“It’s time we tried to roll John.”
“Aarghhh, whaaaat do you aarrggh mean by weee, does that umm meeean you’re gonna do the er um rolllliiing?"
“John, you’re beating me to the punch each and every time."
“I know, you’re aarrgghh just toooo argh slow and eeeasy.”
"You’re keeping me talking, instead of exercising. You’re conning me again John.”
“Arggh, it’s er argh about time, argh, like I ummm said, you’re argh toooo slow.”
I asked John to move to the edge of his lounge chair. This involved John sitting up. It involved whole body complex wiggling, which included John using his arms, legs, torso, hips and even his head, as John leant forward. While John was doing this, I saw the opportunity to extend. I asked John to start announcing aloud the two times table, which he did. I asked John to continue with all of this until he was at the edge of his chair. This was extremely hard work for John. I asked John if he wanted to rest. John ignored me; he simply kept working. John was now at the edge of his lounge chair.
“Now, do you?” I began to laugh. John looked at me and smiled.
“You’re starting your con job again.”
“Finally, you’re beginning to ummm under-argh-stand something.”
Both of John’s feet were on the floor. I was on John’s left side. I was standing. I now asked John to stand. He leant forward. He started to move backwards and forwards. Then with great effort John stood up. He was standing. There was much cheering by Glenys and myself. John smiled. I asked Glenys to hold John, which she did. I moved the lounge chair back. I then went and held John. I asked John to bend his knees and to move onto his back. With much focus and effort, and very slowly, John began to bend his knees. John was halfway to the floor. I could see that the action was becoming much, much more difficult for John. I immediately asked John if he wanted to stop. He instantly said no, almost irritably that I even asked. John kept bending his knees. He then lent forward,and he stretched out his right arm. John was still being held and supported by Glenys and me. He continued to move towards the floor. He was groaning. The effort was extraordinary. I felt that John’s brain and body was trying to put in place the neurobiological processes that were required for John to be on the floor.
John was leaning forward. He placed both knees and hands on the floor. He grunted loudly. He was now on his hands and knees. How was he going to get on his back from here, I thought? For maximum hólos firings, John had to find the way, was my thinking. Glenys by now was seated on John’s chair. I asked John if he wanted to rest. “You can if you want,” was John brusque reply. “We need to get you on your back.
“What do you mean we?”
“You’re right, John you need to get on your back.”
John remained stationary on his hands and knees. Clearly, he was thinking. Good, I thought, he was making his own connections. John then bent his arms and he lent forward, and as he did so he began to straighten his right leg. John leant forward even more until his chest was nearly on the floor. He then leant a little to the right and then, at the same time, he suddenly straightened his left leg. There’s was what could be described as the tiniest of almost imperceptible thuds. John was now face down on the floor. “Do you need to rest John.”
“You said on the back.” With that John began to rock from side to side, and then with much effort he was on his back. “I want my pillow.” Glenys handed me his pillow. I place it under John’s neck and head. John had made another significant advancement. John was now lying on his back.
Rocking and rolling
“Do you need to rest John?”
“Aarrgh, aarggh you going toooo keep talking?”
"No John, I’m not.”
“Good, argh then get on argh with it.”
“Okay John it’s time to start rolling.”
John began the process to roll. But he could not do it. I watched as he continued to try. He used his arms, he flexed his knees, however he could not roll. And yet, John’s personal effort again provided me with an immense amount of movement information. I then told John I was going to rock him from side to side. “Get on with argh it.” I rocked John from side to side. As I was doing this, I again noticed that when I rocked John to his left, his right knee would rise. And when I rocked him to his right, his left knee would rise. These independent reactive autonomous unconscious knee raises informed me that John had the capacity to roll.
Rocking and then rolling, rolling, rolling
However, for this rolling to take place, the brain and the body (the hólos) had to redevelop and reinforce the neurological and associated neuromuscular pathways for John to roll. Utilising his own thinking and movement capacities, John continued with this process. John was now rocking and rolling on his own, and he was developing momentum. The momentum intensified. This continued and then, at the cups of the roll, the momentum of rolling started, and John was now rolling on his own and very quickly. I stood and I had to move. I stopped John as he was about to hit his front wall. John was successful. “Pillow.” I went and retrieved John’s pillow. I place it under his head. John was breathing heavily.
“Now you,” said John.
“John, I need a rest.”
“Argh you just can’t hack it.”
“John, you’re right.”
It was my summation that all of this was taking place because the appropriate neurological connections had been established, and were a continuation of what had been taking place from the day we started MMT. This process, which now included the rolling, continued and progressed for the next few weeks until John was eventually able to crawl. Once John was crawling efficiently, then it was time for John to walk.
Could John walk?
After some weeks, it was time to see if John could walk. In what became the lead up to John walking, multimovement lounge chair therapy was the warm up, which included John lifting the knees, the legs, moving the arms from side-to-side and turning the head from side to side in the ongoing complex array of patterns. After about 15 minutes of this it was time for John to stand and see if he could now walk, knowing full well that prior to this he had been standing, rolling and crawling. However, even with this taking place, as with all of what had proceeded, there was no guarantee that John would be walk. Plus, he had not walked since August 1991, and now it was March 1994.
Let’s get on with it
However, even with the thought of all of this uncertainty in mind, I was still being encouraged by all of the previous presenting behavioural indicators by John, especially now, in relation to his ongoing rolling and crawling. All of this informed me that John should be able to walk. However, and yet again, I reinforced to John and Glenys, there was no guarantee this would happen. But as always, if you don’t try, nothing will ever happen. John’s response to this this was to say: “Let’s get on with it."
It’s time to walk
John again wiggled and shuffled his body to the edge of his lounge chair. I stood on his left side to support him. Glenys was on John’s right side. John rocked backwards and forwards, he then leant forward and again with immense force he stood up. As noted, John had done all of these movements previously. Now it was time to walk. “Okay, John, it’s time to walk.” I was holding and supporting John on his left side. Glenys was standing next to John on his right side, however, she was deliberately not holding or supporting John.
That’s one small step and one giant leap
I wanted John to use his own thoughts and movement patterns to walk. With much focus, John lifted his left knee and then he placed his left heel on the floor in front of him. He then leaned forward a little, and placed his entire left foot on the floor. It was time to take a walking step with his right leg. John needed to intellectually and physically stretch his thinking. John leant back a little and then, with a little more force, he leant forward. He then lifted his right knee. John began to take his first step. His right foot moved and then swung and hit the back of his left heel. It was time for John to stretch his thinking and body again. I held John and asked him to rock a little, and to also move side to side, and then, at some time, try to move his right foot past his left. With some significant effort, John did. John had taken his first step. This led to the second, a third, a fourth step. John was walking!
Stretch goals involve highly challenging complex movements and intense cognitive work that is and was focused on extending what John could do physically and mentally. He was not focussing on what he could not do. As a result, from late 1993, John’s presenting condition improved dramatically over the ensuing weeks. As alluded to above, in March 1994, some 10-12 weeks after he began MMT, John began to walk and soon after he was walking independently for the first time since August 1991. With his ability to walk, John was also using a calliper (which John referred to as his walking stick). This walking soon progressed to where John was walking outside, on a daily basis, on his own, in the front of his home. Some four weeks later, John ran 10 metres into the arms of Glenys.
As John was running, all that I was doing was supporting John by holding his left arm. And John was running. Yes, he was running. In October 1992, John and Glenys were informed, as John was being discharged from hospital, that he would never walk again. And in March 1994, John was running, and he ran for some 10 metres without stopping. At the end of the run, as John ran into the arms of Glenys. There was cheering, and shouting, and crying, and yelling, and there were tears of joy in this group hug with John, Glenys and myself. We then all slowly and joyfully walked inside. It was nice and warm inside, which was a contrast to the cold weather that was outside. Glenys prepared our usual after session refreshments. The three of us then, as usual, enjoyed each other’s company as we now continued to talk about this monumental day. Those who knew John and his condition were amazed at the healing and significant improvements from his formerly incapacitated state. The treatment using MMT continued every Saturday afternoon on a weekly basis until December 1997 (for a fuller description see Purje, 2018).
The mind and its potential
An example of John’s resilience and recovery, he presented to a large, mainly medical audience at an international conference in Sydney called The Mind and its Potential (2011) where he received a standing ovation that is available to view on YouTube. As Glenys Famechon stated in 2014:
Our lives are pretty much quite normal... A very near to normal life is how I take it. When we go out, sometimes we have to take the wheelchair if we’re in an airport and you’ve got to go for a long, long way, but John walks with the cane, he converses with people... I’m just so confident that John can have a conversation with somebody, and it’s really nice, whereas before it was two words, and then nothing else clicked in. We have a very big social life [now]. (G. Famechon, personal commutation, July 2, 2014).
That concludes part 3 of The brain, multimovement therapy, neuroscience, pedagogy and education. Part 4 will be examining, to a small degree, John’s neurological rehabilitation. This will include the initial accident; the primary medical emergency intervention; the hospital-based medical support and ongoing medically directed physiotherapy; the outpatient clinical physiotherapy; the home-based physiotherapy and hydrotherapy; and the later application of multimovement therapy.
Dr Ragnar Purje is adjunct lecturer in the School of Education and the Arts at Central Queensland University. Under the supervision of Professor Ken Purnell, Purje’s doctoral dissertation focused on the success of his neurologically focused acquired brain injury rehabilitation therapy.
Professor Ken Purnell is from the School of Education and the Arts at Central Queensland University.
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