Trunk Support On Child
Child with Trunk Support
and Esupine Ambulator
Parital standing and moving
Background on the Proximal Stabilization Therapy
Before developing the Proximal Stabilization Therapy (PST),
a number of incidents occurred that raised doubt in my mind
that the prevailing neuro-development treatment did much to help Cerebral Palsy children.
- Once I was reporting progress made by a C.P. child during the previous year.
Progress had been marginal compared to the progress of a normal child.
The doctor presiding over the meeting asked me,
did the child made progress as result of my therapy or
was the progress was due to 'maturation'?.
I wanted to say it was due to therapy. But I knew it was not true.
Since that day, making a difference in the lives of children under my care
has become very important to me.
Yet in the following years the more I tried, the more I got frustrated.
Meanwhile co-working therapists were able to boast about their achievements
with the C.P. children they treated.
- A couple of years later during the summer I was supervising an Occupational Therapy
student for her practicum. Since the majority of children were on vacation,
the student and I collected the data about the children who were attending the
treatment centre where I worked.
The data made me humble.
Other therapist did not have better results than mine.
The rest of the findings are much more disturbing.
- Regardless who treated the child most of the moderate to severely involved
C.P. children developed contractures of heel cords, hamstrings and hip adductors
before they became three years old.
- Those children who received early childhood intervention had surgery
as early as 18 months to 2 years of age.
- These children did not have contractures when they were born.
They developed contractures when they were receiving therapy.
- All the time therapists' reports said the child was making progress!
- I wanted to know why these children were regressing and developing contractures
while they received therapy. I thought I might find answers in Neuropsychology.
For eleven consecutive years I attended Neuropsychology workshops at University of
All the information I collected made me focus my attention
towards following facts:
So helping the weak muscles became the most important task to prevent development of
contractures. A lot of experimenting resulted in the development of the Proximal
Stabilization Therapy program.
- All C.P. children are born with weak muscles of the neck, chest and abdomen.
- The more they make efforts to come to an anti-gravity position,
the more their spasticity increases and contractures develop.
I presented a paper on this program in 1988.
I have videotaped data which shows how the PST works and how it has prevented surgery
in C.P. children.
Most of the seating systems for C.P. children use proximal stabilization.
By securely tying the child to the back of the wheelchair,
proximal stability is achieved in the seating systems.
This results in improvement of these children's hand functions.
However I did not want these children to be tied down to their wheelchair.
I was not satisfied by just hand function. I want them to be self-dependent.
That is the reason I developed the PST program.
During the past eighteen years I have been horrified to see that some people have
made money by using bits and pieces of the PST program and often distorting the program.
The results are disastrous for the child. They virtually extorted money from the parents.
For example somebody made useless trunk supports from lycra and made money this way.
I make the analogy that PST is like a musical instrument, the sitar,
which is made out of a pumpkin shell, metal wires and wood.
On their own, wood, wire or a pumpkin shell are not able to make marvelous music
like the sitar. Similarly, to achieve self-dependence for C.P. children it is important
that the complete PST program be implemented.
The full Proximal Stabilization Therapy consists of orthotic equipment,
parent training, and follow-up.