ABR

As I mentioned in my prior two posts, Trevor, Fletcher and I are in Montreal this week to learn a new therapy called Advanced Biomechanical Rehabilitation (ABR for short). There is lots of information in the link I provided in my last post, but I thought I would excerpt a portion of the website for those who want just the basics:

ABR in a Nutshell

Everyone believes that CP children have poor functions because their brain is too damaged to control normal movements. Respectively CP children are considered incurable because the brain damage is irreversible.

ABR has a different philosophy. We believe that even the badly injured brain has enough electrical plasticity to control normal motor functions, however for this plasticity to “switch on”, a child’s musculoskeletal structure has to be improved to a sufficient level - plasticity threshold. Existing treatment methods fail to achieve recovery of motor functions. This failure is then being blamed on the brain damage.

We believe that the answer is different. Existing treatment methods fail not because of insufficient “reserves” of the damaged brain but because they fail to provide sufficient structural improvements to the musculoskeletal system. As a result, the injured brain has “too little of a good musculoskeletal structure to work with” and cannot show its remaining plasticity (reserves) for control of motor functions.

Musculoskeletal structure reconstruction must come first!

ABR approach makes restoring the mechanical structure of the musculoskeletal system its first and primary goal:

• full range of movements (ex. head being able to move unrestrictedly in all directions)
• proper alignment (ex. legs and pelvis; arms and shoulders, etc.)
• muscular mechanical response (proper muscular balance)

In turn, “quality of mechanical performance” requires “bio-mechanical capacity” of the musculoskeletal system which implies:

• Proper volume, tone and strength of the skeletal muscles
• Proper volume, mobility and alignment of the joints
• Equilibrium of strength and length between reciprocal muscular groups (ex: biceps, triceps)
• Adequate proportions between size and strength of centre (head, neck, trunk) and periphery (arms and legs)
• Cascade of muscular interactions (centre to periphery)

ABR re-establishes, unit by unit, proper skeletal and muscular structure to permit proper, unrestricted performance of movement.

Today all the families beginning their ABR training met for a presentation about the theory behind ABR and the basic premises (as outlined above and discussed further on the ABR Canada Website). Tomorrow, we will break into smaller groups and begin our week-long training on the technique. On Tuesday and Wednesday Fletcher will be evaluated by Gavin, an evaluator based in the Montreal office, and Leonid Blyum, the founder of ABR.

As exciting as learning a new technique that will help Fletcher gain strength and ultimately improve function, almost equally exciting is that I am getting the opportunity to meet some of the women I "know" from the computer. I know so much about these families through their blogs, and it was actually really surreal to meet them in person. I just keep staring at these kids, about whose stories I have spent hours reading, looking at their cute pictures, and here they were, sitting in the next row. It was almost like seeing a celebrity in real life! I met Melanie and Daniel briefly in the hallway, sat next to Jessica and Paxson, had a quick chat in the parking lot with Katy, and had lunch with Marcela, Owen, and Nathan.

The Boys (Owen, Nathan, Fletcher and Trevor) After Lunch

It was wonderful seeing people like me, and kids like Fletcher. I couldn't believe how similar Nathan and Fletcher are. Nathan was laughing and "talking" and it was so weird, if I had closed my eyes I would have sworn it was Fletcher (and every mom can pick their child's voice out of a crowd... it was seriously that identical).

Of course, I can't travel to a new city, and different country for that matter, and make it soley about the therapy. So, we headed down to Vieux-Montreal (Old Montreal) this evening and took a guided carriage tour around the historic district. Yes, we are unabashed tourists, although we only took two pictures (so not too bad): the one below and an identical one after the ride, only Fletcher is sound asleep. Either the history lesson bored him or the horse's gait lulled him into dreamland. Either way, do you think it impractical to schedule carriage rides every day for his afternoon nap?