EARLY STEPS OF CRANIAL THERAPY IN ISRAEL
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EARLY STEPS OF CRANIAL THERAPY IN ISRAEL
A News Article
by Zvi Karni* and John E. Upledger**
ABSTRACT
In this article, a case of a child who was cranially treated for damage to the skull caused by a past accident, and the substantial improvement that has since taken place, are described.
(*) Department of Biomedical Engineering, Technion-Israel Institute of Technology, Haifa, Israel. In 1975-1978, a Visiting Professor at the Department of Biomechanics, Michigan State University, East Lansing, Michigan, USA.
(**) Department of Biomechanics, College of Osteopathic Medicine, Michigan State University, East Lansing, Michigan 48824, USA. In the summer of 1979, a Visiting Professor at the Department of Biomedical Engineering, Technion-Israel Institute of Technology, Haifa, Israel.
Introduction
Cranio Osteopathy - a sub-specialty of the Osteopathic
Profession finds its roots in the work and publications
of William Garner Sutherland whose first book on the
subject entitled "The Cranial Bowl", appeared in 1939.
Since that time an increasing number of Osteopathic
Physicians have developed interests and skills in the
field of cranial osteopathy. Lately, more concern has
been given to the better understanding of the
physiological process which takes place during and after
the cranial treatment. Since cranial osteopathy is a
mechanical therapy and the input of the physician to the
patient are - stresses and deformation, an investigation
into the mechanical aspects of brain physiology must be
pursued. Problems such as the mobility of the skull
bones, the deformability of the cranium, the circulatory
motion of the cerebrospinal fluid (CSF), internal
pressure distribution and the intercompartmental
permeability and transfer effects, have evolved and are
presently the subject of a more intensive study (1,2,3).
More attention is also being given to the input-output
correlation of treatment to certain physiological effects
by the monitoring of some electromechanical parameters
recorded over the body. The latter are in one-to-one
correspondence with definite mechanical cues that the
physician sensitively picks up with his hands as a
measure and indication of treatment progress. These cues
serve as a basis for the physician's subjective
impressions and act as guidelines in the treatment (4).
The collaboration between cranial osteopaths from the College of Osteopathic Medicine at Michigan State University (MSU), Lansing, Michigan, and bioengineers from the Department of Biomedical Engineering at the Technion, Israel Institute of Technology, which started in the summer of 1975 at the Department of Biomechanics, Michigan State University, has been prolonged and extended to a bi-national and bi-institutional activity upon the return to the Technion of its members after three years of work in the United States. Moreover, since there has been no osteopathic activity in Israel, the initiation of cranial therapy had to be based on the visit of a distinguished member of the community of cranial therapists to the United States.
Dr. John E. Upledger, F.A.A.O., an Associate Professor at the Biomechanics Department, College of Osteopathic Medicine, Michigan State University, Lansing, Michigan, made a recent summer visit to Israel as guest and Visiting Professor of the Biomedical Engineering Department of the Technion Israel Institute of Technology. Presently, he is a leading figure in cranial osteopathy in the United States. In the past few years, Dr. Upledger's primary activity has been in the treatment of brain dysfunctioning children, particularly autistic. Dr. Upledger's summer visit was devoted to the treatment of injured children, to meetings with members of the TIKVA, Association for the Treatment and Rehabilitation of Brain Injured Children and Adults in Israel, and to a cranial survey of the longtime coma cases hospitalized in the country's principal rehabilitation hospital--Loewenstein Hospital, Ra'anana. In view of the encouraging preliminary results seen at the time of this first visit, continuation of the activity in this field in Israel has been planned and will hopefully be carried out in the near future in collaboration with the organizations mentioned above.
In the following, we describe in detail the case of L.M., a seven-year-old child, who was treated by Dr. Upledger first on two occasions in Europe, while on his way to Israel, and later during his stay in the United States. Results from study at the Loewenstein Hospital form a subject by itself and will be reported separately.
L. is seven years old, graceful and very pretty. As she goes off to school each morning her parents feel all the joy of her enthusiasm and motivation. Maybe this year L. will learn to read at her special school and in two years be integrated back into the regular school system.
Four years ago L.'s troubles began after she fell from a swing and hit her head severely. Within a month, L. developed grand mal seizures, which progressed to petit mal and to the petit mal syndrome. After about six months of illness, she made a spontaneous recovery and was completely well for several months. Thereafter, she fell ill again with periodic attacks for which she was treated with a combination of anticonvulsant drugs for three weeks. Her allergic reaction was so severe that her parents could not continue, with a clear conscience, to give her drugs. After a brief visit abroad to the Kingston Clinic in Edinburgh, the child remained well for about a year. However, L., a very robust athletic child, managed to climb and fall a second time, jarring the base of her spine. Her convulsions returned and the medication given did not control her seizures, and even aggravated her condition.
Two years ago, a graduate student of osteopathy, who as a tourist, visited Israel, met the family, examined L. and briefly worked on the child's spine which, according to his findings, had sustained some damage due to the accident. His opinion, however, was that the child also needed cranial osteopathy, in which field he was not qualified. Shortly after the osteopathic treatment, L.'s condition improved considerably. Her sleep was much quieter and her body seemed to gain more strength. Her attacks, whenever they occurred, no longer involved the loss of breathing power and the child now remained conscious during seizures. This was a clear indication to the parents that continued treatment along these lines was imperative and could lead to a cure for the child or at least to a significant improvement in her condition. Economic considerations, however, did not permit pursuance of the treatment at that time.
Several months later, a new drug became available in Israel which proved helpful for L. but did not solve the problems which had developed over the four years of her illness. L. had become high strung and was easily enervated. Her powers of concentration tool a sharp dip downward and displayed a hyperactive tendency which made a normal school framework impossible for her. It was thought that she also suffered from some organic disability, thought the child seemed otherwise intelligent and gifted.
At this stage, the parents contacted Dr. Upledger at Michigan State University to whom they were referred to as an expert in cranial osteopathy. To save the parents and child the long and arduous journey to Michigan, Dr. Upledger agreed to see and examine the child while on a lecture tour in England and France before his planned arrival to Israel. Immediately examining L., Dr. Upledger found that the child had sustained damage to the skull. This injury is usually amenable to the type of treatment he specialized in.
The treatment, normally a 30 to 60 minute long session of CranioSacral manipulative therapy to bring about adjustments, and an immediate effect on the release of spinal fluid blockage and the regulation of the CSF pulse. The parents had expected that the treatment might shock the child and drive her into further convulsions, but the opposite occurred. The following improvements became apparent within a short period:
1. L.'s phlegmatic handgrip turned
into a strong, firm grip.
2. A slight waddle, noticeable in the child's walk,
disappeared completely and the child became the graceful
walker she used to be.
3. Sleep became sounder and the child no longer jumped
up to run about the house with nightmares.
4. Overall quieting of the nervous system with far less
sensitivity to sudden noise, loud bangs and strong
lights.
5. The intellectual facilities took a sudden swing
upward, the child's eliciting interest in books, ability
to hear a children's story to its end, and no lack of
concentration in school.
6. Improved sense of poise and relation to her
surroundings.
7. Aggressiveness to other children greatly diminished,
L. now seeking her own peer group and able to keep newly
made friends.
8. Greater vocalization and far less mental confusion in
moments of distress.
Undoubtedly, L. has made a
substantial progress following the recent CranioSacral
treatments but the road to normalcy is still ahead. The
child still requires drugs and there are significant side
effects due to them. Furthermore, in the autumn, her
seizures returned during a two-week period of cutting new
teeth. Nevertheless, the overall effect of the cranial
treatment still persists and is noticeable by the
parents, friends and family. L. should, of course, be
kept under continued cranial therapy. It is hoped that a
solution to this will be found in the near future
preferably by the establishing of a continued activity of
cranial therapy in Israel rather than arranging for the
patients to be transferred to the United States.
Acknowledgement
In the preparation of the manuscript, the authors
acknowledge with thanks to Mrs. P.M., L.'s mother.
References
1. Livingston, R.B., Woodbury, D.M.
and Patterson, J.L:
Fluid compartments of the brain; cerebral circulation, in
Ruch, T.C. and Paton, H.D. (eds.): Physiology and
Biophysics, 19ed., W.B. Saunders, Philadelphia, 1965,
pages 935-958.
2. Marmaron, A., Shulman, K. and
LaMorgese, J:
Compartmental analysis of compliance and outflow
resistance of the cerebrospinal fluid system / J.
Neurosurg. 43, 1975, pages 523-534.
3. Agarwal, G.E.:
Bluid flow--a special case, in Brown, J.H.U., Jacobs, J.E.
and Stark, L. (eds): Biomedical Engineering, F.A. Davis
Co., Philadelphia, 1971, pages 69-81.
4. Upledger, J.E. and Karni, Z.:
Mechano-electric patterns during CranioSacral osteopathic
diagnosis and treatment. Journal American Osteopathic
Association, 1979.
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