Ayushi did not cry immediately at birth and seemed rather blue but responded fairly quickly to oxygen given nasally. At age of 2.5 months her head control was noted to be very poor and she started physiotherapy at 4 months of age for clearly delayed development. As she grew, she got stiffness in both her lower and upper extremities. She was weak at the foot and collapsed on the inside of the foot during standing and also could not straighten her knees during standing and assisted walking. She started her treatment with Dr. Rajul Vasa at age 10.
Ayushi Shah before Vasa Concept
Ayushi had delayed milestones. Till the age of 10 years she followed Bobath therapy in USA and at home. She underwent Botox in the hamstrings and the calf muscles in 2004. She was made to wear splints for a couple of years and usedtreadmill with overhead support to walk. She also ambulated within the school and community using the assisted devices but she was unable to stand and walk INDEPENDENTLY.
Following is an account of observation made by Ayushi’s parents over the years while being treated with VASA CONCEPT
Before - After Video
Videos - After Vasa Concept (playlist)
- More stable hands
- Fist remained open without pulling
- Could maintain long sitting, which was not possible ever before
- Could go slightly backwards in long sitting.
- She used to keep her body tight while sleeping, but now that tightness has almost gone.
- She used to be rocking a lot while sitting, but now that has become less.
- Could crawl faster and could turn herself easier.
- She was not able to sit in 90 and push her legs out then. By now, she was much better.
- Could hold her hands up and sideways, which she could never do before.
- Despite this, she did better in crawling in terms of speed and also in terms of balance.
- While sitting also, she was steady.
- Her legs had become more and more released, and the tightness was decreasing.
- Earlier, she used to curve her body; she used to pull her legs towards the body involuntarily. That decreased significantly.
- Earlier, Ayushi’s lower back was curved. In her sleeping position, her lower back was almost like a bridge, where one could easily slip his/her hands through. That decreased significantly over the year.
- Balancing was better on the ball
- Targeting of ball was much better, and faster.
- She fell less while crawling, and was also able to balance better.
- She started controlling all force with her hands better
- In sand, she did better in sit to stand, especially while coming up. When she went forward in the sand, it was more controlled than before. (Earlier she could not control it herself.)
- Mobilization of pelvic region looked much better.
- The overall body response was much better
Exercises that she followed:
All force – hold and pull and make a table with her back
Kneeling in the back
Sitting Zapp on the bench
Cobra to camel and vice versa
Sand exercises – sand filled till just above the knee, on two different legs. Basic exercise – sit to stand and ball throwing.
Lifting pelvic while sitting; goes down and bang.
In sand, she did better in sit to stand, especially while coming up. When she went forward in the sand, it was more controlled than before. (Earlier she could not control it herself.)
Mobilization of pelvic region looked much better.
The overall body response was much better.
- Her thigh muscles, ankle muscles and hip muscles have loosened up significantly.
- There is impressive control on her kneeling.
- The tightness and spasticity has decreased.
- Her legs have become very relaxed.
- She takes pains to control her body herself.
- Twisting and turning in backwards direction is better.
- She can do long sitting almost on her own now. She just about manages to touch her toes.
- She tries to shift herself in various directions.
Overall Physical Observations:
- Earlier, Ayushi was never given a chance to perform any tasks on her own. This was because of the fear of falling backwards. All her exercises were heavily in the vertical direction (i.e. standing exercises/ walking exercises). As soon as she re-started crawling and reaching the object, she has learnt how to take the call herself. (Example – she is able to go to the toilet herself now, opening the door and sitting on the pot, etc. This, I believe is due to the motivation to perform her duty or task HERSELF.)
- Earlier, she used to bang herself (some body part or the other) very frequently. This implies that her control over her body was minimal, almost like a stone. This has significantly changed over the course of time. Now she immediately comes back to her mean position in case of a loss of balance. Since almost two years, she hasn’t experienced any significant injury (in the head or elsewhere). Now, she can control her head by saving it from falling. She makes use of her hands and her body to save herself from falling.
- Her sense of direction has improved to a great deal. Now she knows her path clearly. One doesn’t need to tell her how to reach a place – she makes her way on her own. This has probably come by using her sense while crawling. Earlier, she used to be forced to walk, and this way she used to lose her sense of direction. Others directed her, resembling a robot.
- Ayushi’s hand functions have improved. She has started using her hands and fingers individually also now. There is more motor coordination in her hands, as in she can use her hands individually also in a better way now. She writes more clearly too.
- Ayushi sits on the floor in quite an erect position now. Earlier she used to rock a lot. Now, she doesn’t move as much while sitting.
- Started liking studies much more; she now takes interest in her studies. This is probably because of the fact that she can concentrate better, and hence can understand what is being taught to her.
- Ayushi was always a social child. She always enjoyed the company of people. Now, she has more things to talk about with them. Earlier, she used to get lost, but now she is in more control over herself. She is aware of the goings-on around her. She is a good observer.
- She tries to follow instructions, but finds it a little difficult to remember them blow-by-blow.
- She still gets random fits of laughter, but they have significantly decreased now.
- She has definitely become more mature than before.
- She now remembers to swallow her saliva. Her drooling has significantly decreased.
- She gets lost easily. She does take a lot of time to get over it. We need to call out her name 5-6 times and only then does she come back to where she was.
- When she is behaving difficult, she literally sticks to the place where she is, and it takes a lot of time to make her move.
Observations in her face and head:
- Tightness in forehead has decreased.
- She can focus better with her eyes now. They don’t falter that much anymore
- Now, she remembers to shut her mouth without prompting.
- While talking, her lower lip is tighter than the upper lip.
- Her tongue is very stiff – she doesn’t seem to use it too much.
- She can’t do much with her face; expressions are tough for her to make. All she can do is raise her eyebrows. She cannot so much as bring her eyebrows together.
- Lately, she has started shaking her head to and fro too much. This is involuntary, and it takes time for her to stop.
- She cannot cope up with moving visuals. She still has issues with watching TV. She however, likes music.
Ayushi Shah History
Immediately after birth, Ayushi was significantly hypotonic, and did not lift her head until she was thirteen months old. She rolled at two years of age and began sitting with support shortly after that. Gradually, she developed tightness in her body.
She has undergone intensive therapy in the USA, in the years 2000, 2002 and 2004, with two different therapists and their teams. Throughout her life of ten years, she was following a local therapist. Ayushi underwent botox in her legs, in the year 2004, and the casts remained for approximately two and a half months. She was given injections in both the hamstrings and the gastrocs. She has never gone under any other type of surgery. Earlier, the main objective was only to make her stand and walk independently. Hence, the exercises and the main program were only to achieve this, and nothing else.
Ayushi was given an assistive device such as a walker to ambulate within the school and community. She also wore splints for a couple of years and used the treadmill to walk.