Interview of Jean-Luc SAFIN

Healing with hands has existed since the essence of time. A person in pain will express a need to be touched where it hurts and ask whether it feels normal, or they may ask to have the painful part move. I think that all healers practice posturology/orthopraxy to a certain extent without necessarily being aware of it so long as they are treating the patient in the upright position.


WHAT IS ORTHOPRAXY?
Orthopraxy can be classified as belonging to the manual therapy group, in other words a therapeutic touch in treatment. It may in many ways resemble chiropractic or osteopathy, however the main difference being that they lack the additional physiological dimension of treating the patient in the standing the position. Orthopraxy allows for the patient to remain standing throughout the treatment session, from thereon it is the brain which takes over and manages all the sensorial information that has been collected by the hands reacting to recalibrate the body in relation to the physiological dimension necessary to the human..

BIPEDY


How do we remain in the upright position? How do we live as humans maintaining homeostasis in this standing position? We rely on feedback and feed forward from the various receptors such as somesthesic,visual, auditory equilibrium or inner ear. These help us to detect movement as well as acceleration and deceleration; the feet contain the only receptors that may be in stimulated continuously due to the fact that we have an almost constant contact with the ground. in short we use our feet and our somesthetic receptors, eyes, inner ear to remain in the atanding position. With all of the above taken into consideration it is then the brain via these various receptors that allows the body to function efficiently with a minimum of energy expenditure, otherwise known as postural tone. The body can therefore redirect the energy in order to achieve efficient locomotion, without pain. This makes man active, but in such a way as to conserve energy allowing him to be productive and efficient therefore without pain

LINKS WITH POSTUROLOGY


Posturology deals with the suffering human body on both a diagnostic and a therapeutic level. Whether the pain is of musculoskeletal or or in relation to the control sytems of bipedal posture the patient is treated in standing. As the patient remains in standing during the treatment session it becomes very apparent that that the neurophysiological context in which these 2 disciplines evolve is very closely related.

WHO IS ORTHOPRAXY FOR?

Orthopraxy is a very gentle therapy as it treatment the person in the natural upright position as well as using the brain's reactions meaning there are no contraindications and can be used with the elderly and babieS. A few minutes ago i was saying how we treat the patients in their physiologically normal posture, therefre when treating the baby he is in his natural physological position which of course means the baby will be treated in a developmentally appropriate position as his peripheral and central nervous system are still immature not allowing him to stand. Our treatment must therefore influence his NS via the physiological pathways available to the baby. At the other end of the spectrum we may encounter the paraplegic who's base of support is not the feet but the pelvic area where his main proprioceptive information is also gathered. We will treat this type of patient in the sitting position which his usual antigravity position.

WHO PRACTICES ORTHOPRAXY?

Osteopaths, physiotherapists who have followed a specific and specialized training program. There is now a list of the accredited therapists available from the APRO .

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To find out a bit more.........

How to relive tension without manipulation

It may appear extraordinary we don't rely on the well known biomechanical dimensions which are used osteopathic and chiropractic techniques which use levers, articular biomechanics in their reasoning, whereas for us articular biomechanics is of little importance.

Why? Because we yet again "trick" the NS into re-establishing pre-injury homeostasis. We essentially aim to influence the CNS by having an effect on the receptors in the soft tissues throughout the whole body, causing them to depolarise following a therapeutique technique which then allows the message to reach the brain and use short reflex arcs. So in other words we try to lure the CNS as shown by many researchers such as ROLL with tendon vibration, the Scandinavians, EDING, JOHANSSON or MOBERG concerning cutaneous stretch. We can create kinaesthetic illusions by the use of techniques that stimulate the conjunctive tissues causing the illusion of an articular movement, in other words the patient's brain will believe there is movement, perceives movement, for him this is reality, however in reality at an articular level, there has been no movement. For the brain there is no difference, there has been the sensation of movement, therefore the patient's reaction inevitably follows. What is great is that with this trick we have given ourselves the ability to create sensorial illusions which can be used therapeutically

concrete examples of this illusion may be seen in the treatment of neurological pathologies such as hemi negligence when a patient having suffered a parietal CVA, has residual diplopia and is given prism lenses in order to give the illusion of restoring proper function or undergo electrical stimulation in the cervical region, or even galvanic electrical stimulation in the inner ear. The CNS has incredible potential the key is knowing what to do in order to get therapeutic benefit

Lasting effect of treatment benefits

Clinical experience and data recorded from non-operator dependent apparatus have clearly demonstrated that the effects of treatment are long term and not just transitory. Simply because sensory manipulation, therapeutic touch have created transient information which the CNS has perceived as a modification of its state. There is always residual images. In other words the brain, which constantly functioning, takes note of the state of the body and these residual images persisting may be transmitted to the memory and at this precise moment the subject will simply perceive a new state of his body, another body. it is this that will give us this persisting therapeutic effect in other words durable over time

Orthopraxy and multidisciplinary

Orthopraxy allows us to observe corrections of postural tone, rotations of the scapular and pelvic girdles, these may be observed with the naked eye. There are instances when the treatment doesn't have the desired effect, or any effect at all, too good to be true for it to be 100% effective. Occasionally the desired corrections do not take place and are not durable, are not long-lasting. It is in this case that a specific sensory organ which needs to be targeted, either visual, vestibular or podal at this point a diagnosis and a treatment will be best if referred to a specialist such as the ophthalmologist, the orthoptist, the dentist specialised in ocluso-dontology or specialising in postural therapy who can manipulate in a lasting manner the sensory organ in question which lead to a permanent reprogramming of posture that we were not able to generate with our hands.

Indications and contra -indications

We are limited by the plasticity of the organic systems. Plasticity, therefore the capacity of the musculoskeletal system to move. What is fixed is fixed, however we do see benefits obtained with patients suffering with major arthritic changes in the vertebral column (it is here that we observe the most spectacular effects), they may obtain important gains in walking perimeters and reduction of pain. There is another area which imposes restrictions, that is the integrity of the regulatory loops whether long or short found in the neurological system. The skin and conjunctive tissue containing the mechanical receptors must be allowed to depolarise and generate a message. The nerve pathways must be functional, the integration system at the level of the CNS or the spinal cord must be functional and the motor system, the muscle, the muscle fibres must also be intact. If this is not so then obviously there will be limitations to our system. Limitations does not mean contra-indications or non-indication, if we take for example a neurological pathology such as Parkinson's with these people who are extremely rigid kinetically, we have noticed that they like our techniques because we are going to allow them to gain plasticity at a muscular level and we are going to increase a walking perimeter, modify the parameters of locomotion and this they are grateful for as it gives
more comfort? Although we do not treat the disease itself but we treat the physical consequences, and here we still may have an effect and the doors stay wide open.

Objective proof of ttt effect

There are 2 ways to quantify: operator dependent (
Fukuda, Romberg, kinesiology, biomecanics, etc) which remain very subjective as they contain an element of patient therapist relation. So in spite of everything we can have limited trust and when we know that our hands just as our somesthesia may be tricked by sensory illusions as easily as the eye or the inner ear, we have to admit to limited confidence in the results obtained. There are other tools of evaluation, non-operator dependent whereby we can verify with such apparatus as force platforms, also used in posturology, which allow us to record the capacity of the patient to remain in his base of support in the most efficient way. Another tool at our disposal is the semi dynamic platforms to measure dynamic low energy expenditure balance whilst executing complex tasks
A placebo effect like with many other therapies must be taken into account. 35-40% has been recognised in the medical fields and may be applicable in orthopraxy but not to the detriment of the obvious and recognised neurophysiological effects of
Orthopraxy. We shouldn't try to hide the existence of this element; however she should remain cautious when talking about sensory illusions and their therapeutic use, some people may all too rapidly make the link with a placebo effect. We must therefore endeavour to focus more precisely on the neurophysiological effects in order to understand that sensory illusions are therapeutic when in the hands of experts who have gone to the trouble of giving reason to their actions