The Quadriplegic Child
The majority of children in the ABR Program have the diagnosis of quadriplegic. This diagnosis refers to the outer extremities and suggests that both the arms and legs have been effected.
ABR recognizes that in order for these children to achieve functional improvement of the arms and legs, it is necessary to focus ones initial attention upon two fundamental functional elements:
Trunk strength and stability
Without acquiring significant head control and without having stability and strength within the trunk of the body, any discussion about weight bearing (internal Link zur Weight Bearing) upon the arms or upon the legs is fruitless. And weight-bearing ability always precedes the development of movement function!
No one would choose to build a twenty story building upon a foundation designed for a one family ground level dwelling. Yet the attempts to require a child with significant trunk instability or compressional weakness to stand or to walk could be compared to the described constructional fiasco.
In fact, it is the compressional weakness within the thorax and abdomen that result in the:
lack of stability of head positioning
insufficient range of movement of the head
no head counter balancing movements
The same compressional weakness, on the other hand results in an obvious rigidity of the spinal column.
This spinal column rigidity ensures that the child exhibits:
No side bending
Limited rotational movement in the vertebral column
Limited forward and backward movement of the trunk
Difficulties with counter balancing
The description above outlines the initial targets of ABR work for quadriplegic individuals. Without improvements in these areas, it cannot be expected that such children can gain improvements in arm or leg function.
Countless ABR parents can confirm that improvements in the structural dysfunctions described above lead to improvements in the function and usage of the outer extremities for quadriplegic children.