Download PhysioQfinal[1]

this conference was kindly sponsored by
Myotubular Trust Family Conference
Physiotherapy Questions & Answers
Senior Paediatric Physiotherapists:
Hilary Rattue (HR)
Sarah Protheroe (SP)
Q How can I make stretching exercises less boring and
cumbersome?
SP – It has to be fun. If you are struggling with a long regime
then check – do you need to do it all? You may be better with a
shorted sequence – just doing the vital stuff and making it fun.
Q What is the right age to get moving?
SP - With a very poorly very young child then movement may be
tricky but in general, start as soon as you can.
Q What are best toys to help to get a child moving?
SP & HR - best toys are:
1
2
3
4
Ones you can play in water (sensation, freedom, fun)
Massage (muscle tone and fun)
tickling!
Squeaky toys from a petshop are often easier to squeak
than children’s toys
5 Switches – pressure pads needing only light pressure to
make toys (like bubble machines) work
6 Piano pads
7 Air hockey – particularly small executive toy size
8 10 pin blowing use a shoot as your child can still direct the
ball even if they can’t hold it.
9 Tricycle – even if you push them its good for posture
10bubbles
Ask your physiotherapist which local charities can fund toys. You
can find toys at:

SpaceKraft Limited, Titus House, 29 Saltaire Road,Shipley, West
Yorkshire BD18 3HH tel 01274 581007 www.spacekraft.co.uk


Rompa... the sixth sense tel 0845 230 1177 www.rompa.com
Read SP’s useful ‘hand-out’ below:
LEARNING TO MOVE
What are the benefits of movement?
helps to maximise potential strength
helps to stimulate circulation and lung expansion (except if child is unwell and
being calm may be the priority)
helps child explore and learn about their body and their environment
helps child to interact with others
it’s fun
What role do the muscles play?
to maintain a steady posture (lying, sitting, standing)
to steady and brace one part of the body while another part moves
to bend or straighten a joint, eg bend an elbow or turn your head
to overcome gravity
to overcome friction
to work against opposition to movement, eg tight clothes or tight joints*
to stimulate bone growth through muscle pull on attachments to bone
*tightening of joints and muscles – due to stillness of body or can develop due to
overuse of specific muscles, eg calf muscles tend to tighten and shorten in children who
walk by using maximum tension of the calf muscles
How can I help my child to move?
Reduce the hindering effects of gravity, friction and opposition to movement and offer
physical support to help steady your child as they move. By developing strength,
confidence and pleasure in moving in this way your child may gradually require less
help.
EXAMPLES:
1 supported in side lying – reduces effect of gravity on arm movements
2 hand resting on a toy car or similar – the wheels reduce the friction and make
arm movement easier
3 slippery finger paints – friction free
4 sliding hand up a chalky board is easier than lifting arm up unsupported
5 unrestricting clothing for easier movement
6 Water!
7 hand in a bowl;
8 held on your lap in the bath (please consider safety issues)
9 hydrotherapy pool
10 swimming pool
Desire to move
Movement should be linked to play and fun because your child is pre-programmed to
play in order to learn and your child’s participation, enthusiasm and pleasure will have a
significant impact on the amount your child will gain
Sensory aspects of movement
Movement of muscles to produce controlled useful movement requires knowledge of
body shape, spatial awareness and being familiar with a variety of positions and
sensations.
10 place your child in as many different positions as he can safely tolerate, eg lying
on his side, back, front, held sitting upright, sitting on a trike, sitting on a horse,
standing in a standing frame
11 touch and massage: stroke, tickle, cuddle. Try gentle touch to his head and
face. Bring his hands up to explore his own hair, face, head.
12 Water – the sensation of liquid – varying temperatures (but not too hot to scold!)
13 Vibration – vibrating toys, vibrating cushions – introduce carefully as they take
some getting used to!
14 Textures – vary the textures of toys – soft; hard; rough; smooth, etc
Spine
Weak trunk muscles (spine, abdominal, shoulder and pelvic muscles) lead to a floppy
sitting posture and the child will bend their back into a psotion where they can find
support eg leaning forwards and to one side to rest arm on chair armrest. This is
described as Postural Scoliosis. If the child is stuck permanently in an asymmetrical or
flexed spine posture it is described as a Fixed Scoliosis. A postural scoliosis can
develop into a fixed scoliosis. Seating which promotes a symmetrical upright posture
but also offers support when the child fatigues is helpful. Exercises to maintain
flexibility of the spine can also help.
This information is as “food for thought” only and you should always consult
with your own Physical Therapist before trying something new with your child.