ABR METHOD (TECHNIQUE)
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ABR technique origins - modelling the respiratory mechanics of a healthy infant.
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- To a great extent, the ABR technique imitates the naturally occurring mode of strengthening of internal respiratory muscles that takes place during the child's first year of life. In the first months of life, prior to the unfolding of the gross-motor development, the child lies primarily on his/her back or stomach - essentially unable to use the arms and legs.
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At the same time the infant possesses specific bodily proportions: a large trunk and short limbs; and a specific bodily structure: a soft, pliable skeleton, with a great percentage of cartilage which has not yet undergone the hardening process or full ossification.
Due to these specific proportions, almost the entire bodily weight of an infant is supported by the rib cage alone (without the help of the arms).
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On the other hand, because of the softness of the skeleton, a significant portion of this required body weight support is provided directly by the internal muscles of the respiratory system, utilising their intrinsic sustaining tension in order to maintain the shape of the body. Because of this substantial underlying tensional force, it is the active breathing that brings the strengthening and effective growth of the respiratory muscles with a much greater efficiency than later in life.
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The reasons for this are as follows:
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First of all, because there is a by far greater involvement of the deep smooth respiratory muscles in the breathing excursions. Later in life the primary role belongs to the superficial intercostals muscles and the diaphragm.
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Secondly, because the respiratory muscles then have to work with maximum effort during inhalation in order to expand the chest against this tension and against the body weight.
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Thirdly - because the deep, smooth, respiratory muscles have to work «full time», including during the exhalation phase, controlling the chest deflation in the so-called eccentric mode.
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Later in life the exhalation happens as a relatively passive deflation.
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- As the child matures, the skeleton - in this case the rib cage - hardens and then the body weight is passively absorbed by the emerging tensile strength or hardness of the ribs themselves. As a result, little to no extra effort is necessary from the side of the smooth respiratory muscles, and therefore the opportunity for their «supercharged» strengthening and growth disappears.
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In the first 3-4 months a child executes this breathing against its own weight 24 hours / 7 days a week, but even later - for the next 3-4 months - the infant further spends a good 18-20 hours a day lying down, continually building the respiratory system and the strength of the trunk, that then becomes the «nucleus» of the body's biomechanical structure - its' strongest core.
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Only when this core has formed properly, the control of the arms and legs becomes possible, and, in addition, we see that a tremendous acceleration in the acquirement of mobility and motor skills occurs from the age of 7-8 months and onwards.
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Even a rough calculation shows us that the healthy child spends 4-5 thousand hours developing the internal structures (smooth muscles in particular) before gaining strength and stability enough to control the arms and legs.
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- A brain-injured infant is deprived of this natural advantage. The respiratory muscles are sufficiently weaker than those of a healthy child's and lack sufficient strength to overcome the body's weight in breathing. As a result, the only option left for the CP child is excessive use of the diaphragm, which provides the suction necessary for drawing air into the lungs by bulging downwards into the abdominal cavity and spreading the lower ribs sideways.
This is a so-called «paradoxical» type of breathing, which affects all CP children. As a result the CP child fails to achieve the formation of the strong biomechanical «core» or «nucleus» of the smooth muscles of the thoracic and abdominal cavities, which the healthy child develops via respiration over the first months of life. Without this «core», a CP child is then unable to meet the challenges presented by the growth of the arms and legs, which get proportionally larger and heavier later in life. As the result the imbalance between the weak trunk and enlarging limbs becomes more and more pronounced as a CP child gets older, eventually leading to a complete distortion of the muscular-skeletal system, resulting in spasticity, rigidity, contractures, etc. This situation increases dramatically as the child gets older.
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Unfortunately, this window of opportunity for spontaneous development of proper strength and growth of the smooth muscles of the respiratory system is very narrow - and as the CP child gets older it closes completely.
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The challenge that led to the development of the ABR technique was the re-creation of a similar effect of smooth muscle strengthening which is otherwise naturally present in the healthy child - regardless of the age of or severity of the child's condition.
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This unusual challenge resulted in the development of an unusual technique.
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Essentials of ABR Technique:
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The child as passive recipient of the ABR treatment - why the therapist does all the work and not the child himself/herself? |
Smooth muscles are involuntary muscles. This means that they are beyond control of the conscious mind or will, and therefore a child cannot exercise them by his or herself.
In so far as the ABR technique is a hands-on application performed by the parent as the therapy provider, the child's body is a recipient of kinetic impact delivered by the application of the hand of the parent (provider). The mode of application causes an automatic reaction from the smooth muscles, gradually building their strength through the absorption of kinetic energy delivered by the parent's compression movement. This is the same way in which the smooth muscles strengthen naturally when the small child breathes against the body's weight.
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Towels under the working hand - A soft air cushion as transmitter of the ABR movement |
The ABR technique aims at internal layers of myofascia (smooth muscles) rather than the external skeletal muscles.
Pressure delivered directly by a bare hand, causes only elastic rebound of external muscles and bones, whereby all the kinetic energy of the movement is «wasted» and lost on the body's surface. The task faced by ABR was to find a method of transmitting the external input of kinetic energy to the deeper layers of the body.
The solution was found - unexpectedly enough - through the placement of an «air cushion» between the working hand of the therapy provider and the child's body.
At first, this is quite surprising- one expects t he 'air cushion' to reduce the impact as a pillow would, by simply absorbing the kinetic energy of the hand movement. The thicker the pillow, the greater the energy loss would be.
However, the reality is quite the opposite: If such an air cushion is properly shaped (in the lens form) and compression is done very slowly, then this air cushion maintains near constant thickness throughout the movement. The impact of the hand movement reaches the deep internal smooth muscles and all the kinetic energy of a movement works towards their strengthening, instead of being wasted at body's surface.
Everyone who experiences ABR Technique is always amazed how the increase and proper build-up of this air cushion actually magnifies the impact very, very clearly.
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The optimal shape and density - Pneumatic LensTM |
Nothing can arise out of nowhere. The strengthening of the smooth muscles of internal organs requires a source of energy other than the body's own metabolism. This energy comes in kinetic form from the movement of ABR therapist's hand. But how do we «trap» this kinetic energy, and how do we have it delivered to the deep internal structures of the body ensuring that it is absorbed there in the form of new biochemical bonds in the tissues? - This is the essence of ABR Technique.
The shape, form and density of the build-up of ABR air-cushion each has an effect upon the ability of the air-cushion to transmit the kinetic energy from the moving hand of ABR therapist to the target of the smooth muscles in the underlying compartments of the body's volume.
After experimenting with a variety of sponge- and foam-like materials to build an air cushion between the hand and the body the surprising «optimal material» was discovered: towels.
Optimal magnification of kinetic input of a working hand was found to be obtainable through constructing a dome shape out of thick, soft towels. This dome shaped towel build-up - which is most recently being supplemented with quilting lining material - is called by the ABR therapy the «Pneumatic LensTM». The towels allow for endless adjustments in constructing an air cushion in a variety of thicknesses and shapes, corresponding to the individual child's body and to the area of application.
Just as an architectonically designed dome shape of acoustic speakers minimizes the «waste» of sound and projects it, so does our pneumatic lens magnify the movement of the hand from the apex or top of the dome-shaped towel construction to the target - here being the underlying bodily volumes.
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The optimal movement - quasi-static - why the hand of ABR therapist does not seem to be moving? |
Equally important to the shape and density of the air cushion, is the quality of the applied movement. If the movement of the hand is too fast, the hand sinks through the towels and the air cushion thus reacts as an ordinary pillow would, absorbing the impact and not creating a Pneumatic LensTM effect.
Here we arrive at the second essential feature of the ABR technique, which is the «quasi-static movement». The quasi-static movement is a movement so smooth and slow, that it has almost no acceleration. The movement begins at an indiscernible speed and proceeds in that mode. (A superficial observer might conclude that the hand is still.) This ensures that the towels themselves are not compressed, but that the «lens» moves as one entire volume - complete with the air in the towels - achieving thereby the desired effect of transmission of movement simultaneously to greater internal bodily volumes.
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Personal comment by L. Blyum:
My observations and experience with ABR Technique demonstrations.
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"Most people who first observe the administration of ABR therapy do not see the movement of the hand. If they do see it, they cannot imagine that the person lying under all those towels can feel anything «with such a little movement».
The quasi-static mode of ABR movement typically provokes another reaction. Many people observing ABR applications from a distance for the first time ask me whether the method is really physical or whether it is another popular day «cosmic energy» transfer. Having demonstrated the technique to hundreds of people the world over, the reaction, which is inevitably evoked, is: "Wow, that feels a lot stronger than I expected." The demonstration and direct experience of the ABR method as a recipient is useful in confirming its effect as a tangible and hands-on method.
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Spastic, short and tense skeletal muscles - how does ABR address them? |
The ABR technique achieves the release of muscular tensions, shortness and spasticity with unparalleled efficiency, which far exceeds, and is incomparable to the effect reached by stretching.
However, it would be completely incorrect to say that the ABR technique «aims» at the release of these superficial muscles.
ABR aims at strengthening of the smooth muscles of the airways, of tracheal cartilage, of fibrous intervertebral discs, of spinal dura, etc. (i.e. deep internal myofascial layers). Internal strengthening is the only direct aim of ABR.
The release of the skeletal muscles is a «happy coincidence» or «fundamental biological law» (whichever name you prefer). The from-the-inside-out cascade effect rules the performance of the skeletal muscles. When internal myofascial structures weaken, the superficial muscles (dozens and dozens of them) automatically shrink and/or collapse. If, on the other hand, internal structures get stronger, the superficial muscles automatically release, elongate and increase in volume.
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The safeness of the ABR technique |
ABR uses towels to construct Pneumatic LensesTM that address the internal smooth muscles. Moreover, the use of such «air cushions», combined with very slow (quasi-static) mode of hands-on pressure application, ensures that there is no compression of the superficial tissues (skin, bones and superficial muscles) - thus avoiding any mechanical risks.
The softness and gentleness of the ABR method is very relaxing for the patients, as well as being extremely safe.
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