We now move onto the progress of another girl from Penang Foundation Class, which teaches standard exercise to the parents so that they can do the exercise on their child affected by Cerebral Palsy.

Unlike the family of A from Malaysia, this girl's parents managed much less hours.  Within the span of 15 months (from Nov 2016 to Jan 2018), they only managed 24 hours of tapping, 24 hours of torso wrap and 6 hours of hands and feet.  Obviously the working hours are big constraints because both parents work full time and have no helpers.  However, despite the relatively poor hours, F shows impressive results from the exercise.  

We want to celebrate with the parents for what they have done.  On the other hand, we encourage them to press on for greater results in the near future.  They are encouraged to look for opportunity for more hours as follows:

1. weekends and holidays
2. 10 to 15 mins as small chunk of opportunity -  ABR results are from the cumulation of hours.  Hence opportunity chunks of 10 to 15 mins can quickly accumulate to sizable bulk of hours.  
3. Start exploring doing the power wrap for one area or more, depending on the child's tolerance, during the night time.  It takes 5 to 15 mins to wrap (depending on the area) and if the child sleeps with the wrap, it would have easily gained another 8 to 10 hours of mechanical stimulation within the uniform tension of the power wrap.  

She has gained an impressive amount of weight and size.  Her weight gain of 3.2kg over the 1.5 year is great.  We will see later the increase of her size in the before and after pictures.  

First we want to look at the impressive reduction of her global spasticity and stiffness of the entire body.   In that sense, because the spasticity is so global, it rightfully belongs to dystonia reduction.  

Children affected by Cerebral Palsy are typically very depleted in his size and depth of trunk.  They often look skinny and flat when it is viewed from the side.  That is due to the weak lung and its surrounding weak myofascia tissues.  

But when the chest and its surrounding myfoascia tissues has another deeper level of weakness, the ribs will begin to rotate inwards individually and as a whole all the ribs will rotate upwards thereby creating additional artificial depth to the thorax.  This is what we call the 'fake thoracic depth' effect.  

As the underlying chest and myofascia strengthens, the ribs begin its reverse journey and start turning downwards and backwards towards the back.  The results is the reduced fake thoracic depth and flatter appearance of the chest.  

Lets take a closer look at the side view of his thorax in Nov 2016.

These were the observation of his thoracic condition in Nov 2016.  With the impressive volumetric improvement and the strengthening of his chest, there are a number of great transformations seen here.  

Increase in size is a common challenge among the children affected by Cerebral Palsy.  Many children have difficulty putting on weight for years.  One should not be surprised that a typical child or teenager affected by Cerebral Palsy are skinny and are under weight because of their poor metabolism.  Rate of metabolism