BUNGEE ROPES HELPED MY DAUGHTER TO WALK
Footsteps therapy uses trampolines to help get confidence back
Tuesday August 25,2009
Minty Hoyer Millar, 17, who has cerebral palsy, has become mobile with the aid of a strange device called the spider. Her mother Pip, 49, tells her story
Minty was my fourth child so I was aware she was not progressing as she should. I saw she was struggling to achieve the usual baby and toddler milestones. At 12 months she was assessed and we were told she was physically and mentally handicapped and would never achieve beyond the capabilities of a four–year-old. I was devastated.
Doctors weren’t sure what was wrong. Cerebral palsy, a neurological disorder affecting balance and movement was confirmed when Minty was 22 months old. I learned it leaves sufferers with little or no mobility. We were told we’d have to wait more than a year to see an NHS physiotherapist. I researched the condition to see what other help was available but it became clear we would have to do all the work to make sure she had the best life possible.
‘It gives kids a confidence boost'
As Minty got older she was very floppy. By the time she was nine she could only crawl. She couldn’t stand, had no balance and very little speech.
I felt sad when I looked at her. I wanted her to be part of everything but she couldn’t. It was frustrating and upsetting because I knew from day one that she could achieve much more. With three other children, William now 22, Thomas, 20, and Henry, 19, we just had get on with it.
I spent my spare time finding out more about treatments around the world. I heard about a therapy called Footsteps in the city of Koszalin, north-west Poland. It uses exercises that focus on improving movements such as rolling over, supporting, reaching, grasping and holding.
It also teaches patients to shift their body weight and move from one place to another, enabling greater mobility and independence and encouraging increased self-confidence. All sorts of apparatus including balls, rolls, trampolines and ladders are used. We begain travelling to Poland every other month and after a year Minty was more mobile and happier.
There we discovered a device called the spider. It is a frame with bungee ropes attached which holds the child in place while physiotherapists work on improving their muscle strength and posture. It looks like a giant spider’s web.
By supporting Minty in an upright position it allowed her to move independently. Therapists could put her body through various exercises in different positions so it could be aligned properly. This helped develop her balance. It was great fun and she enjoyed it a lot.
With it she learned to stand independently and walk a little bit. Stimulating so many different muscle groups even helped her speech.
I couldn’t help thinking it was a huge shame that so many others in the UK were missing out on the opportunity Minty had. Then in 2004, when Minty was 12, my husband Christian suggested we set up our own Footsteps centre in an outbuilding at our home in South Warborough, Oxfordshire, so that others could use the spider. I was excited about the idea. Eventually we persuaded two amazing physiotherapists Filip and Gosia to come over from Poland to work with us.
When children use the spider it can be the first time they have stood upright. It gives them a huge confidence boost and the therapists can try lots of exercises with them.
They have a new sense of freedom. The spider helps with stability and balance and the children love playing games like catching balls while using it.
Last year we set up the Footsteps Foundation charity to help families who can’t afford the treatment, which costs about £1,800 for a three-week course.
W e’ve raised more than £110,000 to date and have been thrilled to send out grants to families who would otherwise have not been able to come to us. Minty is now walking independently and is very social. Her speech is fantastic. She’s a delight and very much a teenager. She still spends four afternoons a week on the spider. It might have been hard in the beginning but once she realised how much progress she was making her motivation and determination kept her going and she’s achieved so much.
l For more information call the Footsteps centre on 01865 858 382/065 or visit footsteps.ltd.uk
l For the Footsteps Foundation charity www.footstepsfoundation.com
Interview by PENNY STRETTONDR ALISON STEWART is an Edinburgh-based GP with an interest in cerebral palsy. She says: Cerebral palsy is the name given to a group of conditions that cause movement problems. The most common type leads to stiff or rigid muscles in the limbs and can range from mild to severe. It results from damage to the brain usually before birth or from an incorrectly developed brain.
It affects about one in 400 people. Physiotherapy is the prime technique for treating cerebral palsy. It prevents muscle weakness and enhances walking and standing. Anything that improves movement and motor skills and helps to enhance a person’s life is beneficial.
Tuesday August 25,2009
Minty Hoyer Millar, 17, who has cerebral palsy, has become mobile with the aid of a strange device called the spider. Her mother Pip, 49, tells her story
Minty was my fourth child so I was aware she was not progressing as she should. I saw she was struggling to achieve the usual baby and toddler milestones. At 12 months she was assessed and we were told she was physically and mentally handicapped and would never achieve beyond the capabilities of a four–year-old. I was devastated.
Doctors weren’t sure what was wrong. Cerebral palsy, a neurological disorder affecting balance and movement was confirmed when Minty was 22 months old. I learned it leaves sufferers with little or no mobility. We were told we’d have to wait more than a year to see an NHS physiotherapist. I researched the condition to see what other help was available but it became clear we would have to do all the work to make sure she had the best life possible.
‘It gives kids a confidence boost'
As Minty got older she was very floppy. By the time she was nine she could only crawl. She couldn’t stand, had no balance and very little speech.
I felt sad when I looked at her. I wanted her to be part of everything but she couldn’t. It was frustrating and upsetting because I knew from day one that she could achieve much more. With three other children, William now 22, Thomas, 20, and Henry, 19, we just had get on with it.
I spent my spare time finding out more about treatments around the world. I heard about a therapy called Footsteps in the city of Koszalin, north-west Poland. It uses exercises that focus on improving movements such as rolling over, supporting, reaching, grasping and holding.
It also teaches patients to shift their body weight and move from one place to another, enabling greater mobility and independence and encouraging increased self-confidence. All sorts of apparatus including balls, rolls, trampolines and ladders are used. We begain travelling to Poland every other month and after a year Minty was more mobile and happier.
There we discovered a device called the spider. It is a frame with bungee ropes attached which holds the child in place while physiotherapists work on improving their muscle strength and posture. It looks like a giant spider’s web.
By supporting Minty in an upright position it allowed her to move independently. Therapists could put her body through various exercises in different positions so it could be aligned properly. This helped develop her balance. It was great fun and she enjoyed it a lot.
With it she learned to stand independently and walk a little bit. Stimulating so many different muscle groups even helped her speech.
I couldn’t help thinking it was a huge shame that so many others in the UK were missing out on the opportunity Minty had. Then in 2004, when Minty was 12, my husband Christian suggested we set up our own Footsteps centre in an outbuilding at our home in South Warborough, Oxfordshire, so that others could use the spider. I was excited about the idea. Eventually we persuaded two amazing physiotherapists Filip and Gosia to come over from Poland to work with us.
When children use the spider it can be the first time they have stood upright. It gives them a huge confidence boost and the therapists can try lots of exercises with them.
They have a new sense of freedom. The spider helps with stability and balance and the children love playing games like catching balls while using it.
Last year we set up the Footsteps Foundation charity to help families who can’t afford the treatment, which costs about £1,800 for a three-week course.
W e’ve raised more than £110,000 to date and have been thrilled to send out grants to families who would otherwise have not been able to come to us. Minty is now walking independently and is very social. Her speech is fantastic. She’s a delight and very much a teenager. She still spends four afternoons a week on the spider. It might have been hard in the beginning but once she realised how much progress she was making her motivation and determination kept her going and she’s achieved so much.
l For more information call the Footsteps centre on 01865 858 382/065 or visit footsteps.ltd.uk
l For the Footsteps Foundation charity www.footstepsfoundation.com
Interview by PENNY STRETTONDR ALISON STEWART is an Edinburgh-based GP with an interest in cerebral palsy. She says: Cerebral palsy is the name given to a group of conditions that cause movement problems. The most common type leads to stiff or rigid muscles in the limbs and can range from mild to severe. It results from damage to the brain usually before birth or from an incorrectly developed brain.
It affects about one in 400 people. Physiotherapy is the prime technique for treating cerebral palsy. It prevents muscle weakness and enhances walking and standing. Anything that improves movement and motor skills and helps to enhance a person’s life is beneficial.
Labels: Cerebral Palsy, Footsteps therapy, Neurologic Disorders, Physiotherapy, spider therapy
27 August 2009
Mobility sufferers to benefit from horse therapy
AN inspirational woman with cerebral palsy is opening a horse power therapy centre to help people with neurological disorders improve their mobility.
Dr Dorothee Debuse has spastic diplegia – cerebral palsy which affects her legs – and first experienced the healing power of hippotherapy, a specialist physiotherapy intervention using horses, when she was eight years old.
Now she is setting up hADVERTISEMENTer own centre – Horse Power for Ability – in Titilington near Glanton after receiving more than £8,000 funding from One North East as part of the funded by the Northumberland Uplands LEADER programme which is made available through the Rural Development Programme for England (RDPE).
Dr Debuse, 38, grew up in Germany and qualified as a chartered physiotherapist in 1994 after studying at Northumbria University, where she now works as a part time lecturer.
But pursuing her love of horses and helping others through therapeutic riding remained paramount and she is now preparing to open the unique service to the public.
The project will provide three jobs for the area – a specialist physiotherapist post, a horse handler and an assistant post – with more jobs to follow in the future.
Dorothee said: "Because I have cerebral palsy I know what it feels like to be a patient so I'm in an ideal position. When I was eight years old my movement improved vastly after starting therapeutic riding - after four weeks I was able to ride a bike. My condition drove me to become a physiotherapist and after working in Germany where hippotherapy is renowned I feel very passionate about helping people with neurological problems in this region.
"Riding a horse has proved to be incredibly empowering, giving people a great deal of hope with raised self esteem and a feeling of achievement both physically and psychologically. It's beautiful to witness."
She added: "When I worked in Germany I saw some examples of really good practice and my ultimate aim is to establish a Centre of Excellence in Hippotherapy in the UK.
"There is no service like ours that I know of in the whole of the UK, there are only a handful of trained physiotherapists in this field, some of which have retired.
"People have told me that after receiving hippotherapy they 'feel like they are walking on a cloud' and these are people with real neurological problems. Other people have said that after hippotherapy 'it feels like their knees aren't tied together any more' – a few people have used those exact words.
"I get goose bumps when I know we can help people achieve such a change in their ability to move, and ultimately, in their quality of life."
Supported by her husband Stuart, Dorothee has been working with her horse to prepare him for his work, and has bought special equipment for the centre.
It is hoped that the service will be open by November.
Tom Burston, Local Action Group Co-ordinator said: "The Northumberland Uplands Local Action Group is delighted to support Dorothee in the setting up of Horse Power for Ability.
"We are trying to encourage the development of new ideas in Northumberland and Dorothee's plans are really exciting. This is going to help create jobs and opportunities that don't exist in Northumberland at present."
People interested in using the service can find out more by visiting www.horsepowerforability.com.
At present it is a private service but Dorothee hopes that when the benefits of hippotherapy become well-known in this country, it will eventually be a service offered through the NHS.
Dr Dorothee Debuse has spastic diplegia – cerebral palsy which affects her legs – and first experienced the healing power of hippotherapy, a specialist physiotherapy intervention using horses, when she was eight years old.
Now she is setting up hADVERTISEMENTer own centre – Horse Power for Ability – in Titilington near Glanton after receiving more than £8,000 funding from One North East as part of the funded by the Northumberland Uplands LEADER programme which is made available through the Rural Development Programme for England (RDPE).
Dr Debuse, 38, grew up in Germany and qualified as a chartered physiotherapist in 1994 after studying at Northumbria University, where she now works as a part time lecturer.
But pursuing her love of horses and helping others through therapeutic riding remained paramount and she is now preparing to open the unique service to the public.
The project will provide three jobs for the area – a specialist physiotherapist post, a horse handler and an assistant post – with more jobs to follow in the future.
Dorothee said: "Because I have cerebral palsy I know what it feels like to be a patient so I'm in an ideal position. When I was eight years old my movement improved vastly after starting therapeutic riding - after four weeks I was able to ride a bike. My condition drove me to become a physiotherapist and after working in Germany where hippotherapy is renowned I feel very passionate about helping people with neurological problems in this region.
"Riding a horse has proved to be incredibly empowering, giving people a great deal of hope with raised self esteem and a feeling of achievement both physically and psychologically. It's beautiful to witness."
She added: "When I worked in Germany I saw some examples of really good practice and my ultimate aim is to establish a Centre of Excellence in Hippotherapy in the UK.
"There is no service like ours that I know of in the whole of the UK, there are only a handful of trained physiotherapists in this field, some of which have retired.
"People have told me that after receiving hippotherapy they 'feel like they are walking on a cloud' and these are people with real neurological problems. Other people have said that after hippotherapy 'it feels like their knees aren't tied together any more' – a few people have used those exact words.
"I get goose bumps when I know we can help people achieve such a change in their ability to move, and ultimately, in their quality of life."
Supported by her husband Stuart, Dorothee has been working with her horse to prepare him for his work, and has bought special equipment for the centre.
It is hoped that the service will be open by November.
Tom Burston, Local Action Group Co-ordinator said: "The Northumberland Uplands Local Action Group is delighted to support Dorothee in the setting up of Horse Power for Ability.
"We are trying to encourage the development of new ideas in Northumberland and Dorothee's plans are really exciting. This is going to help create jobs and opportunities that don't exist in Northumberland at present."
People interested in using the service can find out more by visiting www.horsepowerforability.com.
At present it is a private service but Dorothee hopes that when the benefits of hippotherapy become well-known in this country, it will eventually be a service offered through the NHS.
Labels: Hippotherapy, Neurologic Disorders
20 June 2009
Identifying Neurologic Disorders
A new study provides a novel theory for how delusions arise and why they persist (Devinsky O. Delusional misidentifications and duplications: right brain lesions, left brain delusions. Neurology. Jan 2009;72:80-87). Orrin Devinsky, MD, a researcher at the New York University (NYU) Langone Medical Center, performed an in-depth analysis of patients with certain delusions and brain disorders and observed a consistent pattern of injury to the frontal lobe and right hemisphere of the brain.
The cognitive deficits caused by injuries to the right hemisphere lead to overcompensation by the left hemisphere, which results in delusions.
"Problems caused by these brain injuries include impairment in monitoring of self, awareness of errors, and incorrectly identifying what is familiar and what is a work of fiction," says Devinsky, professor of neurology, psychiatry and neurosurgery and director of the NYU Epilepsy Center. "However, delusions result from the loss of these functions, as well as the overactivation of the left hemisphere and its language structures, that 'create a story', a story which cannot be edited and modified to account for reality. Delusions result from right hemisphere lesions, but it is the left hemisphere that is deluded."
Delusions are pathologic beliefs that remain fixed, despite clear evidence that they're incorrect. "Delusions are common problems in a variety of psychiatric and neurological disorders," says Devinsky. Psychiatric disorders with delusions, such as schizophrenia, have been proven to have functional and structural brain pathology, he adds. But now, improved diagnostic techniques are allowing clinicians to be able to identify neurologic disorders among other patient populations with delusions.
In the study, most neurologic patients with delusions had lesions in the right hemisphere and bifrontal areas. For example, the neurologic disorders of confabulation, capgras and prosopagnosia result from right-sided lesions. Confabulation is incorrect or distorted statements that are made without conscious effort to deceive; capgras is the ability to consciously recognize familiar faces, but not emotionally connect with them; and with prosopagnosia, patients may fail to recognize spouses or their own face but generate an unconscious response to familiar faces.
The right hemisphere of the brain dominates self-recognition, emotional familiarity and ego boundaries. After injury, the left hemisphere tends to have a creative narrator that leads to excessive, false explanations. The resistance of delusions to change, despite clear evidence that they are wrong, likely reflects frontal dysfunction of the brain. This dysfunction impairs a person's ability to monitor himself and to recognize and correct inaccurate memories and familiarity assessments. Thus, right hemisphere lesions may cause delusions by disrupting the relationship between and the monitoring of psychic, emotional and physical self to people, places and body parts.
"Our knowledge of delusions is limited by our ability to comprehend the patient's irrational thought process," says Devinsky. "The pathogenesis of delusions likely includes many mechanisms that span overlapping psychological, cognitive and neurological disorders. Future research should explore the psychological, cognitive and pyschologic-anatomic systems that change during the emergence and resolution of delusions, as well as strategies to treat delusions."
Other studies have looked at delusions related to brain injuries. In one study, nine patients with right-hemisphere infarctions at a stroke rehabilitation unit had frequent delusion. While stroke size didn't correlate when compared with the control group, the presence of brain atrophy was a significant predictor of delusions. When delusions occurred, it was usually caused by a right-hemisphere lesion.
Other research has shown that reduplicative paramnesia and capgras syndrome cases with unilateral brain lesions implicate the right hemisphere, usually the frontal lobe of the brain. Among 69 patients with reduplicative paramnesia, lesions were primarily in the right hemisphere in 36 cases (52%), bilateral in 28 (41%) and left hemisphere in 5 (7%). Also, in 26 capras patients, lesions were primarily in the right hemisphere in 8 (32%), bilateral in 16 (62%) and left sided in 2 (7%). For both delusional syndromes, many bilaterial cases had maximal damage in the right hemisphere.
--Source: NYU Langone Medical Center
The cognitive deficits caused by injuries to the right hemisphere lead to overcompensation by the left hemisphere, which results in delusions.
"Problems caused by these brain injuries include impairment in monitoring of self, awareness of errors, and incorrectly identifying what is familiar and what is a work of fiction," says Devinsky, professor of neurology, psychiatry and neurosurgery and director of the NYU Epilepsy Center. "However, delusions result from the loss of these functions, as well as the overactivation of the left hemisphere and its language structures, that 'create a story', a story which cannot be edited and modified to account for reality. Delusions result from right hemisphere lesions, but it is the left hemisphere that is deluded."
Delusions are pathologic beliefs that remain fixed, despite clear evidence that they're incorrect. "Delusions are common problems in a variety of psychiatric and neurological disorders," says Devinsky. Psychiatric disorders with delusions, such as schizophrenia, have been proven to have functional and structural brain pathology, he adds. But now, improved diagnostic techniques are allowing clinicians to be able to identify neurologic disorders among other patient populations with delusions.
In the study, most neurologic patients with delusions had lesions in the right hemisphere and bifrontal areas. For example, the neurologic disorders of confabulation, capgras and prosopagnosia result from right-sided lesions. Confabulation is incorrect or distorted statements that are made without conscious effort to deceive; capgras is the ability to consciously recognize familiar faces, but not emotionally connect with them; and with prosopagnosia, patients may fail to recognize spouses or their own face but generate an unconscious response to familiar faces.
The right hemisphere of the brain dominates self-recognition, emotional familiarity and ego boundaries. After injury, the left hemisphere tends to have a creative narrator that leads to excessive, false explanations. The resistance of delusions to change, despite clear evidence that they are wrong, likely reflects frontal dysfunction of the brain. This dysfunction impairs a person's ability to monitor himself and to recognize and correct inaccurate memories and familiarity assessments. Thus, right hemisphere lesions may cause delusions by disrupting the relationship between and the monitoring of psychic, emotional and physical self to people, places and body parts.
"Our knowledge of delusions is limited by our ability to comprehend the patient's irrational thought process," says Devinsky. "The pathogenesis of delusions likely includes many mechanisms that span overlapping psychological, cognitive and neurological disorders. Future research should explore the psychological, cognitive and pyschologic-anatomic systems that change during the emergence and resolution of delusions, as well as strategies to treat delusions."
Other studies have looked at delusions related to brain injuries. In one study, nine patients with right-hemisphere infarctions at a stroke rehabilitation unit had frequent delusion. While stroke size didn't correlate when compared with the control group, the presence of brain atrophy was a significant predictor of delusions. When delusions occurred, it was usually caused by a right-hemisphere lesion.
Other research has shown that reduplicative paramnesia and capgras syndrome cases with unilateral brain lesions implicate the right hemisphere, usually the frontal lobe of the brain. Among 69 patients with reduplicative paramnesia, lesions were primarily in the right hemisphere in 36 cases (52%), bilateral in 28 (41%) and left hemisphere in 5 (7%). Also, in 26 capras patients, lesions were primarily in the right hemisphere in 8 (32%), bilateral in 16 (62%) and left sided in 2 (7%). For both delusional syndromes, many bilaterial cases had maximal damage in the right hemisphere.
--Source: NYU Langone Medical Center
Labels: Neurologic Disorders