Wednesday, July 11, 2012

Respiratory Mechanics and the effects on the Brain in Cerebral Palsy

I have just finished reading a very short (but informative) musing from Leon Chaitow regarding breathing...more specifically, how respiratory mechnics contribute to overall systemic homeostasis.  After reading some of his rants, I experienced a clarity of sorts...not exactly "revelations", rather a more clear tangible understanding of the complex relationship between the biomechanical competence and systemic competence.  Although it is a relatively intuitive understanding, it is sometimes difficult to verbalize and put into some formal context that can be understood.  Therefore, I think it will be very valuable to at least attempt to deliver some of these "moments of clarity" in an effort to further understand the multi-layered complexity of Cerebral Palsy (CP).  It should be remembered that understanding and improvement potential go hand-in-hand...the more we understand the physiological reality, as well as the overall conceptual message, the better we are in formulating strategies that are efficient and contribute in a more immediate and permanent manner.

The importance of proper respiratory mechanics is well understood and quite easy to relate to.  However, most of the understanding is based on a relatively simplistic view of  "bringing oxygen in and expelling carbon dioxide".  In addition, most of the focus with respect to breathing is placed on the lungs.  Although this is an obvious focal point, the larger picture should still be the context from which these focal point are examined.

This perspective is vital in the understanding of rehabilitative priorities in CP.  Chaitow's discussion on breathing was related to a significantly less complex situation (hyperventilation).  If the simple act of hyperventilation results in such significant changes in the brain environment, the effects in the CP individual can be assumed to be more significant simply due to the fact that the respiratory dysfunction is constant.

Cerebral Blood Flow
The image on the left is a brain scan during normal breathing and a scan during hyperventilation.  The obvious reduction in cerebral blood flow is quite significant.  Although it is obvious that hyperventilation is not a consistent condition in the CP individual, the respirstory dysfunction IS.  Therefore, cerebral blood flow is not only reduced, but it persists 24 hours a day.  In addition to the reduced blodd flow, Chaitow lists:

-Smooth muscle constriction of the intestines
-Bronchiole constriction
-Magnesium and Calcium imbalance in muscles

There are more, but the overall message is quite clear.  The discussion is therefore directed to the general root causes of this characteristic dysfunction of respiratory mechanics in CP.  This list is also quite extensive, however in an effort to maintain the flow of this post, I will summarize some of them below:

-Insufficient circumferencial volume of the thorax
-Reduced elasticity of the individual ribs and ribcage
-Extremely weak connective tissue system that is characterized by:
         -weak upper respiratory pathways
         -unstable trachea (leads to turbulent and disrupted air flow)
-Distortion of the bony alignment of fascial bones
-lack of sufficient control of the lips and tongue
-lack of division between the clavicles and upper 3 ribs
-underdevelopment and underuse of the upper lobes of the lungs

There are numerous strategies that are currently in place in an attempt to improve respiratory mechanics, however the overwhelming majority are formulated with the objective of "teaching" proper breathing mechanics...or using some repetitive training mechanisms in the hopes of reducing this challenge.  The reality is that breathing is a function that should require LESS mental focus and be something that is AUTOMATIC and not the result of training.  Increased mental and muscular effort placed on breathing is not only metabolically expensive, it negatively affects cognitive development potential and creates more difficulties to an already neurologically challenged system.

Although this post is clearly more of a rant, the main message should be relatively clear and understood:  adressing the structural and biomechanical considerations as a priority has a positive cascade effect on all of the other considerations (social, cognitive, systemic, metabolic, neurological).  Therefore, a focused and intelligent strategy to improve thoracic volume and elasticity will ultimately contribute to better brain metabolism and homeostasis.   IMPORTANT NOTE:  These are my personal views and do not necessarily reflect those of Mr. Chaitow.  I have reviewed his comments on this subject and have simply provided my own interpretation based on my professional experiences with CP.  Fortunately, Mr. Chaitow has generously provided some feedback on my interpretation and understanding of his perspective and this exchange is posted in the comments section.

You can refer to the One Giant Leap Facebook page for Chaitow's discussion as well as other interesting subjects.



  1. As promised, an excerpt from my brief exchange with Leon Chaitow:

    Greeting, Mr. Chaitow. i am a practitioner who works primarily with disorders of movement and posture...most of which are individuals and children with Cerebral Palsy. In the overwhelming majority of these children, the thorax is underdeveloped and lacks proper elasticity and thoracic volume. In addition, there is a profound dysfunction of respiratory mechanics which is most commonly characterized by paradoxical breathing patterns. Although the answer to my question is likely quite intuitive, how much do you think this structural distortion and dysfunction contributes to an increase in the negative response in the brain as described in your post on breathing?

    LEON CHAITOW: Profoundly, I would say...but while structural work can obviously make some changes to the restrictions, the barrier to progress comes with the difficulties associated with communicating and teaching better breathing habits

    GAVIN BROOMES: Indeed. I think my main philosophy would be that the structural improvement can serve as an effective catalyst in the ultimate response (therefore success) to teaching better breathing habits...a symbiosis of sorts. briefly, would you consider this to be correct or is your view somewhat different?

    LEON CHAITOW: that's precisely how I see it...enhance structure and the possibility of functional improvement is markedly improved.

    Many thanks to Mr. Chaitow for his generous input!

  2. Quantity of oxygen is very important in treating brain related injuries, diseases or any common issues such as migraine pain. I suggest people with brain problems can take rest in a very natural environment where lots of oxygen is present. By staying in such place you can give your body and mind essential oxygen for getting optimum function out of them.