‘Negative contribution’ of automatic postural control on development of child with brain lesion.

1. ‘Negative contribution’ of automatic
postural control on development of
child with brain lesion.
By
Rajul Vasa [India]
for
ESMAC in SWEDEN

2. ELEPHANT BABY walks after birth

3. Baby with mother.

4. Baby’s COM supported by mother.

5. Safety of COM
• We all know that safety of
COM is a priority of all living
beings.
• we also know that human
baby at birth is not equipped
with automatic control on
COM safety like animal baby.

6. Gravity
From No Control on COM at birth,
to
complete control on COM safety
automatically
is the journey
we all have made as infants to get
connected to the gravity.

7. Inlaying anticipatory control
Different developmental postural
milestones unfolded during this
journey we made as infants to get
connected to the gravity. Resultant
effect of our journey is we developed
automatic control on safety of our
COM with inlaying of anticipatory
postural connectivity among distant
postural centers of our brain.

8. Exploiting gravity
• Exploiting gravity
and experiencing
disequilibrium and
re-equilibrium from
within by raising
COM in different
developmental
postures is critical to
inlaying of
anticipatory postural
control post birth for
automatic safety of
COM.

9. Central axis
• Poor control on
central axis; ‘The
head neck and
trunk’ results into
disequilibrium and
fall unless
passively
supported by
parents or devices.

10. Brain - Equipped with anticipatory
control!

11. Limbs provide safety to COM.

12. Lesion in the brain
• Baby with brain lesion and paretic
muscles is unable to exploit gravity
for its development and gets into
disequilibrium from gravitational
force that threatens safety of COM
making gravity a liability unlike TD
children who can exploit gravity for
their growth and development.

13. Degrees of freedom
• Fluidity in movement of COM
with slightest movement of flail
linked segments + increased
degrees of freedom from paresis
+ flail weak muscles unable to
generate force becomes huge
threat to safety of COM.

14. Raising COM in different postures.
• Baby with poor control on
head neck and central axis +
paretic muscles + constant
disequilibrium from gravity
finds it hard to raise COM
without threatening COM
safety.

15. Problem Solving
• Constant threat to COM safety, makes Self-
organizing brain to take inability to raise
COM with paretic body
as an opportunity
‘to solve disequilibrium problem’
by
not raising COM high above the support
surface for an indirect safety from within.
This results into more delay in
development.

16. Optimal economic solution
Delaying motor milestone and not
raising COM above the support
surface actively is an optimal and
most economic solution
in terms of energy cost by self-
organizing brain with lesion.

17. Fluid character of COM Movement
• Besides delaying postural milestone
so that COM does not rise above the
support surface, brain also begins to
make extra provisions
against
fluid character of COM movement
for more safety.

18. Safety measures are automatic.
• Safety of COM is automatic for a
brain with lesion or without lesion.
Only difference is
brain with lesion uses different
tools from within when paretic
muscles cannot generate force to
combat gravity.

19. ‘Defensive’ as against ‘In control’
• Self-organizing brain when
cannot control and restore COM
to safety it turns..
highly defensive
with
special measures of safety
from within.

20. Log
• Self-organizing brain works towards
restricting fluid change in movement
of COM with morphological changes
in tissues which are available in
abundance throughout the body and
can restrict or freeze linked
segments into a log like structure so
that COM movement can be frozen
or it gets highly restricted.

21. Sensory processing
• Self-organizing brain works optimally.
With freezing of COM movement it
also takes benefit of reducing, sensory
chaos with reduced afferent inflow
from log like body unable to move by
itself
thereby
economizing on energy
on sensory processing.

22. Tools within
• Self-organizing brain exploits
tools from within like fascia and
connective tissue available in
abundance which connects entire
body with one another to make
multi linked body work as ‘one
whole integrated unit’.

23. Contracture
• Morphological changes in
fascia and connective tissue
results into Contracture that
helps reduce degrees of
freedom in linked segments
thus provide indirect safety.

24. Homeostasis
• Contracture in connective tissue
within and around paretic
muscles that make up 40 % of
body mass helps develop some
force within to bring in
homeostasis
of forces
within and outside.

25. Negative contribution of automatic
postural control
• Automatic safety measures like delaying
postural milestone, not raising COM, inlaying
anticipatory control of freezing and restricting
COM movement with morphological changes
for a log like body from contracture in self
defense contribute negatively in the growth
and development of child unless one is able to
therapeutically prioritize safety of COM
automatically with ‘Re-reorganization’ of self-
organized brain.

26. Dark side of automatic safety of COM.
Automatic control on safety
of COM is a major
contributing factor behind
delay in postural
development in children
with brain lesion.

27. Solution of the Millennium
Vasa Concept is the solution of the millennium.

28. Vasa Concept
1. To Re-reorganize the self-organized brain of
the child with lesion by capitalizing on
speedy growth of CNS post birth before body
and brain succumb to gravity with negative
plasticity and adaptability.
2. To promote COM movement in all the 3 axis
by prioritizing safety of COM in different
mechanically stable postures to promote
development from within.

29. Vasa Concept
1. To prevent CNS from turning defensive
against gravity with inlaying of negative
solution like not raising COM with delay in
development and freezing and restricting
COM movement with contracture.
2. To convert disadvantage into an advantage
by capitalizing on affected CNS, MSS, and
gravity to make them work in tandem with
one another for growth and development.

30. Vasa Concept
1. To prevent negative contribution of
automatic postural control from taking
control of the child with contracture,
stiffness and delay in development that
disturbs inlaying, pruning, amplification,
integration of major physiological systems
with poor general condition making
controller the CNS get controlled by
periphery the PNS and MSS.

31. Exploit & Promote resources within.
• Vasa Concept exploits gravity, brain and body
as the best tools as against manmade tools.
• Vasa Concept exploits Spino-spinal circuits
with inter limb knowledge and inter limb
sensation and all major sensory receptors for
different afferent inflow to influence the
motor outflow for development of
milestones.

32. Exploit & Promote resources within.
• Vasa Concept promotes disequilibrium
and re-equilibrium from within and not
externally induced.
• Vasa Concept promotes non muscular
forces like GRF, inertia of body, body
mass for stability, inter-segmental forces
to approximate joints for extra stability

33. Philosophy behind Vasa Concept
• VASA CONCEPT is based on
influencing; the influencer
“the affected CNS”.

34. Philosophy behind Vasa Concept
• CNS is an invisible internal controller of COM
“the invisible”, to be controlled.
• Posture is an external visible controller of
COM.
• Position of COM influences both the
controller; “CNS and posture”.

35. Philosophy behind Vasa Concept
• Characteristics of invisible COM is its fluid
character. COM is always unstable and ready
to find new position.
• Exploit it to our advantage as Unstable COM
is the most essential ingredient to make CNS
to respond instantly motorically before
controller; ‘the CNS’ gets controlled by ‘the
MSS’ with contracture that freezes and
restricts COM.

36. What to do?
• Introduce the sub cortical stability to COM
wherein the COM rises above the ground
automatically, safely with development of
strength in muscular links enabling different
configuration of posture to influence the
growing CNS to grow normally & also develop
the postural programme that connect COM
movement, instantly with internal CNS
connections to influence the MSS, an instant
tool to stabilize the COM

37. Channelize before brain self-organizes
negatively.
• One can channelize self-organizing
brain to exploit its highest plastic
time period post birth for optimal
perceptual cognitive intellectual
development and prevent child from
getting label of mentally retarded
and physically handicapped.

38. What not to do
• Do not allow the self-organizing brain to
become defensive and restrict degrees of
freedom of flail MSS by freezing COM with
passive tissue contracture for; safety is always
a priority.

39. ‘U’ turn
If, one can take care of disequilibrium and
threat to safety by building anticipatory
postural circuits in the brain one can take
a U turn from palliative approach for CP
to solution based approach with desirable
growth.

40. Vicious Circle
• VASA CONCEPT recognizes that weak muscle
links & tight muscle links becomes the
hindrance in achieving the stable posture.
Unstable posture poses threat and affects
CNS safety. This makes CNS react instinctively
in self defense by choosing any possible motor
strategy that helps restrict the COM
movement. This affects the growth of MSS,
that sets in never ending vicious circle.

41. VASA CONCEPT
• Is to exploit the affected brain itself as the
best tool for its growth and development.
[convert disadvantage into advantage]
• Is to exploit gravitational force as most
powerful tool to develop brain. [gravity is
available for free]
• Is to exploit multi-linked body itself to develop
milestone. [convert disadvantage into advantage]

42. VASA CONCEPT contd.
• Is to promote control on global center of mass [COM] to
make muscles grow and develop without letting any
passive tissue contractures to develop at all. [Keeps
secondary tertiary complications always at bay, this will
save time of orthopedic surgeons for other more satisfying
surgeries, energy of child and parents, money for parents,
state and insurance companies will save big money as well,
MULTIPLE BENEFITS ]
• To promote restoration of COM from within with
development of brain for long term memory of automatic
spatiotemporally effective postural control. [This makes
physical dependence become history for the child and tag of CP becomes
obsolete].