|As one of the many news reports of the Fritzl captivity in Austria filled our TV screens last week, I happened to watch some local children playing football outside on a fine early May evening. Struck by the natural careless beauty of our children playing joyously outside, I found myself contrasting these children’s relaxed movements with the physically restricting conditions the Fritzl children and their mother have endured for so many years and in the children’s case, for all their lives. |
Whilst obviously this tortured family will need huge psychological guidance to begin to come to terms with their past and prepare for a very different future, I could not help but think how health professionals will begin to address physical deconditioning from years spent living in such cramped conditions.
Extreme physical, let alone psychological deconditioning presents great challenges in rehabilitation. For a start, in terms of the children, having no exposure to Vitamin D via everyday sunlight is likely to have had serious consequences for the inherent strength of their bones. Without Vitamin D bones become brittle. Bone strength is also determined also by genetics, diet and demand placed on the bony structure.
It appears likely that the Fritzl children have not had access to the 5 fruit and veg a day that is considered optimal in the developed world. On a simple level graduated exposure to sunlight, a better diet and appropriately prescribed vitamin supplements will make a huge difference to their bone health.
Speed of healing within the body depends on many factors, but is at it’s greatest up to early adulthood. The rate of cell turnover in children far exceeds that of adults. This means the children’s musculo-skeletal system has every chance of recovering well. Unfortunately, from news descriptions of their mother, it may be that her bones may already be significantly more demineralised and osteoporotic than similarly aged women leading normal active lives. Restoring her bone health may not be as straightforward as her children’s.
Both bone and muscle density and strength respond to physical demand. In general, the more stress in terms of physical activity placed on the body, the fitter it becomes. Obviously, living in such a low cellar of tiny dimensions suggests that this families’ inherent fitness must be abnormally compromised.
I am sure that by now their physical fitness has been examined in detail. A rehabilitation regime has probably already commenced for their physical recovery. From the heart muscle, to muscles of respiration, muscles of the spine and limbs, a graduated programme will be required to address recovery of each component. General fitness, joint and muscle flexibility, muscle strength and physical endurance all need a separate focus.
Careful consideration and ongoing monitoring will be necessary to prevent weakened skeletal and muscular systems being is pushed too hard too soon. These debilitated bodies will much more prone to local soft tissue injury than the normal population.
Posture will be a big issue for the older children and their mother. I can only imagine how tiring they will find it to restrengthen their neck muscles having spent years stooping under low ceilings, never being able to stand up straight. The weight of the head on damaged neck muscles, such as after a car crash presents a challenge for many patients undergoing physiotherapy as we speak. Think how much more difficult it will be to address years of stooped posture.
However the physical freedom of being able to stand up straight, walk, run, sit and stand without gross restriction must provide a great starting point for all professionals in this difficult and thankfully rare case. Just being able to use all their five senses , to see, hear, touch, taste and smell the world we all know and often forget about as it surrounds us must be capable of bringing joy to these tortured souls and bodies.
Improving physical status can be a powerful path towards addressing psychological wellbeing. The old adage ‘a healthy body creates a healthy mind’ is surely well placed here. Hopefully, using the physical route will places the Fritzl survivors securely on the path to a new life