head control exercises

[ansam mahmod]

hi ,im needs for control head exercises for cp child or pku. he is have hypotonia on head and trunk unbalance


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[estherderu]

dear Ansam,

It is not easy to give you an answer to your question, because we cannot see and observe the child you are treating.
How old is the child? Is he or she mentally able? I do not understand, does the child have CP or PKU?

I suggest you go to SfA Resources for Parents, Teachers and Therapists | skillsforaction.com site.
On this site you will find a lot of information and practical ideas.
You can also check this forum carefully. I suggest you look at all the mails in the paediatric section.

The problem you address has been spoken of before. Maybe you can read the posts and that will help you as well.

kind regards

Esther

[ansam mahmod]

thanks 4 ur respond,on this website u will show my px ali pku chil due to cp and didnt have balance on head or trunk his case very late development as children 3 years unbalance this px take courses physical therpay when he was 6 month and non progress ,mmmmmm do think he will walk in one day with this later ,see on its ali pku - YouTube

[estherderu]

Thank you Ansam, and please thank his parents for allowing us to see him.

I need to ask you a few more questions.
Are you treating him alone? I understand you are a student.
Do you have a paediatric physiotherapist, or a university tutor you can consult and who can help you with this child?
Am I right in understanding that he did recieve physiotherapy when he was 6 months?
Did he recieve therapy for a long time? What did the treatment consist of?

Do you have any books on young infants that you can check?
Please take a good look at the website I linked in the mail. You will learn a lot there.

kind regards

Esther

[ansam mahmod]

thanks ester for ur interest ok i will respond on ur equation ,firstly im graduated last month and i didnt treat him before discuss and make plane on everything on his case as u show its very late motor development ,i visited hip physiotherapist who was works with him and i show they boring ,this children take course when he was 6 month as i told u and his family very interesting on his situation and do anything physiotherapist told them, so the mean reason made me go to asking because their boring from him no progress ,the programme which the child take it ,passive ROM.motor learning ,and last month as i hear from the physiotherapist ali have spasticity on upper limb than upper now on one month upper become flaccid and lower slight spastic ,this answer on ur asking if u want any information to solve with me this case pleas im here

[junior_physiotherapist]

Therapeutic Exercise
The exercise program should be developed in relation to the assessment of the child, the identified long- and short-term goals, and the functional abilities of the child.
Upgrade the difficulty of the program to progress the child to greater achievement in strength, endurance, and coordination.
Active movement and much repetition are needed for a child to "learn" a movement.
Avoid prolonged holding in static positions during treatment (smoothly graded transitions in movement with brief holding of midline or neutral alignment is more desirable)

---------- Post added at 07:38 PM ---------- Previous post was at 07:37 PM ----------

..............Imposed weight shifts and transitions in move*ment should be varied, both in speed and range, so that the child cannot anticipate rhythmic displacements.
Weight shifts and transitions in movement must be practiced in different positions for improved function.
Focus on:
Strength.
Endurance.
Balance and coordination.
Dissociation (break of mass movement).
Use of external support
Address the sensory problems
Address musculoskeletal changes.

---------- Post added at 07:39 PM ---------- Previous post was at 07:38 PM ----------

...........To increase strength:
Progress the movement from a gravity-eliminated movement to one that is working against gravity,
Alter the amount of assistance given by the therapist so that the child has to use greater force and control.
Specific resistance exercise for targeted area
To improve endurance:
Increasing the number of repetitions of a movement
Lengthening the time of exercise.
...............Dissociation:
Focus on dissociation of one limb from the opposite limb and limbs from body.
Emphasis should be placed on achieving greater differentiation of the joints within a limb as well.

---------- Post added at 07:39 PM ---------- Previous post was at 07:39 PM ----------

...............Use of external support:
E.g., therapist's hands or a piece of equipment
Can be used to provide initial support to inhibit excessive stiffness, maintain alignment, initiate a weight shift, support a movement, or aid smooth transitions of movement.
Should be altered intermittently at first to provide the child with an opportunity to practice the movement independently.
Move the support from a proximal point (trunk, shoulder, or pelvis) to a more distal point along the limb → child will assume a greater degree of control over the movement at the unsupported joints.

---------- Post added at 07:41 PM ---------- Previous post was at 07:39 PM ----------

Examples of Activities in Therapeutic Session
Child side-lying, head supported on small pillow or towel; therapist's hands on child's abdominal muscles; lower extremities dissociated or symmetrically flexed; toy placed in front of child at chest level

Maintains head in line with trunk; sensory input to abdominal muscles; will encourage downward gaze, flexion of neck, and shoulder flexion in gravity-eliminated position; will provide a midline orientation of the body

---------- Post added at 07:42 PM ---------- Previous post was at 07:41 PM ----------

From side-lying, backward weight shift into supine with buttocks maintained elevated off the support with hips and knees flexed; lower extremities just outside lateral dimensions of trunk


Activation of axial flexors and antigravity movement of upper extremities; elongation of axial and hip extensors.

---------- Post added at 07:43 PM ---------- Previous post was at 07:42 PM ----------

Some book might be of help!

REQUIRED AND RECOMMENDED TEXTBOOKS AND READINGS:
• Campbell, S., Vander Linden, D.W., Palisano, R.J. (2005) Physical Therapy for children. Third edition, W .B. Saunders Company, Philadelphia.
• Campbell, S . (1999) Decision Making in Pediatric Neurological Physical Therapy. Churchill Livingstone, New York.
• Tecklin, J. (2007) Pediatric Physical Therapy. Fourth edition, Lippincott Williams