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ABR in Perspective - Today’s Health Care System

The following list was presented at the International Conference for Cerebral Palsy in Sydeny Australia in February 2009 by a leading orthopedic specialist.  It outlines the medical communities perspective for the treatment of the level V child:

Do the Right Things at the Right Time


We have translated the list following for the normal understanding:

  • Adductor releases – surgically performed releases of the adductor muscles in the legs
  • Botox calf muscles – injections of botolinum toxin – a nerve toxin into the calves
  • Botox Uls - Botulinum toxin injections for upper limb spasticity
  • VDRO’s –Varus Derotational Osteotomy – or Hip rotational operation on both sides
  • r/o blade plates – further hip surgeries involving installing metal plates to improve the acetabular coverage of the trochanter
  • STR’s – Soft Tissue Releases – Surgerical interventions that  attempt to obtain muscle lengthening.
  • Botox – further injections – to “prevent further hip luxation”
  • ITB pump – Intrathecal baclofen pump (a metal “puck” sized pump inserted into the abdominal space with a spinal drip directing bachlofen directly into the spine)
  • BIL  Vulpius
  • Subtalar Fusions – the foot is surgically fixed in extension at the ankle
  • Botox for drooling – fascial injections of botulin toxin
  • Salivary gland surgery – to stop drooling altogether
  • Spinal Fusion T3-L4 – The spinal column is surgically disseminated and fused with the help of a steel rod placed between the 3rd thoracic vertebrae and the fourth lumbar vertebrac
  • LLD – Limb length discrepancy – surgivcally treated with limb lengthening reconstruction surgery or LRS
  • PO
  • Recurrent left hip luxation – more VDRO surgery

Successive invasive surgical interventions combined with constant or repeated doses of toxic medicines bearing heavy side effects and psychosis inducing withdrawal symptoms are itinerary treatment for a severely affected child.

In spite of the exceedingly high costs psychologically for the child and parents, the high financial burden for the health care system, as well as the questionable health benefits, the outcome for the child is predictable and stays essentially the same:  the child is strapped into a corset, braces and motorized wheel chair - being molded and fixed into this form through repeated surgical interventions.

The massive agenda reiterated as “Do the Right Things at the Right Time” above, can easily raise questions for parents as to the quality of life for such an individual.  Especially since such persons are usually unable to communicate the effects of these treatments to those around them.

Is it so that we can best evaluate the quality of life of a level V individual based upon the x-ray of the hip joint after successive hip surgeries?

ABR however takes an entirely different approach to addressing the problems of even severely affected children individuals.

This approach is available to parents, family members and to care- givers, but is essentially unavailable to the medical community due to one decisive factor:  the time budget.

The medical community is faced with limitations owing also in part to the limited time allotment available to them within the present health care system.  Their achievements must be attained in minutes and hours at best.  The weeks and months of conditioning and strengthening needed to improve the life quality of such individuals, or to prevent their further deterioration is not being seriously considered as possiblity within the existing health care programs.

ABR offers a basic conditioning for such individuals.  We do not seek to fight with the spastic muscles through invasive measures, but take the body of the affected individual as our starting point, and through systematic strengthening measures attain a normalization of compressional weakness, reduction of spasticity and achievement of basic weight bearing elements.

It is self explanatory that ABR is a non-invasive, non-chemical, non-forceful and therefore a non-medical form of conditioning for mild to severely affected individuals.