Wednesday, December 14, 2016

Cerebral Palsy and Rehabilitation 101

Cerebral palsy (CP) is an umbrella term that refers to a group of disorders affecting a person's movement. Although it is typically described by impairment of motor function and it primarily affects body movement and muscle coordination, CP is actually caused by brain damage. This brain damage is a non-progressive brain injury of the brain that occurs while a child’s brain is still developing — before birth, during birth, or immediately after birth.

CP affects body movement, muscle control, muscle coordination, muscle tone, reflex, posture and balance, along with fine motor skills, gross motor skills and oral motor functioning. Other impairments may include intellectual impairment, seizures, and vision or hearing impairments.

What makes CP such an umbrella term is that every case is unique to the individual. The type of movement dysfunction, the location and number of limbs involved, as well as the extent of impairment, will vary from one individual to another.

There are many ways to classify CP. Some examples include (but are not limited to):
  • Severity:
    • Mild – child can move without assistance; his or her daily activities are not limited.
    • Moderate – child will need braces, medications, and adaptive technology to accomplish daily activities.
    • Severe – child will require a wheelchair and will have significant challenges in accomplishing daily activities.
    • No CP – child has CP signs, but the impairment was acquired after completion of brain development
  • Topographical:
    • Monoplegia/monoparesis - one limb is affected
    • Hemiplegia/hemiparesis- arm and leg on one side of the body are affected.
    • Diplegia/diparesis - usually indicates the legs are affected more than the arms; primarily affects the lower body,
    • Quadriplegia/quadriparesis - all four limbs are involved
  • Motor Function:
    • Spastic Cerebral Palsy is characterized by increased muscle tone.
    • Non-spastic Cerebral Palsy will exhibit decreased or fluctuating muscle tone.
      • Ataxic/ataxia: affects coordinated movements, balance, posture, walking ability, eye movements, depth perceptions and fine motor skills requiring coordination of the eyes and hands such as writing.
      • Dyskinetic displays as involuntary movements. Athetoid is especially noticable in the arms, legs, and hands. Dystonia/Dystonic is accompanied by an abnormal, sustained posture and affect the trunk muscles more than the limbs.
Rehabilitation will play an important role in coordinating the care of these often very involved patients. Physical, occupational, and speech therapy are available to help with many aspects of care, including, but not limited to, those relating to spasticity management, activities of daily living, communication, and much more.

Physical therapy (PT) will teach the child along with the parents and caregivers exercises and activities that are necessary to help the child reach his or her full potential and improve function. Postural and motor control training is very important and will be a huge focus during PT. Daily range-of-motion exercises are important to prevent or delay contractures that are secondary to spasticity and to maintain the mobility of joints and soft tissues. To improve strength, PT will prescribe and teach progressive resistance exercises to improve function. PTs may refer the child to an orthotist to prescribe bracing to help improve posture and positioning. Some PTs may utilize Kinesio Taping to help in reeducating muscles for stretching and strengthening.

Occupational Therapy (OT) will focus on activities of daily living, such as feeding, dressing, toileting, grooming, and transfers, along with focus on the upper extremity. The goal typically is for the child to function as independently as possible with or without the use of adaptive equipment. Activity-based interventions such as modified constraint-induced movement therapy (mCIMT) and bimanual intensive rehabilitation training (IRP) can be utilized to improve the child’s ability to use the affected extremity and improve independence with self care. Some OTs who are trained in feeding can help with any feeding difficulties that the child may have.

Speech Therapy (ST) will play a big role in helping to improve swallowing and communication. Many children with dyskinetic cerebral palsy and some with spastic cerebral palsy have involvement of the face and oropharynx, causing dysphagia, drooling, and dysarthria. ST may also recommend and teach the child how to use augmentative communication devices if they have some motor control and adequate cognitive skills. Some Speech Language Pathologists (SLP) who are trained in feeding can help with any feeding difficulties that the child may have.

Remember that incorporating play into all of a child's therapies is important. Just like with all of our children that we treat, therapy should be fun, not work! Therapists, parents and caregivers should seek fun and creative ways to motivate children, especially those who have a decreased ability to explore their own environment.

References:
Rehabilitation and Cerebral Palsy (Christine Thorogood, MD, 2013): http://emedicine.medscape.com/article/310740-overview
Types of Cerebral Palsy: http://www.cerebralpalsy.org/about-cerebral-palsy/types-and-forms

DISCLAIMER: "The San Diego Pediatric PT" claims no credit for any images posted on this site unless otherwise noted. Images on this blog are copyright to its respectful owners. If there is an image appearing on this blog that belongs to you and do not wish for it appear on this site, please contact me via e-mail at veronicaglendpt@gmail.com with a link to said image and it will be promptly removed.

Wednesday, November 30, 2016

Clumsy kiddo? Try PT for Balance Training!

Lately I have been evaluating a ton of kiddos who parents say their biggest concern is their child's clumsiness. These kids tend to trip over their own feet, stumble over surface changes, and have difficulty going up and down the stairs safely. While poor balance can be seen in children with diagnoses such as cerebral palsy and Down syndrome, it can also present itself without an official diagnoses.

What many parents don't know is that physical therapy can help with balance training! PT isn't just for children with developmental delays - as Physical Therapists, we are trained to improve or restore mobility, and balance training is one of our expertises!

Earlier this year, Fong et al published a study and found that a specific functional movement–power training program was effective in the enhancement of balance strategies and neuromuscular performance in children with developmental coordination disorder (DCD). It also appears to be effective as a stand-alone intervention designed to improve balance strategies, postural stability, and leg muscle performance. Even if your child does not have a diagnosis of DCD, these exercises can still be taught to your kiddo to help them improve their balance!

Here are the functional movement exercises from that study that you can use with your kiddos who are having trouble balancing:

- Standing balance on a stability trainer! My personal favorite is the dynadisc, but you can also use a BOSU or a rocker board as well. This will help to train bipedal static balance and proprioception. Have them throw and catch a ball or reach for objects around them for a dynamic challenge!


- One-leg balance on the ground! As simple as this exercise is, single leg balance helps to train unilateral static balance and proprioception. When we walk, we spend 40% of the time in swing phase, which means that we are only on one foot during this time, which makes working on single leg balance important for our daily mobility! Once they have mastered this, progress to one-leg balance on a stability trainer.


- Walk along a straight line with heels raised to train dynamic balance and coordination! Progress to heel-to-toe walk along a straight line to facilitate dynamic coordinated muscle contractions in the limbs and trunk.


- Double-leg jump forward! Jumping helps to train dynamic balance and coordination. Progress to single-leg hop forward - aka HOPSCOTCH! This also will help to strengthen the hip and knee extensors and calf muscles. 


- Walk and balance a ball on a plate simultaneously - you can have them play waiter/waitress! This exercises helps to train dynamic balance and coordination!

 

These next sets of exercises are part of the power training program. Have them perform 4 sets of 10 of each of these exercises to improve lower limb muscle strength, power, and contraction speed.

- Squats! You can have them hold onto heavier objects and toys as they progress to make an added strength challenge.


- Hip flexion in supported standing! Have them pretend that they are marching like a soldier. You can use ankle weights or a Theraband for an added strength challenge. Have them unsupported for an added balance challenge! 


- Knee extension in sitting! Just like the hip flexion exercise, you can also use ankle weight or a Theraband for an added strength challenge. To make this exercise more fun, you can have them kick a ball or a balloon!

- Hamstring curls while lying on their stomach, using ankle weights or a Theraband!


- Ankle dorsiflexion! My favorite way to do this exercise is have them sitting on the floor and cue them to "bring their toes towards their nose" while pulling the Theraband.


- Seated calf raises! If this is too easy, have them perform it in standing! Unsupported standing will also be an added balance challenge.


References:

Fong, S. S., Guo, X., Cheng, Y. T., Liu, K. P., Tsang, W. W., Yam, T. T., ... & Macfarlane, D. J. (2016). A Novel Balance Training Program for Children With Developmental Coordination Disorder: A Randomized Controlled Trial. Medicine, 95(16).

DISCLAIMER: "The San Diego Pediatric PT" claims no credit for any images posted on this site unless otherwise noted. Images on this blog are copyright to its respectful owners. If there is an image appearing on this blog that belongs to you and do not wish for it appear on this site, please contact me via e-mail at veronicaglendpt@gmail.com with a link to said image and it will be promptly removed.

Wednesday, November 2, 2016

Physical Therapy and Autism - Why PT is Beneficial!

When a kiddo is diagnosed with Autism Spectrum Disorder (ASD), the services most used for these kiddos include Speech, Occupational Therapy (OT), Applied Behavior Analysis (ABA), and Psych/Special Education(12). Many people don't realize that Physical Therapy is available for these kiddos as well!

Some clinical findings that you may see with kiddos diagnosed with ASD include low promixal muscle tone (especially in their core region), delayed postural reflexes, poor integration of reflexes, difficulty crossing midline, difficulty with visual tracking, reliance on peripheral vision, and difficulty with playground tasks such a catching and kicking a ball(4). Many of these kiddos may have some form of dyspraxia, which is a developmental coordination disorder, and may have poor motor planning - their movement execution is intact, but their movement preparation may be atypical. Kiddos diagnosed with ASD have a lack of anticipation, which can be related to motivation and/or attention(7). They may have difficulty with imitating movements, as they may difficulty perceiving biological motion and their visual attention has less attention to salient aspects of human interaction(9).

So where does PT come in? PT can help your kiddo improve their balance in order to access their environment more safely and independently. Studies show that kiddos diagnosed with ASD have abnormal proprioception, rely mostly on their visual system to maintain their balance, and have difficulty integrating their visual, vestibular, and somatosensory input for balance(5). Physical therapists are trained to help improve balance through a wide variety of static and dynamic tasks.

Gait may also be affected in kiddos diagnosed with ASD. One study found that gait in children with autism was consistent with cerebellar ataxia - they had difficulty walking on a line, had variable stride lengths and gait speeds, and postural abnormalities and asymmetries(8). These kiddos also have difficulty making improvements with external cues such as visual markers. Once they are in action, they have difficult using environmental cues to modify their movement. Physical therapists are experts at gait! We can help your kiddo learn how to walk more safely and effectively to prevent future injury and allow them to access their environment more safely and independently.

Kiddos diagnosed with ASD may also be at risk for becoming overweight/obese and have decreased fitness. Restrictive food preferences and gastrointestinal issues play a big role in overall fitness of kiddos diagnosed with ASD. Their decreased preference for group activities make it challenging for kiddos to participate in physical education class and extracurricular activities(3,6,10,11). Physical therapy can help your child boost their cardiovascular and muscular endurance through fun games and activities to help them stay active and decrease their risk of obesity!

Here are some learning strategies for kiddos diagnosed with ASD(1,2):
  • Focus on specific items in memory tasks rather than relational processing or seeing the whole task. This also relates to movement! For example, instead of focusing on diving into a pool, separate the task into different parts and focus on each part of the sequence of the dive.
  • Use one or two dimension visual aides to help teach a child a task. Because they have difficulty perceiving human motion, having a cartoon picture of someone performing the task or a doll may help them to understand better.
  • If they are also receiving OT and Speech, ask their OT and their SLP how they communicate with the kiddo and what have been the best ways for them to have success. Kiddos diagnosed with ASD do well with structure, so by tailoring your treatment session in a way similar to how their other therapists do their sessions will be beneficial for the kiddo to have success.
References
1. Bowler, D. M., Limoges, E., & Mottron, L. (2009). Different verbal learning strategies in autism spectrum disorder: Evidence from the Rey auditory verbal learning test. Journal of Autism and Developmental Disorders, 39(6), 910-915.
2. Brown, J., Aczel, B., Jiménez, L., Kaufman, S. B., & Grant, K. P. (2010). Intact implicit learning in autism spectrum conditions. The quarterly journal of experimental psychology, 63(9), 1789-1812.
3. Lang, R., Koegel, L. K., Ashbaugh, K., Regester, A., Ence, W., & Smith, W. (2010). Physical exercise and individuals with autism spectrum disorders: A systematic review. Research in Autism Spectrum Disorders, 4(4), 565-576.
4. Ming, X., Brimacombe, M., & Wagner, G. C. (2007). Prevalence of motor impairment in autism spectrum disorders. Brain and Development, 29(9), 565-570.
5. Molloy, C. A., Dietrich, K. N., & Bhattacharya, A. (2003). Postural stability in children with autism spectrum disorder. Journal of autism and developmental disorders, 33(6), 643-652.
6. Rimmer, J. H., Yamaki, K., Lowry, B. M., Wang, E., & Vogel, L. C. (2010). Obesity and obesity‐related secondary conditions in adolescents with intellectual/developmental disabilities. Journal of Intellectual Disability Research, 54(9), 787-794.
7. Rinehart, N. J., Bradshaw, J. L., Brereton, A. V., & Tonge, B. J. (2001). Movement preparation in high-functioning autism and Asperger disorder: a serial choice reaction time task involving motor reprogramming. Journal of autism and developmental disorders, 31(1), 79-88.
8. Rinehart, N. J., Tonge, B. J., Iansek, R., McGinley, J., Brereton, A. V., Enticott, P. G., & Bradshaw, J. L. (2006). Gait function in newly diagnosed children with autism: cerebellar and basal ganglia related motor disorder.Developmental Medicine & Child Neurology, 48(10), 819-824.
9. Rogers, S. J., & Vismara, L. A. (2008). Evidence-based comprehensive treatments for early autism. Journal of Clinical Child & Adolescent Psychology, 37(1), 8-38.
10. Sowa, M., & Meulenbroek, R. (2012). Effects of physical exercise on autism spectrum disorders: a meta-analysis. Research in Autism Spectrum Disorders, 6(1), 46-57.
11. Srinivasan, S. M., Pescatello, L. S., & Bhat, A. N. (2014). Current perspectives on physical activity and exercise recommendations for children and adolescents with autism spectrum disorders. Physical therapy.
12. Wise, M. D., Little, A. A., Holliman, J. B., Wise, P. H., & Wang, C. J. (2010). Can state early intervention programs meet the increased demand of children suspected of having autism spectrum disorders?. Journal of Developmental & Behavioral Pediatrics, 31(6), 469-476.

13. Ronan, S. (2015). An Evidence Based Approach to Gross Motor Dysfunction in Children with Autism [Powerpoint slides]. Retrieved from  Columbia University Program in Physical Therapy.

DISCLAIMER: "The San Diego Pediatric PT" claims no credit for any images posted on this site unless otherwise noted. Images on this blog are copyright to its respectful owners. If there is an image appearing on this blog that belongs to you and do not wish for it appear on this site, please contact me via e-mail at veronicaglendpt@gmail.com with a link to said image and it will be promptly removed.


Thursday, October 27, 2016

Physical Therapy and Down Syndrome

Did you know that October is Down Syndrome Awareness and Acceptance Month? There's no better way to end the month of October with my last blog post of this month focusing on how physical therapy can benefit kiddos with Down Syndrome.

Karyotype of a female with Trisomy 21 (NDSS 2012)

So what exactly is Down Syndrome? It's actually a genetic condition where there is an extra chromosome, located on chromosome 21. This is why you may have also heard of Down Syndrome being called "Trisomy 21," as there are 3 chromosomes located on 21 instead of 2. According to the National Down Syndrome Society, the incidence of Down Syndromes is 1 in every 691 children, and it affects all people of all racial and economic backgrounds.

Every child is unique, therefore every child presents differently. However, some of the classic musculoskeletal signs of Down Syndrome that tend to affect their gross motor development includes poor muscle tone (hypotonia), loose joints (ligamentous laxity), and atlanto-axial instability (AAI).

AAI is excessive movement of the top 2 vertebrae in your spine, which can lead to subluxation. While most kiddos may not show any symptoms, neurological symptoms can occur such as intermittent or progressive weakness, changes in gait pattern or loss of motor skills, loss of bowel or bladder control, increased muscle tone in the legs, or changes in sensation in the hands and feet. Young kiddos with Down Syndrome should get an x-ray and be screened when they're around pre-school age, as screening before that age may be confusing because the bony structures may not show up clearly. High risk activities that should be avoided include tumbling, diving, swimming the butterfly stroke, and collision sports (NDSC 1991).

When working with any kiddo, you have to find their areas of strength and areas of difficulty. Areas of strength for children with Down Syndrome include social skills, learning through visual support, and reading words. These kiddos are some of the most friendly kiddos you'll ever encounter, which make it so much fun to work with them! They enjoy being around people and are very affectionate. Using demonstration, pictures, or gestures are great ways to use visual support to help them learn. 
Some areas of difficulty include motor development, communication, and memory. Their fine and gross motor development may be delayed. Expressive language, including speech clarity and grammar, may be a challenge.

The goals of PT for these kiddos are not necessarily to accelerate the development of a gross motor skill, but to minimize the development of compensatory movement patterns. (Winders 2001). Due to their low muscle tone and their loose joints, many of them often figure out other ways to access their environment. As physical therapists, we want to facilitate a life long love for movement! By teaching them correct movement patterns, we can minimize future injury, improve their strength and balance, so they can access their environment in the best way they can!


According to Patricia Winders, PT, Physical Therapy services should:
  • Be concerned with the kiddo's long-term function
  • Seek to minimize the development of compensatory movement patterns
  • Be based on a thorough understanding of the compensatory movement patterns that children with Down Syndrome are prone to developing
  • Be strategically designed to build strength in the appropriate muscle groups so that they will develop optimal movement patterns
  • Focus on gait, posture and exercise.

Winders wrote a chapter in the book Down Syndrome: What You CAN DO, titled "The goal and opportunity of physical therapy for children with Down syndrome." Winders came up with strategies in working with children with Down Syndrome, which I have found beneficial in my practice. Here are some strategies to use when you are working with these kiddos:


  • Decreased ability to generalize. This means that a skill learned in one setting does not necessarily transfer to another setting. For instance, they may do an awesome job climbing the stairs at home, but when confronted with stairs elsewhere, they may regress to a more primitive stair-climbing strategy until they have relearned the skill in the new setting.
  • Deliver information in small bite-sized pieces. If a child appears to have plateaued with a skill, the problem is most likely because the next piece of information is too large and needs to be further broken down.
  • Structure, consistency and a familiar environment. This is so important if you hope to get the best performance. Do not try something new or challenging when the child is tired, hungry or not at his best for some reason. Minimize distractions for the environment. Remember, quality over quantity!
  • Follow the child's lead. They must be motivated to perform a particular skill. Try to model your style of interaction after the parents' style, since it is familiar to the child and most likely to be successful.
  • Know when to quit. Some will only give you two repetitions at a particular skill and then insist on moving on. Other children will gladly give you a dozen repetitions. Set up the game so that the child is successful and avoid frustration!
  • Be strategic in planning your session. Practice what the child is ready to learn. Tackle the most difficult skills first before the child becomes tired. Alternate difficult tasks with easier ones to give the child time to recover their strength.
  • Be strategic in providing support. Children with Down Syndrome may become quickly dependent on support. Provide as little support as possible while still allowing the child success and remove the support as soon as possible.
  • Skills will be learned grossly at first and then refined. For example, children will initially learn to walk with a wide base and their feet externally rotated. While not an optimal gait pattern, it needs to be allowed initially and then refined through the post-walking skills. 
  • Do not interfere with an established skill in which the child has achieved independence. You will not be successful in introducing change and the child will only experience you as nagging. Change will need to be made at the next level of motor development. For instance, some children, instead of learning to creep on both kn earn to creep on one knee and one foot. Once this pattern has been established and the child is proficient in its use, you will not be successful in altering it and will succeed only in angering the child. Teach the child to use both knees in climbing up stairs rather than interfering with the established pattern.
I hope you found this informative and useful! Please feel free to comment with any questions or concerns you may have!

References
  • National Down Syndrome Society (NDSS) (2012). What is Down Syndrome? Retrieved from: http: //www.ndss.org/Down-Syndrome/ What-Is-Down-Syndrome/ 
  • NDSC Statement On: Atlanto-axial Instability (1991). Position Statement on Atlanto-Axial Instability. Retrieved from: http://www.ndsccenter.org/wp-content/uploads/AtlantoAxial_Instability.pdf
  • Winders, P.C. (2001). The goal and opportunity of physical therapy for children with Down syndrome. Down Syndrome Quarterly, 6(2), 1-5.
  • Yoon, L. (2015). Down Syndrome [Powerpoint slides]. Retrieved from Columbia University Program in Physical Therapy.
DISCLAIMER: "The San Diego Pediatric PT" claims no credit for any images posted on this site unless otherwise noted. Images on this blog are copyright to its respectful owners. If there is an image appearing on this blog that belongs to you and do not wish for it appear on this site, please contact me via e-mail at veronicaglendpt@gmail.com with a link to said image and it will be promptly removed.

Monday, October 24, 2016

Fun Activities with Bean Bags!

Here's a list of awesome ways that the therapists in the Pediatric Physical Therapists Facebook group use bean bags to work on balance, strength, coordination, and more!

- Sit or walk with them on your head to work on good posture!
Image result for bean bag activitiesWalking while balancing a bean bag on his head

- Not only are they good for learning how to throw, but they are also good for learning how to catch - they don't bounce out and they give deeper input! 


- Crab walk and have to keep them on their belly! You can also place bean bags on cones and have them crab walk and kick them off cones!


- Cross midline to put them from floor to a bucket on their other side!

Crossing the midline with a bean bag toss

- Put them on the top of the feet to work on heel walking, and don't let them fall off! Great activity for our toe walkers to strengthen the ankle dorsiflexors and promote posterior weight shifting!
- Creeping with them on the back and then "dump truck" them off by going into tall kneel!

- Pick them up with toes to place in a bucket - you can do this either in sitting or standing to work on single leg stance!

- Place them on the ground near the balance beam, have them sidestep across the beam, and when they come across the bean bag, they have to squat down to pick it up and maintain balance - Good for posterior weight shifting too for kiddos that toe walk and are too anterior!

- Hold it between their ear and shoulder and carry it to a target to work on active sidebending - great for older kids with torticollis!

- Have them standing on a dynadysc or balance board and toss them to you as you move around them to practice throwing to a target, trunk rotation and standing dynamic balance! 

- To make crunches fun! Have them lay on their back over a Swiss ball, grab a bean bag and use core strength to sit up so they can throw them in a bucket!

- Throw them while doing tall kneel/half kneel on a swing!

- Bear walk and use foot or hand to knock them off top of cones!

- Place them under a yoga mat at all different spots to make uneven terrain!

DISCLAIMER: "The San Diego Pediatric PT" claims no credit for any images posted on this site unless otherwise noted. Images on this blog are copyright to its respectful owners. If there is an image appearing on this blog that belongs to you and do not wish for it appear on this site, please contact me via e-mail at veronicaglendpt@gmail.com with a link to said image and it will be promptly removed.

Friday, October 21, 2016

Fun Activities with Hula Hoops!

Growing up dancing Hula and Tahitian, no toy was more fun to show off to my friends than the hula hoop! Here are other ways that the therapists in the Pediatric Physical Therapists group use a hula hoop to work on strength, balance, and reaching those gross motor milestones!
  • Jump in/out to work on jumping forward and over obstacles - easy clean up hop scotch! 
              
  • Hold them vertically and have kids step in and out - great way to work on single leg balance and body awareness!
  • Jump Rope with the Hula Hoop! - talk about coordination!
  • Have them catch the hoop - have the kiddo stand beside you, roll it down a long hall to see if they can catch up to it and stop it. You can also play "catch" by rolling it back and forth between you and the kiddo! 
  • Roll the hula hoop while they try to jump/crawl through on the run - great for projected action sequences for higher level kiddos! 
  • For kids learning to walk, have them hold onto an end while you hold onto other end. You can also use this to practice walking backwards too!
  • Use it as a target for throwing bean bags!
  • Crab walk across a pathway of vertical hoops without touching their feet or hands on them - added challenge to the basic crab walk!
  • Use a hula hoop as a place marker - good for teaching ball skills! Have them stand inside the hula hoop so they don't walk closer to the target!
  • Place at the bottom of the stairs as a "puddle" to jump into
  • Have them pull you on scooterboard while you both hold onto the hula hoop - or vice versa!
  • Hold on to hoop while kneeling on airex pad or rocker board to play "tug of war!
  • Use one in the center and ones all around like a flower and have them jump forward and sideways in a flower pattern coming back to center each time!
  • If you have other kiddos around, make a large circle with all of them holding onto the hula hoop and if when you say freeze they have to stand on 1 foot
  • Use both hands to pick them up and to to put over large cones to work on bilateral coordination
  • Step in/out to work on single leg balance and safety awareness!
  • Remember the game Skip-It? Use the hula hoop spinning it around 1 ankle while hopping over it with the other!
  • Use them in an obstacle courses - either place them at a certain distance to jump into, or hop or stand on one foot in them!
Comment on this post if you have any other creative activities!

DISCLAIMER: "The San Diego Pediatric PT" claims no credit for any images posted on this site unless otherwise noted. Images on this blog are copyright to its respectful owners. If there is an image appearing on this blog that belongs to you and do not wish for it appear on this site, please contact me via e-mail at veronicaglendpt@gmail.com with a link to said image and it will be promptly removed.

Monday, October 17, 2016

Fun Activities with a Yoga Mat!

Yoga mats are a great tool to use not just for yoga, but for therapeutic activities as well! Here is the list compiled by the Pediatrics Physical Therapy Facebook group of fun activities you can do using yoga mats!

  • Easy DIY traveling hopscotch - great for jumping practice!



  • Hamstring Stretch - roll part of the yoga mat to help those kiddos who have trouble getting a full hamstring stretch!



  • Use a mat to work on maintaining a straight path for target practice! 



  • Balance practice - an easy clean up balance beam, great for practicing tandem stance on a rolled up mat! 



  • Use a rolled up yoga mat placed horizontally tapped down with painters tape for stepping on top and down or over! 



  • Rolled up yoga mat with heels on ground and toes on mat - great for our toe walkers who need a passive calf stretch in standing!



  • Roll or scrunch up a mat to use to support babies into quadruped!



  • To practice walking or crawling over uneven surfaces, place pillows, surfboards, large bubble wrap, etc underneath the yoga mat! Add a tunnel over this surface for an additional crawling challenge!



  • Use tape to place lines for jumping with measured out distances and the other side has a straight line for heel to toe walking, walking sideways, and walking backwards - great for those home care PT's who travel!

 

  • Cut one a yoga mat for a non skid, easy to clean padded surface! Great for inclines or a large plastic adapted swing!


  • Tall kneeling with knees on rolled up yoga mat with or without feet on ground - add reaching and midline crossing activities to really work on balance! You can also do this in 1/2 kneel with front foot or back knee on rolled up mat!
  • For the little ones, use it as a bolster to have babies straddle and reach down to pick up toys or puzzle pieces for the toddlers!

If you have any more great ideas, please feel free to comment!

DISCLAIMER: "The San Diego Pediatric PT" claims no credit for any images posted on this site unless otherwise noted. Images on this blog are copyright to its respectful owners. If there is an image appearing on this blog that belongs to you and do not wish for it appear on this site, please contact me via e-mail at veronicaglendpt@gmail.com with a link to said image and it will be promptly removed.

Thursday, October 13, 2016

Fun Activities with a Scooter Board!

This is one of my all-time favorite pieces of equipment to use with my kiddos - a scooter board! Mahalo once again to the amazing therapists in Pediatric Physical Therapists Facebook group for all their ideas and to help me compile this list!
  • Sit and use plungers to propel themselves - great for core and arm strength!
  • Slide down ramps on stomach - not only is this super fun, but it's a great way to work on back and leg extension as well!
  • Crawling - place hands on scooter board to focus on lower extremity dissociation
  • Sitting scoot - great to strengthen the hamstrings!

  • Hands or feet on scooter in plank position while sliding in and out - an insane core workout!

 
  • While laying on the scooter board, push feet off wall to propel into bowling pins with head - silly and fun game while strengthening those legs and performing anti-gravity squats!


  • Kneel on scooter and use hands on floor to propel - talk about a core and upper body workout! Can also do this when laying on stomach for more of an isolated upper body workout!

 

  • Scooter soccer - an awesome dynamic core workout!


  • Pulling self on rope while laying on stomach - great for upper trunk extension!


  • Go "Fishing!" Have them scoot to get something, throw them a rope and have them reel themselves in!
  • Tall kneel balance while playing catch or rolling large theraball with them - now that's some great dynamic training!
  • Bridge exercises, placing feet on scooter board for an added challenge!
  • "Inchworms" - place hands on scooter board while standing and "inchworm" their way across the room, pushing the board out as far as they can with their hands then taking small steps back up to their hands.
Comment if you have any more suggestions on fun activities using the scooter board!

DISCLAIMER: "The San Diego Pediatric PT" claims no credit for any images posted on this site unless otherwise noted. Images on this blog are copyright to its respectful owners. If there is an image appearing on this blog that belongs to you and do not wish for it appear on this site, please contact me via e-mail at veronicaglendpt@gmail.com with a link to said image and it will be promptly removed.