WHAT IS ABR?

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ABR stands for Advanced BioMechanical Rehabilitation.
ABR is a unique biomechanically based rehabilitation approach for children and young adults with brain injury that brings predictable recovery of musculoskeletal structure and motor functions.

ABR is the method of structural correction of musculoskeletal deformities. It is a hands-on method performed by the parents who learn the ABR technique and receive individual prescription of applications from the ABR professional staff.

• ABR is a method that re-builds even the most severely distorted musculoskeletal structure
• ABR redefines "rehabilitation" – ABR improves musculoskeletal structure so significantly that normal motor functions recover spontaneously, making special training and management for "motor disabled" unnecessary.

We use no pharmaceuticals, no electrical instruments and no surgeries - ABR is a hands-on method of manual applications to the child's body, based purely on biomechanical principles.

ABR biomechanical reconstruction of the musculoskeletal system follows the path of normal motor development - starting from the neck and trunk and later descending to the periphery (arms and legs).

ABR provides planned progress of the musculoskeletal structure and function through predictable stages. Results are predicted in numbers of hours of exercises done and changes in the alignment, mobility, size, tone and strength of the child's body – specifically in the chest, abdomen and the pelvis.

ABR is more than just a new rehabilitation method; ABR is a comprehensive philosophy of the child's recovery. The cornerstones of the ABR philosophy are fundamental biomechanical principles of the human body's growth and development. Respectively ABR takes bio-electrical and bio-chemical factors into account only through their biomechanical manifestations.

This biomechanical approach allows us to have exact guidance for every single movement. Every single ABR application to a child's body is precisely calculated and adjusted for each individual patient.

ABR opens a new dimension in the treatment of the mildest to the most severe motor dysfunctions in the sense that it gradually brings changes to the mechanical and electrical structure of the muscles, thus allowing spontaneous developments of motor function.

ABR emphasises 3 essential concepts in describing the functional role of smooth muscles or internal myofascia with respect to the body's biomechanical structure:
• Hydraulic (or hydraulic/pneumatic) skeleton. This concept highlights the structural roll of the smooth muscles - in comparison to the classical definition of the «hard», bony skeleton as being that which carries the sole responsibility for the body's structure. Smooth muscles and other structures of internal myofascia are the membranes that maintain the shape of the body, with an effect similar to the whitish-coloured membranes within a grapefruit. These tissues envelop and ensheath the major bodily cavities (cranial, thoracic, abdominal etc.), enwrap each of the bodies individual organs (lungs, liver, stomach etc.) and sustain the smallest compartments within each of the bodies system. It is the hydraulic quality of the smooth muscles that administers inner strength and form. The term 'hydraulic skeleton' is used most frequently by ABR for convenience.

* A normal "hydraulic skeleton" provides normal alignment of the bony skeleton and normality of skeletal muscles - allowing normal motor function.
* Am abnormal, weakened "hydraulic skeleton" results in the collapse of the musculoskeletal system and impossibility of motor function.

• Visceral skeleton (visceral core) is the name used for the observation and discovery that the structures comprising the hydraulic skeleton serve as the body's core and define the mechanical foundation of the internal organs for the body's structure.
• Hydraulic/pneumatic capacity characterizes the "strength" and volume of the hydraulic/ pneumatic skeleton and the quality of «hydraulic support» that it gives to the musculoskeletal system.

The term pneumatic capacity summarizes several main characteristics:
• The level of pressure necessary for the development of sufficient internal volumes.
• The size of internal volumes.
• The level of strength of the myofascial membranes that is necessary to achieve the normal internal pressure/volume ratio. This is in turn required to sustain the challenges of gravity and of the external atmospheric pressure.

The objective of ABR is to restore proper tone to the smooth muscles/internal myofascia, which in a cascade effect restores proportions and alignment of the skeleton. During this process, the muscle tone is normalized and the arms and legs develop increasing muscle mass, normal range of mobility, and finally: sufficient strength - so that the children can develop their movements in normal spontaneous ways. All other approaches address the skeletal muscles directly. Nevertheless, such a direct approach proves to give limited results. ABR sees the direct approaches as the ones addressing the "tip of the iceberg". The underwater part is the smooth muscles.


What are the smooth muscles?

The smooth muscles are the ones that make up the internal organs, such as the liver, lungs, kidneys, intestines, etc.


Why address the smooth muscles?

ABR considers the smooth muscles as the "primary victims" of the brain injury. As their tone significantly drops, following brain injury, the secondary victims are the structures of musculoskeletal system, which distort as a result causing cerebral palsy as the disorder of posture and movement.

The total surface of the lining of internal organs is enormous in comparison to their respective volumes. For example the total active surface of the lungs is about 900 sq. feet (80 sq.m.) in relation to a volume that is approximately 3 litres. This huge surface is necessary for efficient metabolism. On the other hand, it seals the internal hydraulic volume that composes the walls that hold the shape of the bodily cavities.

ABR recognizes the importance of the strength of this lining made of smooth muscles (internal myofascia) for the proper development of a human body and, particularly of the musculoskeletal system, which is supported by this internal "hydraulic skeleton".

ABR considers the smooth muscles to be the primary victims of a brain injury. As their tone drops following a brain injury, the secondary victims are the structure of the musculo-skeletal system, which in turn collapses - changing the normal alignment of muscles and bones and shifting the distances between points of muscular attachments. Such shift of attachments in turn causes the skeletal muscles imbalance: i.e. spasticity and contractures. Finally, such muscular imbalance makes normal movements impossible. The resulting pathological diagnosis is cerebral palsy, as a disorder of posture and muscle control.

This is why ABR proposes a unique technique to administer kinetic input directly to smooth muscles.

ABR is the first and the only approach that recognizes the fundamental role of smooth muscles in the development of the musculoskeletal system.

Unfortunately, in traditional medicinal practice the internal organs are looked upon only from the viewpoint of chemical metabolism, while, on the other hand, the biomechanical approach does not normally focus on anything other than the classical skeleton comprised of «muscles and bones».

Strengthening of the smooth muscles induces gradual growth of internal pneumatic capacity, which in a cascade effect restores:
• volume, shape and strength of the neck and trunk,
• normal alignment of the joints of the limbs, eliminating spasticity and contractures,
• normal volume and then strength of weakened skeletal muscles,
• normal alignment of the shoulder girdle and arms as well as pelvis and legs - allowing normal "insertion" of arms and legs and thus making proper movements possible.

Moreover, restoration of muscular skeletal structure re-establishes normal metabolism (flow of blood and oxygen supply) of 'defective', atrophied muscles and, in addition, normal electrical ascending activity to the brain, opening wide the "back door" to function.

ABR targets the core structures of human body: the smooth muscles of internal organs. To be precise we target the entire complex of internal myofascia (mucosa, smooth muscles, serosa etc. and their sublevels).
• that are directly related to the quality of the general metabolism - regulating proper breathing, swallowing, digestion, evacuation, etc. and being responsible for the general health of a child.
• that we call the hydraulic skeleton of the human body - providing essential "hydraulic support" to the superficial structures of a "classically" defined musculoskeletal system (muscles, ligaments, bones etc.). ABR states that this "hydraulic skeleton" defines the proportions and the alignment of the bony skeleton and the quality of the skeletal muscles.

Normalization of the musculoskeletal system must come first.
• Nervous activity flowing from the muscular skeletal system «ascending» to the brain plays a vital role in the development of normal signals emanating from the central nervous system «descending» to the musculoskeletal system.
• When the musculoskeletal structure is profoundly distorted, any training is narrowed down to quite a limited scope: "trying to put poor structure to some better functional use".
• Without normalization of the musculoskeletal structure, any functional progress of a brain-injured person would always remain significantly limited and largely unpredictable.

Bio-electrical plasticity of the brain
ABR shows evidence that irreversibility of initial structural brain damage does not make motor function recovery intrinsically hopeless. The brain damage is not a critical obstacle for successful biomechanical reconstruction, as long as the musculoskeletal system is addressed in an effective biomechanical manner. There is no critical need to «repair» the brain before initiating the restoration of the biomechanical system.

The brain damage is not a critical obstacle for successful bio-mechanical reconstruction as long as the musculoskeletal system is addressed in a bio-mechanical proper way. There is no critical need to "repair" the brain first.

ABR approach makes restoring the mechanical structure of the musculoskeletal system its first and primary goal. Why? We support the following concept:
Mechanical transformation of the musculoskeletal elements (muscles, joints, etc.) by ABR automatically changes the parameters of their electrical charge. This respectively, changes the electrical activity of these elements (for instance, the skeletal muscles) and then translates into a transformation of the ascending signals sent to the brain, which in turn creates an adequate base for forthcoming descending signals to the muscles.

ABR states that even an injured brain still has enough reserves to rearrange its electrical connections in order to integrate biomechanical structural improvements of the musculoskeletal system, provided that the structural improvements are significant enough.

ABR in a nutshell
Everyone believes that a CP child has poor functions because his/her brain is too damaged to be able 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 allow control of normal motor functions, however, for this plasticity to become activated, a child's musculoskeletal structure has to be improved to a sufficient level - to the so-called plasticity threshold.

Existing treatment methods fail to achieve recovery of motor functions. This failure is then blamed on the brain damage.

We believe that the answer lies differently. 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 utilize 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.? the head being able to move unrestrictedly in all directions)
• proper alignment (ex.: legs in respect to the pelvis; arms in respect to the 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.