by it worked out as seven years worth of full-scale apprenticeship program when we were putting absolutely crazy hours consistently going over 100 hours week without any vacations.

 My father clinic dealt with wide spectrum of musculo-skeletal problems ranging from ordinary back pains and up to the complex impairments, SCI, TBI, CP. 

 I’ve always been attracted by the latter both for a reason of the puzzling complexity of these multidimensional impairments and out of respect to the patients and families -- people who didn’t give up even facing really tough challenges.  I must admit that my main magnet always was and still stays the same – it is a quest for knowledge, trying to figure out the riddles presented my Mother Nature.  Everything else is secondary.  So my reasoning was simple – why bother devoting time and effort to a ‘simple’ back pain or other localized health problems -- since those are just partial and not complex enough. Treatments of those allow one to make a comfortable living but  they are not really worthy of a lifetime cause. 

 And another thing I must say – I absolutely abhor surgery.  For me, so called planned surgery is the acceptance of intellectual defeat. The way I see it – doing surgery is an acknowledgement of the fact that non-invasive, so-called conservative, methods failed. It always surprised me why so few professionals saw it this way.  I’ve read tons of books on a subject of conservative treatment written by doctors trying to figure out the reasons of failure– but was never really convinced that failure of the non-invasive methods to achieve anything substantial was imminent to the ‘incurable’ condition .

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.

 Today ABR has a clear motto “Nothing forceful” but it has been a long journey before that became possible.

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.

 Immediately the key challenges of a strengthening program for severely affected children and adults became obvious:

-       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.

 At first we relied on the work of professionals in the clinic but that was very expensive - 40 to 80 hours of paid professional work per month – very few people were able to afford it. These constraints naturally led to the only workable avenue – teaching family members directly.

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.

 When I hear parents’ stories: “We learned stretching from pictures provided by PT’ or “It has taken our PT 5 minutes to show us how to stretch” – I feel bad – How can one even hope for a chance of getting the maximum from non-invasive physical methods with such a lackluster approach?!.

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.

 However, I digress --let’s get back to the ABR story. As the time went by I’ve seen better and better results in posture and movement of CP kids following the improvements in parents teaching. So I was getting more and more convinced that strengthening itself was the key to progress much more than any of the forceful re-alignment techniques.  I had lost interest in manipulations, adjustments, releases and all those other shortcuts and devoted my focus entirely to the improvement of home exercises strengthening programs. . 

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. 

 So that’s my goal: developing the methods and the home exercise protocols that empower  the parents, improving the teaching methods that give parents the skills and knowledge necessary to become more and more efficient.

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. 

We have grown to quite significant numbers by our standards.  ABR centers look after about 500 kids worldwide through Canada to Europe and to Singapore and we keep growing. 

 ABR today is definitely much better in exercises efficiency, techniques and teaching than it was, say, 5 years ago.  You’ve seen some comparison files already and you’ll see more both in this video and on our websites.  I am not sure how much closer we are to the goal of making a surgeon to roll up his tent.  Because in reality, it is not a tent anymore but more like a fortress of reinforced concrete.

Nonetheless I am optimistic.

 We do focus a lot on video and photo documentation and  accumulated into a huge archive over the years. We do have an elaborated system of testing which is second to none in its thoroughness.

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.

 It’s your dedication to a betterment of a child that drives and fuels us.  Without your day in day out hands on work, ABR would have never come to existence let alone grow worldwide

 And consider myself really fortunate to be able to work alongside and to help people for whom I feel ultimate respect.

 Today’ world is otherwise full of consumerism and self indulgence but at ABR centers we meet a different kind of people, Devoted parents, people with good old family values, who are ready to take personal sacrifices and to do whatever it takes to help a child to get better.

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.