Bugnet Postural Resistance Therapy
H.G. van Wermeskerken and G.H. Lenselink - Kamphuis
The essence of the Bugnet method is to maintain your posture while meeting resistance. ‘The Bugnet exercises give you the feeling that you are in control of your muscles', says Margreet Jonkers - van Gunsteren (65). As a baby she developed polio and was almost completely paralysed. Her illness was the reason the Bugnet method was introduced to The Netherlands.
‘You feel physically better, you can do more and that has an affect on your mental well-being. "Bugnet makes you happy."'
In the nineteen-fifties a polio epidemic in The Netherlands caused serious handicaps to the locomotor apparatus- including paresis and paralysis. Many patients were desperately searching for effective therapies, and over the years, could visit ten to twenty different therapists looking for help with rehabilitation. One of those patients was Margreet Jonkers - van Gunsteren. Her mother gathered information from home and abroad, looking for the one therapy for her daughter's future development. She met Madame Bugnet, who made use of posture and movement patterns: neuromyotherapy. In fact she was building up a facility technique, the same as was used later in the P.N.F. method by Knott and Voss. Madame Bugnet's method proved to work for many polio patients.
Hypermobility / HMS
In practice the method proved to be more widely applicable as a form of therapy in physiotherapy. The exercises, working on the basis of posture reflexes, can be a valuable addition to physiotherapy because posture stability is the basis for functional movement. Patients with various neurological disorders, (i.e. hemiplegia, spina bifida, peripheral neuropathy, dystonia), orthopaedic disorders (scoliosis, posture deviations of joints), post-operative conditions and patients with symptoms resulting from diminished strength of the posture and locomotor apparatus such as hypermobility/HMS benefit from the Bugnet training. In the present setting Bugnet also offers, besides the therapy, the valuable opportunity of a rehabilitation programme that is suitable for do-it-yourself training. The physiotherapist can instruct the patient in a relatively short time and then only needs to supervise now and again.
Intensive exercise programme
Whoever meets Margreet Jonkers can only be impressed by her lust for life and her strength. After a career as a singer and singing master and then later as a spiritual assistant and chaplain, she started her own practice last year as an independent spiritual assistant. Moreover Margreet is the mother of two children. All this was not exactly expected when she, a baby of one year old, could only move her head and her right hand after contracting polio. Margreet has much to thank her mother Mrs. W. van Gunsteren for. ‘She was tireless in her search for therapy for me because she realised that muscles that are not used will atrophy, they will lose their strength. When I was five years old my mother discovered Madame Bugnet's method in Paris. And it worked. After three months of exercising I fell out of bed and broke my leg. Up until then a bed rail had not been necessary, I couldn't move anyway but that had now changed. An intensive exercise programme, carried out with iron discipline for as long as I was growing, ensured that I progressed slowly but surely'.
After the great polio epidemic of 1956 a vaccine was discovered and the illness has been almost completely banished since then, at least in the western world. Polio often starts in the limbs and affects the breathing and the lungs at a later stage. Luckily the illness did not go so far with Margreet; her breathing has always functioned properly. Margreet is in a wheel-chair.
‘Thanks to the Bugnet exercises I can sit, and that means I can lead a fairly normal life. I can do absolutely nothing with my shoulder girdles. I can bend my left arm but not my right, although my right hand functions well. So I lift up my right hand with my left arm. That way I can play piano, although of course I can't hit all the notes properly. Because my left arm had a contracture towards the outside, it was broken on purpose when I was about twelve. The surgeon allowed the arm to heal while it was twisted so that the position of my left hand has been good since then'.
There were six children in the Van Gunsteren family. Despite her limitations and the intensive exercise programme, Margreet grew up as normally as was possible. She played "it" with children from the neighbourhood while being pushed around in a wheel chair, racing around on two wheels. She was teased by her brothers and sisters, but one rule applied: if Margreet needed help that had to be given despite the game and despite quarrels. Margreet, ‘This way I felt that I could just join in with the other children; that I counted. At school I also joined in as much as possible. I fell out of my wheel chair often enough if my friends pushed me over a bump they hadn't seen. "Don't pick me up!" I would shout. One of my brothers was fetched so that he could put me back in my wheelchair like the professionals would. You can't just pull my arm because it will become dislocated.'
Just like her peers Margreet left home when she was eighteen. She went to study theology and lived in Amsterdam. "Of course I had help; every morning someone would come to help me get up, washed and dressed. Friends fetched me for the lectures and took me home again. I had a special stair chair to get up and down the stairs, a sort of steel stretcher with handles and on wheels that was carried by four people so I could visit other student rooms and the students' union. If there was a lot of drinking going on, I made sure that two friends with high levels of responsibility would be the bearers. I had a lovely time as a student. Although naturally it sometimes went wrong; sometimes I would fall out of my chair in the evening and only be found the following morning.'
During that period Margreet exercised three times a week with her friends' help. She also swam once a week. A distinctive feature of Bugnet is that the patient does the exercises himself, assisted by one or more helpers.
When Margreet was twenty-two she married fellow-student Aad Jonkers. Since then he has become Margreets' most important helper. When the couple had children someone came to help in the house. "And to do things with the children, such as skating', says Margreet. ‘I wanted to give them a normal life even though I couldn't do everything with them. When they were little I used to go outside with them on a sort of leash. They did not have bed rails because if Aad wasn't home and a fire started, I couldn't help them get out of bed.'
Margreet is certain that she has much to thank Bugnet for. ‘You feel stronger because you have to work against resistance during the exercises and still keep the same position. You have the control over your posture. That is a completely different feeling to when you have to move in ways you really aren't able to: that affects your self-confidence. By manipulating the muscle involved during a certain exercise, something happens to that muscle and you can tense it even though that was not possible at first. That gives you a fantastic feeling: I can do it! Good posture is important. If I sit up straight I can literally feel that it's good, that everything is all right. My posture has repercussions on my feelings. That's why I say: "Bugnet makes you happy."
With Bugnet it is important that there is enough space. It is important that you have space in the joint to be able to loosen it up and then it works. If you have the space you can achieve something. I notice that not only physically, but also mentally. You need inner space to be able to face up to life well. It means that you know what you want and what you have to do to make it possible. Those that have inner space are able to relate in freedom and peace to all the emotions and attitudes summoned up by a situation. The thoughts and ideas of others for instance. Inner space ensures that you can cope. That is very important in my profession as a spiritual assistant.
· W. van Gunsteren, O. de Richemont and L. van Wermeskerken, Bugnet Posture Resistance Therapy, Frederik Hendrik Stichting, The Hague, 1984 (available from Bugnet Stichting Nederland,(www.stichting-bugnet.eu)
- W. van Gunsteren, O. de Richemont and L. van Wermeskerken, Muscle Training with Postural Resistance, Eburon, Delft, 2004 (translation)