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Cranio Facial Kinetic Science

You are a health specialist: why collaborate with a craniofacial therapist?

The craniofacial therapist can work with diagnoses from different disciplines. It increases efficiency by reducing the number of multiple examinations and the resulting cost and comfort benefits for the patient are obvious.
 

 

But why should you work with a craniofacial therapist?

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The therapists trained at the Faculty of Medicine at the University of Basel come from various professional fields. These are the same professions that may be concerned by interdisciplinary care. This approach requires an effort from all parties to work together to address the patient's problem. Interdisciplinarity should not be just a theory: it should also be experienced in reality (while respecting each discipline), not only through the transmission of information, but also through meetings regarding the patient's problem.

Areas concerned

chirurgiens

MEDICAL FIELD

  • Dental medicine

  • ENT

  • Maxillo-facial surgery

  • Medicine

  • Ophthalmology

  • Orthodontics

  • Osteopathy

  • Pain therapy

  • Pediatrics

  • Physiotherapy

  • Traditional Chinese medicine

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HUMAN SCIENCE

 

 

  • Art therapy

  • Clinical Pschology

  • Ergotherapy

  • Logopedics

  • Psychology

  • Other recognized care therapies: hypnosis, Reiki, hippotherapy, reflexology, etc.

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PEDAGOGY

 

 

  • Children's education

  • Specialized education

  • Teaching

  • Specialized teaching

Why is the training open to people who are not exclusively from the medical field? Because it is a holistic approach to the person, which includes, in addition to the scientific aspects (anatomy, manipulation), communication skills, development (of the child) and observation.

The work on fascias, particularly the one developped by Dr. Guimberteau (Strolling under the Skin), has shown that a trauma trauma - suffered by the body - in a  particular spot has repercussions on the entire body because fascias are present everywhere, surrounding muscles, organs, nerves, etc. They form chains that interact with each other and also affect an individual's emotions.

 

We therefore understand the importance of seeing the body as a whole and no longer as "parts".

The main lines of a craniofacial therapy are based on the following scientific knowledge:

 

1. kost® according to Codoni

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The k-o-s-t® (Körper-­Orientierung-­Sprach-­Therapie or functional speech therapy -­ website in German) is a concept developed by Dr. h.c. Susanne Codoni to treat people with speech and expression disorders or various disabilities. This therapy is at the crossroads of traditional medicine, complementary medicine and pedagogy. It is not only restricted to speech therapists. To treat the patient's functional deficiencies, this holistic vision is based on the person's own resources. Interdisciplinary cooperation provides an overview and a treatment concept based on it. This approach is based on four pillars:

The craniofacial therapist begins by observing the posture and stabilizing it with the stimulation of the k-­o-­s-­t®. They will rely on diagnoses made by other professionals or, if they are non-­‐existent or if the weaknesses or gaps are too great, they will seek the help of a physiotherapist or an osteopath. Collaboration is important here to communicate what has already been done with the patient. The point of communication also applies to the patient-­therapist relationship, otherwise the stimuli will not work.

The communication pillar is very important and is based on the knowledge of

neuro-­linguistic programmin (NLP).

 

An  orthodontist  or  a maxillofacial  surgeon  may  also  need  to  stabilize  the patient's  posture  before  or  after  treatment,  and  we  will  see  this  later,  to relearn good swallowing and speech.

Observation
Diagnostic
Communication
Stimulation

It happens that patients suffer from reoccurrences after their orthodontic treatment. This may be due to general body hypotonia, where the tongue stays in a basal position and causes, with each swallow, pushes against the teeth.

Learning the resting point of the tongue as well as targeted toning bodywork (e.g. k-o-s-t® related to F-A-I-T-H-Kids, by Jens Hentschel - German) allows the patient who is undergoing or followed orthodontic treatment to maintain a good dental occlusion.

FAITH-Kids by Jens Hentschel

image courtesy of Jen Hentschel - Alschwill / Pratteln   

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The consequences of an imbalance of the pelvis and jaw on the spine

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8.5 The Codoni model, reproduced with the kind permission of Dr. h.c. Codoni, all rights reserved. From "Funktionorienterte Logopädie" (2019) - 8 - P.130 - Ed. Spinger

Tensions in the jaw affect the entire spine, disrupting the lordosis of the lumbar vertebrae, which can cause neck, back or knee pain due to overload of the spine and muscle compensation.

The difficulty in making a diagnosis (which the therapist never does alone, especially if they are not a doctor themselves) is in discovering the root cause of the problems. Is it a functional or structural cause, related to constitution or genetics?   As everything is linked in the body, we act on the pelvis by working on the jaw and vice versa. This is why craniofacial therapy will not necessarily be the first element of the medical care. Another specialist can be called in addition, while respecting the skills of each specialization.

 

A good case management system must be put in place to set priorities for the patient’s care.

 

2. FBL - Funktion Bewegungslehre

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For their observations, the craniofacial therapist uses terms that physiotherapists trained in Basel know: the FBL (Funktion Bewegungslehre) of  S. Klein-­Vogelbach -­ website  in  German).  This approach  allows  the  therapist  to  analyze  the  static posture and gait and to measure the differences. The craniofacial therapist is not a physiotherapist (unless they have a Master's degree in physiotherapy). They use the terms of  the FBL to observe and  describe  the  situation. Depending  on  the  observations  made,  they will offer body stabilization exercises (using, for example, ball exercises or k-­‐o-­‐s-­‐ t®, see above). But if the differences are too great, he will need the help of a physiotherapist or an osteopath, or even a doctor. This knowledge allows the therapist to understand the physiotherapist's diagnosis.

These observations can be communicated to the specialist who will be responsible for erecting the patient's posture. This is an essential prerequisite for the work of a successful craniofacial therapy.

 

3. Myofunctional therapy: MFT

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Swallowing: verification of the contact points of the tongue on the palate using an ultraviolet lamp

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Myofunctional therapy (developed in the 1960s by Daniel Garliner in Florida) treats  oro‐facial   dysfunctions.   Through  exercises,  it  helps  the patient to position their tongue in their mouth and find or regain a good swallowing pattern. This  does  not  only concern children. Indeed, some adults keep an  atypical swallowing all their lives. The low position of the tongue in the mouth can be the source of headaches, neck pain, breathing problems, poor  speech, etc. Chewing is also not optimal and causes digestive disorders.

 

The MFT taught in Basel is called "Basler Lällekonzept der myofunktionellen Therapie". It is a holistic vision of goal-­‐oriented patient care in interdisciplinary work.

 

Speech therapists may also use a craniofacial therapist as a complement to their therapy. The craniofacial therapist does not work on sounds or pronunciation, but on the muscles.

 

The face is an essential part of our identity. It reflects our emotions, allows us to communicate, to have a social life and to have self-­‐confidence. This is why a psychologist may also need interdisciplinary work. Craniofacial therapy  also treats scars (keloids or hypertrophics). Not only for beauty (an important social factor) and self‐image, but also because the skin is an important sensor of our proprioception. Any scar disrupts the fascias and the perception of the body in space.

Therapy can also be useful following operations or accidents. The surgeon may call upon a craniofacial therapist following his operation.

4. The medical approach

The Master Cranio Facial Kinetic science courses also include the study of anatomy as well as the nervous system, digestive system, embryology, skull development, pathophysiology of the stomatognathic system, cranio-mandibular dysfunctions, functional orthodontics, functional optometry, etc.


This knowledge allows the craniofacial therapist to understand and explain to the patient how therapy affects the body's functions to integrate new neurological functional patterns.

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Non-exhaustive examples of possible collaborations based on your profession:

Physiothérapie

Physiotherapist

Osteopath

A patient who does not have a good swallowing pattern with a tongue position under constant pressure on the hyoid bone can benefit from craniofacial therapy at the same time as physiotherapy or osteotherapy. The success of the treatment will be reinforced. The effects will affect the entire posture.

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Family doctor

A person with swallowing problems, an injured patient with scars, unexplained chronic pains (migraines, insomnia, digestion problems, etc.). These pathologies can be caused by poor posture caused by the position of the tongue in the mouth or by an atypical swallowing pattern.

 

A lack of lip tone can also lead to difficulties in drinking and retaining food, which will isolate the person socially.

À l'écoute des poumons de bébé

Pediatrician

Children with plagiocepahlia (with helmets), cleft palates, mouth breathing, language difficulties, hypotonia, disabilities, bad habits such as: pacifiers, sucking their thumb, biting their nails, etc.

 

Stimulating posture often leads to significant improvements in expression. Learning to swallow as an adult allows correct jaw development and acts preventively on dental malocclusions.

 

Difficulties in reading, learning or concentrating can also result from poor posture or insufficient body tone and stabilization.

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Dentist

Orthodontist

Maxillofacial surgeon

Craniofacial therapy follows dental, orthodontic or surgical treatments. It deals with scars, stimulates facial muscles, relieves tension, acts on stress and restores primary orofacial functions following operations.

It also acts on bad habits (pacifiers, sucking their thumb, ...) that disrupt a good development of the jaw and tooth location and is a source of treatment failure or recurrence of disorders.

Examen des oreilles

ENT

Oral breathing does not allow filtration or heating of the air through the nasal passages,  which  results  in  more  frequent  infections.  The  therapy  teaches  the patient to position his tongue correctly in the mouth, and through exercises, to strengthen the lips in order to keep the mouth closed and move to normal nasal breathing. This can also have an impact on snoring.

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Ophthalmologist

Optometrist

Since sight is one of the main sensors of posture, with the deep short muscles of the neck being closely related to the eyes, craniofacial therapy is welcome for tense, stressed patients who have constant pressure on the cervicals. Craniofacial therapy affects the entire posture and can be a complementary aid, just as functional optometry is for successful craniofacial therapy

It is important that the patient situate themselves in space in space to facilitate their daily life. To go further: Complex interactions between eyes and neck, (available in German and French only) by D. Barell

Orthophoniste

Logopedist

Children who lack muscle tone and do not have an aligned posture can benefit from craniofacial therapy, in addition to speech therapy, as well as those with mouth breathing, poor tongue position and persistent infant swallowing.

 Therapy is also effective in getting children out of the habit of having a pacifier and other  bad  habits  that  disrupt  postural  alignment  and  interfere  with  speech therapy.

Myofunctional therapy is not only for the elderly or children with disabilities. There are many atypical swallowings in the adult population that have not been detected and that lead to unexplained chronic pains.

Enfant Psychologue

Psychologist

Recognized therapies

The k-­o‐s‐t®  is very useful for relaxing masseters and the cranio‐mandibular joint in case of bruxism for example. Anxiety and fears bring their share of tensions in the face and neck, which then become tensions throughout the body.

 

Working on posture and face is very useful to develop or restore self­‐confidence. A good  perception  of  your  breathing  relieves  tension. A  patient  suffering  from bruxism followed by a psychologist will need muscle treatment in parallel.

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Educator

Teacher

The  teacher  or  educator  are  important  actors  and  should  be part of  any therapeutic network. Their observations are important for therapists: what are the ergonomics in the classroom, what is the student's behaviour, their dynamics, how is their development?

 

This should not be forgotten, as children spend a lot of time in school or in out-­of-­home care.

 

It is important to know a child's cognitive development to know what can be expected from them in therapy.

Literature: to go further, scientific sources

 
  • Fascias :        

    • Informations about fascias on Tom Myers' website : https://www.anatomytrains.com/

    • GUIMBERTEAU J.Cl. et ARMONSTRONG C. (2015)  - Architecture of Human Living Fascia: The Extracellular Matrix and Cells Revealed Through Endoscopy   - Handspring publishing

    • ARTE sur youtube : Fascinants fascias : The mysterious world under the skin

  • FBL : (German)

    • SPIRGI-GANTERT I. et SUPPÉ B. (20014) - FBL Klein-Vogelbach Funktional Kinetics, Die Grundlagen, 7. Auflage (D) - Springer Verlag

    • SPIRGI-GANTERT I. et al (20016) - FBL Klein-Vogelbach Funktional Kinetics, Ballübungen, 6. Auflage (D) - Springer Verlag

  • MFT : myofunctional therapy   (readings mainly in German) :

    • CODONI S. - various publications to consult here (German)

    • Amazing film to watch (German): the language as you have never seen it before!

    • GARLINER D. (1976) - Myofunctional Therapy - Saunders publication

  • CODONI et al. (2019) - Funktionsorientierte Logopädie: Der Einfluss von Haltung und Bewegung auf Schlucken, Sprechen  
    und Sprache (D) - Springer Verlag

  • Presentation films of the LWZ (Lippen-Wangen-Zunge Trainer) : LWZ films (brochure available in French, request by e-mail to: www.tcfjura.ch)

 

Useful links :

List of qualified therapists

 

Association of craniofacial Therapists (German) :  https://www.fksc-mft.ch/Verband/

Study informations : advanced studies unibas