A child hasn't weight bearing

[muhana85d]

Hello everyone

I working in Pediatric hospital and one of my patient is a child 13 month old, she unable to stand and mainly there is no weight bearing, when I hold the child in upright position she flex her hips, knees and
ankles.
child able to roll and sit and creep and also has good recognition.
she recieved 15 treatment session of weight bearing ex's and passive ROM
and place her on stand table.and no improvment

My Question. Is there any new suggest ex's or technique to deal with this case ?

And thank you

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[estherderu]

Yes, dear colleague,

Why do you want this child to bear weight?
What is the childs' diagnosis?
What is your therapy goal?

Are you aware that some children do not start to bear weight untill they are older?

The fact that she is crawling is a good sign, that means she is actually weightbearing (hips) a little, that is a good first step....

I would say the best therapy might possibly be... wait and give her some time. Try to see which signals she is sending you, what can she do. Children that are hypermobile, hypotoon, have pain are often late with their milestones.......


Do tell us more, it is always hard to give advice when you cannot see the child.......

There is a lot of literature on VARIABLITY of milestones and , speaking from the childs perspective, manners to reach a new movement goal.
Children can be delightfully creative in moving.

Esther

[muhana85d]

Thank you very much

I will give you more information about this case
She 13 month old
she had done a CT scan before 3 month and show mild brain atrophy
but other medical and lab. analysis are normal

You know that's every baby has a step and automatic
walk reflex

But as mother's child said, she didn't has those tow
reflex after birth

After assessment child unable to place her feet on floor and when I hold her in stand position she flex her hips and knees and no erection of lower limbs.

My treatment goal is to acheive standing and weight bearing

So what's your suggestion for plan of treatment

[PamVersfeld]

Hi

Esther Is correct - typically developing children do reach their milestones at different ages, and hypermobile infants tend to be later than the norms.

However, the fact that the baby has mild atrophy suggests that she may need some extra help in developing the basic skills.

The tendency to lift the legs up is called "sitting on air" and is associated with something called "dissociation of maturation" (See Dissociation of motor maturation. [J Child Neurol. 2003] - PubMed result)

Passive standing is not going to develop the strength needed for standing.

You need to get this baby pulling herself up into standing. This is easier from a position with the baby sitting on a low step in front of a small table - get her to stand up from this position. If her legs tend to flop out to the side, you may need to help her to keep them in line with her hips by holding her thighs straight and keeping her feet flat on the floor.

Also let her stand on her knees in front of a low step - and get her moving from sitting to kneeling, in preparation for getting up into standing.

You will find many of these activities described in detail at Babies and toddlers with low muscle tone and joint hypermobility | skillsforaction.com.

(These pages are going to be updated in April with video clips showing the different activities. If you would like to receive news of the updates, please subscribe as a user to receive the skillsforaction.com newsletter.)

Pam

[estherderu]

Dear Muhana,

I agree fully with Pam, that in the case of brain atrophy you need to stimulate the child, not wait and see.
Her site is wonderful and contains very practical information.

More information on variability of movement can be found on the following website Karen E. Adolph > Home

Esther

[illuminatidinesh]

However, the fact that the baby has mild atrophy suggests that she may need some extra help in developing the basic skills.

Correct the atrophy in the brain might slow her development. U need to assist her in this case.

I working in Pediatric hospital and one of my patient is a child 13 month old, she unable to stand and mainly there is no weight bearing, when I hold the child in upright position she flex her hips, knees and
ankles.

This might suggest that she could have set flexor tone. First U need to break that. Lifting and carrying positions also help s here.

child able to roll and sit and creep and also has good recognition.
she received 15 treatment session of weight bearing ex's and passive ROM
and place her on stand table.and no improvement

Creeping indicates that the child weight bears on shoulders and hips, now the question is has the dissociation taken place ? From ur post I doubt it.

[daniel_sadana80]

Hello,
I working in Pediatric hospital and one of my patient is a child 13 month old, she unable to stand and mainly there is no weight bearing, when I hold the child in upright position she flex her hips, knees and
ankles.
child able to roll and sit and creep and also has good recognition.
she recieved 15 treatment session of weight bearing ex's and passive ROM
and place her on stand table.and no improvment

My Question. Is there any new suggest ex's or technique to deal with this case ?
I just want to help... maybe you can give the position first and just give engram for usual. and after that i always treat in kneeling and crawling for proprioseptive improvement... and after that we start to weight shifting..
that's all,,

may be it can help..
thanks,
Daniel

[illuminatidinesh]

I just want to help... maybe you can give the position first and just give engram for usual. and after that i always treat in kneeling and crawling for proprioseptive improvement... and after that we start to weight shifting..
that's all,,

may be it can help..
thanks,
Daniel

Exactly My thought but I think It would be better if U could elaborate in ur tech. Our friend needs it.