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Home Wellness Research Birth Trauma Manual Therapy in Children: Proposals for an Etiologic Model

Manual Therapy in Children: Proposals for an Etiologic Model

Wednesday, 12 November 2008 17:25

From the excerpt: In research done in the Netherlands, healthy newborns were examined routinely after birth and a noticeable amount of intracerebral lesions were found. In our studies, infants born by cesarean delivery are underrepresented, and even more so if one excludes from this group the breech position, a frequent indication for a cesarean delivery.

A cesarean delivery is no guarantee that the cervical spine was not mechanically strained. Depending on the length of the abdominal incision and the urgency of the operation, the child may have been pulled out forcefully. In most cases the cesarean delivery is at least less demanding on the suboccipital structures than a vaginal delivery.

Studies of the intracranial structures of apparently healthy newborns showed a high percentage of signs of microtrauma of brain stem tissues in the periventricular areas. It seems probable that the exposed structures of the occipito-cervical junction suffer at least as much as the cranium. Wischnik et a. have shown this in experimental studies of the biomechanics of delivery, as have others. The injury of the intracranial and subcranial structures is thus the rule, not the exception. The ability of most newborns to overcome and repair these lesions shows the enormous capacity of the not yet fully developed brain to cope with trauma at this stage.

The optimal development of the brain, which persists well beyond the 16th year, depends on adequate and consistent sensory input. The importance of proprioceptive unbalances for the efficient repair of cerebral lesions becomes evident.


Heiner Biedermann, MD