Page Four P H Y S I O T H E R A P Y July, 1956. THE NEUMANN-NEURODE BABY GYMNASTICS By A. P A P P E N H E I M , M.C.S.P. R E M E D I A L exercises, m a s s a g e a n d m a n i p u l a t i o n s ca n d o a l o t f o r t h e t o d y ( an d so ul ) o f a d u l t s a n d c h il d r en . T h e y a c h i e v e m o r e f o r ba b ie s , t o d d l e r s a n d n u r s e r y - s c h o c l ag er s. It is, in d ee d , in o u r sm a ll es t c h i l d r e n t h a t we ha ve o u r g r e a t e s t c h a n c e t o i m p r o v e a n d c u r e. T h e i r b o n e s ar c still so f t e n o u g h t o r e s p o n d c o m p a r a t i v e l y q u i c k l y t o r e ­ p e a t e d m a n u a l p r e s s u r e o r t o t h e pull o f th ei r ow n tr a i n e d m usc les . T h a t is, in s h o r t , w hy we s h o u l d lose n o t im e in see in g t o it t h a t i n f a n t g y m n a s t i c s , a n d all t h a t be l o n g s t o it, c o m e s w it h i n t h e r e a c h o f o u r sm a ll es t c h i l d r e n — b ef o re t h e i r p o s s i b l e w e a k n e s s e s h a v e e n g r a i n e d t h e m se lv e s a n d m a d e t h e m s e lv e s felt b e y o n d t h e o r i g in a l fault. I t is f o r t u n a t e t h a t in t h e N e u m a n - N e u r o d e Ba by G y m ­ n a s t i c s w'e h a v e a sy s te m at h a n d t h a t h a s p r o v e d it's va lu e f o r o v e r t h i r t y y e a r s in m a n y co u n t r i e s . T h e ex er cis es a r e c a l c u l a t e d t o assist n o r m a l ph ysi ca l ( a n d m e n t a l ) d e v e l o p m e n t o f t h e grow-mg in fa nt . T h e w o r k is d i r ec te d t o w a r d s th e p r e v e n t i o n a n d c u r e o f phys ica l d e f e c t s at t h e ea rl ies t S U I T A B L E m o m e n t . In his b o o k B a b y G y m n a s tic s ( S a e a g lin g sg y m n a s r ik ), D t l e f f N e u m a n - N e u r o d e h a s d e s c r i b e d a n d fully il lu st r at ed t w e n t y - t w o bas ic exercises. T h e t w e n t y - t h i r d a n d lates t e d i t i o n o f this b o o k l e t w>as revised a n d b r o u g h t o u t in 1956 by t h e late N e u m a n n - N e u r o d e ' s d a u g h t e r , M r s . G . K ai s er . T h e p u b l i s h e r s a r e : M e ss rs. Q u e l l e & M e y e r , H e i d e l b e r g , G e r m a n y . T h e ex er cis es in thi s sy s te m ar e d e s i g n e d t o e n c o u r a g e the b a b y ' s s p o n t a n e o u s m o v e m e n t s . All p a r t s o f th e b o d y ar c m o v e d in a wa y t h a t is n a t u r a l a n d p l e a s u r a b l e t o the child. S ix months old normal baby perform ing high back arching with the author in Johannesburg, 1956. T he late DetlefT N eum ann-N eurode working at his S ta te R egistered S ch ool between the two World W ars in B erlin, G erm any. It is in t er es t i n g to realize t h a t t he b a b y g y m n a s t i c s are th e resul t o f N e u m a n n - N e u r o d e ' s o b s e r v a t i o n s o f p h ysi ca l def ec ts , n o t in ba b ie s , b u t in a d u l t s — to be pr ecise, in r e c r u it s o f t he G e r m a n c a v a l r y w h o m he h a d t o t r a i n d u r i n g t h e first W o r l d W a r ! T h e f r e q u e n t fa u l t s he n ot i c e d in th e m a k e - u p o f t h o s e r ec r ui ts m u s t ha v e b ee n as s t a g g e r ­ ing t o h i m as it w as t o t h o s e w h o m a d e a su r v ey o f h ea lt h c o n d i t i o n s o f th e so l d i e r s o f t h e la st w ar . (I r e m e m b e r r e a d i n g t h a t as m a n y as 6 0 % o f t he so l d i er s in v a r i o u s c o u n t r i e s suffe red f r o m flat feet). T o i m p r o v e m a t t e r s , to b r i n g s t r e n g t h a n d e n d u r a n c e w h e r e he n o t i c e d w e a k n e s s a n d c o m p l a i n t s , m u s t h a v e been a h a r d j o b . T h e u n e n d i n g s u p p l y o f new su ff ere rs f r o m ca ch ne w b a t c h o f so l d i e r s m u s t h a v e b ee n baf fling t o h i m — n o t t o m e n t i o n t h e a m o u n t a n d d u r a t i o n o f in te ns iv e work, t h a t h a d t o be d o n e to a c h i e v e a n y t h i n g li ke a sufficient a m o u n t o f i m p r o v e m e n t . (I h a v e b ee n i n f o r m e d t h a t , d u r i n g the last w ar , it w as six h o u r s in t en si v e r e m e d i a l exer cises dail y, fo r a m a x i m u m p e r i o d o f six we ek s , w h ic h w as r e q u i r e d in th e S o u t h A f ri c a n A r m y ) . N o w o n d e r , t h e n , t h a t N e u m a n n - N e u r o d e b e g a n t o lo o k f o r th e ph ysi ca l e d u c a t i o n o f y o u t h as a m e a n s to p r e v e n t t h e f a u l t y g r o w t h in th e a d u l t . T h e r e f o r e , as s o o n as p ea ce w as d e c l a r e d , N e u m a n n - N e u r o d e t u r n e d his e n e r g i e s t o t h e d e v e l o p m e n t o f p hy si c al t r a i n i n g for ch i l d r en o f s c h o o l age. T h e y b e c a m e th e o b j e c t o f m u c h e n t h u s i a s t i c a c ti vi ty o n g y m n a s t i c a n d t h e r a p e u t i c lines, ( w it h a n i n t e r e s t i n g b o o k l e t o n t h e s ub je ct e m e r g i n g f r o m it). A g ai n , N e u m a n n - N e u r o d e st r u g g l e d h a r d w i t h all th e c o m m o n d ef ec ts he e n c o u n t e r e d in th es e ch i l d r e n . T h e r e a l i sa t i o n fo rc e d itself u p o n h i m t h a t hi s g o o d in fluence o n t he ch i l d 's g r o w i n g b o d y c a m e — t o p u t it m i l d l y — r a t h e r la t e , n a m el y, at a tim e, w h e n f a u l t y m o d e s o f d e v e l o p m e n t h a d a l r e a d y b ee n fully es t a b l is h e d , a n d b a d h a b i t s h a d j o i n e d fo rce s w it h t h e m . S o it b e c a m e c l e a r t h a t h e h a d t o s t a r t still e ar li er t o a ch i ev e the g o o d re su lt s he so a r d e n t l y w as w o r k i n g for. I t w as t h e n t h a t N e u m a n n - N e u r o d e be g an t o l oo k t o the R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 3. ) t o d d l e r a n d y o u n g b a b y f o r a n y si g ns o f s i m i l a r w e a k ­ nesses t o t h o s e o f th e o l d e r chil d. H e di d n o t need t o s e a r c h lo n g : C o n t r a r y to the w i d e - s p r e a d view t h a t ba b ie s d o n o t . as a rule, s h o w ty pi cal w e a k n e ss e s o f s t r u c t u r e , he di sc o ve re d t h e cl ea r b e g i n n i n g o f m a n y c o m m o n fa u lt s in t h e sma ll limb s a n d b od ie s o f ba b i e s a n d t o d d l e r s alike. ( T o d a y , detaile d st u d i e s on this ag e g r o u p o n m a n y t h o u s a n d s o f A m e r i c a n c h i l d r e n h a v e s h o w n t h a t , as f ar as th e f o o t is c o n c e r n e d it's c h a r a c t e r i s t i c p o s i t i o n in s t a n d i n g a n d w a l k i n g is fully e s t a b l is h e d by th e f o u r t h y e a r o f life— a n d d o e s no t t e n d t o a l t e r a f t e r th a t ) . In c o n s e q u e n c e , his idea o f d es i g n in g c o r r e c t iv e a n d p r e v e n t i v e exercises fo r th e b a b y a n d y o u n g ch i l d w as b o r n . T o s t a r t wi th, N e u m a n n - N e u r o d e s p a r e d n o ef fo rt t o l ear n as m u c h as pos si bl e a b o u t p e d i a t r i c s f r o m e m i n e n t d o c t o r s . S t a r l i n g wi th his o w n b a b y d a u g h t e r , a n d b r i n g in g in m o r e a n d m o r e bab ies, he g r a d u a l l y d e v e l o p e d his series o f b a b y exercises, car ef ul ly a d a p t e d t o th e b o d y o f t h e ba b y . T h e c a u t i o u s a n d d i s c r i m i n a t i n g w a y in w h i ch he a p p l i e d his ne w skill w on th e c o n f i d e n c e o f d o c t o r s a n d m o t h e r s ali ke . His w o r k a n d pr est ig e g r ew a n d m a d e it n e c e s sa ry t o t r a i n o t h e r s to help him. H e t h e n a p p l i e d f o r p e r m i s s i o n t o o p e n a t r a i n ­ ing sc h o o l f o r b a b y - g y m n a s t s in Berlin. T h e c o n d i t i o n w as m a d e , h o w e v e r , t h a t h e h a d first t o p r o v e t h e g o o d results o f his i n f an t g y m n a s t i c s at t he f a m o u s c h i l d r e n 's clinic in B e r l i n - S c h a r l o t t e n b u r g . H e su c c e e d e d a n d f o u n d e d his s c ho o l, gi vi ng his p u p i l s a t w o y e a r s t r a i n i n g wit h a S t at e su p e rv i s e d e x a m i n a t i o n in su ch sibje cts as A n a t o m y , P h y si o lo g y, P a t h o l o g y , B a b y - G y m n a s t i c s , B a b y - C a r e , etc. W h e n N e u m a n n - N e u r o d e di ed in 1945, his p u p i l s were e n ga g ed in his w o r k in M u n i c i p a l C h i l d r e n ’s h o s p i t a l s a n d baby -clinics, as wel[ a s in p r i v a t e p ra cti ces . M a n y o f t h e m wen t a b r o a d . I t m u s t be sai d f r o m t h e s t a r t t h a t t h e exercise s ar e beneficial t o all b a b i e s — a n d n o t re ser ved t o t h o s e wit h a p a t h o l o g i c a l c o n d i t i o n . In t h e o r d i n a r y b a b y th ey e n c o u r a g e a n d e n s u r e c o r r e c t d e v e l o p m e n t — gi vi ng th e ch il d, t he r e a n d t he n, th e s t r o n g ba ck it n e e d s fo r life n a d t h e g o o d ar c h e s o f t h e f o o t t h a t will s t a n d u p t o w e i g h t - b e a r i n g fr o m th e s ta rt . T h e b a b y ’s e x p r e s s i o n s o f c o n t e n t m e n t a n d j o y w h e n p e r f o r m i n g th e exer cis es p o i n t to th e fact t h a t he is t r e a t e d t o s o m e t h i n g sa tis fy in g . W i t h o u t w o r d s the exercises a t t e m p t a t “ s p e a k i n g t h e c h i l d ’s l a n g u a g e . " Jn t he p la ce o f v er ba l su g g e s t i o n s p o s i t i o n s a n d s e n s a ­ t i o n s a r e us ed t o inv it e t h e b a b y t o be n d a n d st re tc h, t o h el p o r resist e x a c t l y w h e r e it is ne ed ed . All t he time th e i n f a n t r e s p o n d s t o a n a p p r o p r i a t e st i m u l u s . It m a y be t h e s t r o k i n g o f th e f o o t o r p e r h a p s his bein g se cu re ly held in a h o r i z o n t a l p o s i t i o n . F o r i n s t a n c e : — H e l d in sid e -ly in g, a t a d i s t a n c e f r o m t h e t a b l e h e will i m m e d i a t e l y begin t o s t r u g g l e u p w a r d s with h e a d a n d t r u n k in a d ec i d e d ef fo rt t o ri g h t him sel f. I f he is n o t tired he will lo ve t o a c h i e v e s u c h a s t r o n g m o v e m e n t se ver al tim es o v e r t h u s giv in g a g o o d t r a i n i n g t o his l at er al t r u n k m uscles. In th e ca s e o f th e f o o t o n e m a k e s u se o f t he u su a l reflexes a n d t o u c h e s th e i n n e r sid e o f th e sole. T h e f o ot will t u r n i n w a r d s — t o w a r d s t he s p o t t h a t w a s t o u c h e d — a n d , with p r ac t i ce , thi s r e s p o n s e will g r o w fa st e r a n d so m u c h s t r o n g e r t h a t y o u c a n ex er t c o n s i d e r a b l e r es i s t an ce e a c h ti m e t o it. T h u s by “ r e fl e x - s tr o k i n g ” o n l y y o u c a n effectively s t r e n g t h e n t he m u s c le s t h a t f o r m t h e a r c h o f t h e fo ot . F u r t h e r m o r e , yo u c a n a l t e r a p o o r h a b i t u a l p o s i t i o n o f t h e fo o t , o f t e n seen o n a b a b y in a c r a d l e , n a m e l y f r o m th e a r c h - w e a k e n i n g c o n s t a n t o u t w a r d t u r n i n g t o t h e a r c h - f o r m i n g c o n s t a n t i n w a r d t u r n i n g . P a r t ic u la r l y in t h e ca s e o f a fl at -f o o t ed p a r e n t ( o r tw o ! ) th e sign s o f a p o o r l y d e v e l o p e d a r c h o r M rs. H . S ch u tt, now in Johannesburg, training N eum ann-N eurode G ym nasts at the Training S ch o o l in P ahl near M unich in 1948. a n k l e s h o u l d n o t be o v e r - l o o k e d . T h e y s h o u l d be s h o w n t o a d o c t o r a n d , wit h his c o n s e n t , t he p a r e n t s s h o u l d be s h o w n h o w to fo rti fy t h e a r c h - f o r m i n g m u sc le s o f th eir o f fs p ri n g, b ef or e w e i g h t - b e a r i n g c o m p l e t e l y d e s t r o y s a n o f t e n insi pi ent a r c h . P a s s i v e m o v e m e n t s f o r m still a n o t h e r m o d e o f in vi ti ng m u sc le ac ti v it y . S u c h m a n i p u l a t i o n s e v o k e in th e b a b y the wish t o h el p o r t o h i n d e r — e i t h e r o f w h ic h b ei n g o f benefit t o his w o r k i n g muscles. F i n a l l y t h er e a r e th e m o v e m e n t s c a u s e d ‘ ‘ b y i n v i ­ t a t i o n . ’ ’ T h e b a b y is pl a c e d i n t o a p o s i t i o n f a v o u r a b l e t o a ty p ica l b a b y p e r f o r m a n c e . O f fe r i n g t w o fingers t o the b a b y ly in g in th e c ot is a well k n o w n on e. I n thi s s i t u a t i o n eve ry b a b y h a s a n o b v i o u s o r la te nt te n d e n c y t o g r a s p the fingers. A c c o r d i n g t o his ag e a n d st a t e o f h e a l t h he will a t t e m p t o r s uc ce ed in p u l l i n g h i m s e l f to th e s i t t i n g p os s i t i o n . T h e r e a s o n w h y we c a n use all t h es e di f fe r en t w ay s o f i nv i t i ng a b a b y t o m o v e d u r i n g his da il y te n to fifteen m i n u t e s N e u m a n n - N e u r o d e exe rcise s, lies in th e fact t h a t all h e a l t h y ba b ie s h a v e a lo v e f o r m o v e m e n t a n d for bein g se cu re ly h a n d l e d . In fact, a p a r t f r o m m o u t h activ it y, b o d y m o v e m e n t s a r e his m a i n so u r c e f o r g a i n i n g p l ea s u re . O n th es e f a c t o r s th e b a b y g y m n a s t i c is ba se d . T h e i r a p p l i c a t i o n e n a b l e t h e skilled p h y s i o t h e r a p i s t t o m a k e a b a b y w o r k h a r d a n d e n t h u s i a s t i c a l l y in all d i r e c t i o n s — t h u s lay i n g t h e f o u n d ­ a t i o n t o h e a l t h y a n d s y m m e t r i c a l d e v e l o p m e n t o f all his s t r u c t u r e s . W h a t is th e bes t ag e f o r b a b y t o begin ex e r c i se s? T h e a n s w e r is f r o m f o u r t o n in e m o n t h s . B e fo r e t h a t ti m e, the b a b y ’s need f o r p e a c e a n d sleep is, o r s h o u l d be, p a r a m o u n t . T h e r e is, a m o r e o r less p r o n o u n c e d t e n d e n c y t o r e m a i n in p o s i t i o n s o f p r e d e l i c t i o n . T h e k ne es a n d hip s, f o r e x a m p l e , t e n d t o be held flexed a n d a r e un w i l l i n g t o ex t e n d fully. All this is ph y si o l o g i c a l a n d m u s t n o t be d i s t u r b e d R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 3. ) Page Six P H Y S I O T H E R A P Y July, 1956. In Joh an n esb u rg, 1956: M rs. G . R u ssel giving N eu m an n-N eu rod e B a b y -e x e r c is e to her six m onths old so n M ic h a e l. u n n e c e s s a r i l y . B e y o n d t h e ag e o f n i n e m o n t h s , o n t h e o t h e r h a n d , t h e in f a n t a w a k e s t o th e w is h t o s t a n d o n his o w n legs. H e n o l o n g e r d e l i g h t s in b e i n g h a n d l e d . H e m u c h p re fe rs n o w t o be h e l p e d i n t o a s i t u a t i o n w h e r e he c a n excl us iv ely p r a c t i c e s t a n d i n g a n d w a l k i n g , f o r n o t h i n g else in t e r e st s h i m q u i t e as m u c h a t th i s st a ge . S o , wh-ere po ss i b l e , he s h o u l d be left t o it. O f c o u r s e , t h e r e a r e m a n y c o n d i t i o n s in b a b y h o o d w h i c h m u s t be t r e a t e d b e f o r e a n d b e y o n d t h e f o u r t o n in e m o n t h s s ta ge . W i t h sufficient skill a n d in sig ht thi s p r e s e n t s n o di ffi cu lt y — n e i t h e r t o i n f a n t n o r t o p h y s i o t h e r a p i s t . T o r t i c o l l i s , E r b ’s p a l s y a n d m i l d c l u b - f o o t , f o r e x a m p l e , a r e t r e a t e d a f t e r t h e first d a y s o f life. S ev er e v a l g u s a n k l e s a n d p r o n o u n c e d b o w legs c a n n o t be left u n t r e a t e d whi lst t h e c h i l d l e a r n s t o w a l k a n d s t a n d . B u t t h e c h i l d su f f er i n g f r o m g e n e r a l w e a k n e s s a f t e r , let us sa y, l o n g p e r i o d s o f d i a r r h o e a o r m a l n u t r i t i o n is b es t t o t r e a t a t t h e f a v o u r a b l e t i m e f r o m f o u r t o n i n e m o n t h s , w h e n we c a n ex p e c t t h e q u i c k ­ e s t a n d h a p p i e s t r e s p o n s e . P o l i o -m y e l i t i s , c h e s t c o n d i t i o n s , m i l d r i ck et s, s c ol io s is , c o n s t i p a t i o n , l a c k o f a p p e t i t e , l e t h a r ­ gic a n d e ffo rt le ss b e h a v i o u r m u s t be t r e a t e d w h e n e v e r t he c o n d i t i o n is d i a g n o s e d a n d p r e s e n t e d f o r t r e a t m e h t by t he d o c t o r . N a t u r a l l y , n o t r e a t m e n t m u s t be giv en t o c h i l d r e n w h o r u n a t e m p e r a t u r e o r suff er f r o m a n in f e c t i o n o r f r o m s o m e a c u t e di g es ti v e d i s t u r b a n c e . O t h e r c o n t r a - i n d i c a t i o n s ar e c o n g e n i t a l d i s l o c a t i o n o f h i p , t r u e c l u b f o o t a n d o t h e r se v e re t a l i p e s c o n d i t i o n s . H e r e t r e a t m e n t w i t h b a b y e x e r ­ cises o n l y b e g i n s a f t e r i m m o b i l i s a t i o n in p l a s t e r o f P a r i s h a s b e e n d i s c o n t i n u e d . M i l d c l u b fe et, h o w e v e r a r e well a m e n a b l e t o m a n u a l s t r e t c h e s a n d , m o s t o f all, reflex act ivities. M o t h e r s c a n l e a r n t o give t h e i r i n f a n t s b a b y g y m n a s ti c s . A c o n d i t i o n t o th i s is t h a t t h e y l e a r n t h e c o r r e c t p r o c e d u r e first. T h e ri g h t c h o i c e o f ex er cis e, t h e a m o u n t , t h e s e q u e n c e in w h i c h t h e y a r e p e r f o r m e d a n d , m o s t i m p o r t a n t o f all, t h e c o r r e c t a n d s e c u r e gr ip , all m a t t e r i m m e n s e l y f o r g o o d a n d sa fe resu lts. A h o l l o w b a c k c a n eas ily be i nv it ed in­ s t e a d o f p r e v e n t e d ! S u c h a m i s t a k e is likely t o be m a d e by t h e u n i n f o r m e d , a n d th e resu lt w o u l d o n l y b e c o m e a p p a r e n t ye ar s a f t e r w a r d s . P a r e n t s a n d g y m n a s t s a li k e m u s t learn t o r e f r a i n f r o m t r y i n g t o p u s h t h e b a b y ' s p e r f o r m a n c e b e y o n d his o w n i n d i v i d u a l r a t e o f g r o w t h . N e i t h e r m u st t h e y s h o w o f f his g y m n a s t i c a b i l i t y t o r e l a t i v e s a n d friends, as th is, so N e u m a n n - N e u r o d e tells us, m i g h t inci te a p er ­ f o r m a n c e t o o d a r i n g a n d t o o lo n g t o be sa fe. In his o w n w o r d s : — " E x p e r i m e n t s m u s t n o t be m a d e w i t h i n f a n t s . " M o s t p a r e n t s c a n c o m e t o u n d e r s t a n d t he u n d e r l y i n g p r i n c i p a l s o f t h e w o r k . T h e p h y s i o t h e r a p i s t t r a i n e d in bab y w o r k w o u l d e x p l a i n t o t h e m t h a t , w h e r e e v e r possible, a ct i v e ex er ci se t r e a t m e n t , f r e q u e n t l y p e r f o r m e d , is p r ef e r ­ a b l e t o p a s si v e t r e a t m e n t in i m m o b i l i s i n g s p l i n t s ; t h a t c o r ­ r e c t i o n c o m e s best a b o u t by t h e e s t a b l i s h m e n t o f cor re ct a n d s t r o n g m u s c l e p u l l ; t h a t t r e a t m e n t s h o u l d n o t be fo r c e d u p o n a ch il d. W i t h p a t i e n t p e r s e v e r a n c e , u n d e r ­ s t a n d i n g a n d a litt|e r e s o u r c e f u l n e s s b a b i e s d o c o m e to p e r f o r m ev e r y ex er ci se w i t h o u t o b j e c t i o n . I f t h e c h i l d ’s p e r s o n a l i t y is r e s p e c te d , if a n o c c a s i o n a l r ef u s al is o v e r l o o k e d a n d se l f- ex p r es s i o n i n v i t e d — b a b y g y m n a s t i c s will spell p l e a s u r e s e s s i o n s . O n l y a s s u c h c a n t h e y bring all t h e bene fits t h e y a r e c a p a b l e of. D e l iv e r a n c e ... f r o m p a in . . . . th e h u m a n ita r ia n fu n c tio n of o f th e p r a c t i t i o n e r . . . . n o w a c co m p lish ed w ith g r e a t e r speed, m o re eco n o m y a n d w ith a h ig h e r d e g r e e o f s a f e ty th a n e v e r before. F u ll d e t a i l s a n d c lin ic a l n o t e s on t h e u s e of R E N O T I N in t h e t r e a t m e n t o f M ig r a in e , N e u r it is , L u m b a g o , S p r a in s a n d M y a lg ia m a y b e o b t a in e d from E x c lu siv e D istributors fo r Southern A fr ic a P H A R M A C E U T I C A L S L T D . P . O . B O X 7 7 9 3 J O H A N N E S B U R G R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 3. )