Activity, activity, activity new approach in CP

[Bobby Nabeyama]

Hi Bobby,

Nice to see you around again here.
This news is certainly sad and disturbing.
Can you say this is the case in the whole of the U.S.A.? and how about Canada?

I would say that things are different in the northern European countries.

I know how difficult it is to let go of something you have done so much with (in my case Vojta and Bobath therapy for example).
But from experience I can say that the knowledge (+ practical bits) I learned from these courses are still implemented (a little)... but coming from a very different thinking process with different goals and as part of functional movement training.

It is not hard to do,
and it actually increases the scope of your practical skills and possibilities if you dare think in function.....

I do hope people will be inspired and try.
I have noticed that a number of young physio's I have worked with here in Spain do not find it difficult to think in function because it is so logical. It might even be easiest if you have not had any prior training in a given method.

Parents understand fully straight away and are sometimes even better at creating goals and steps to reach these goals than we are. (sitting on toilet seat alone and sliding off the toilet seat was an example parents came with for their 4 yr old quadriplegic child)

I have been joined here by Pam Versfeld who also has a fantastic site with lots of practical information.
Movement therapy for children web-manual | skillsforaction.com


kind regards

Esther

Hello Esther. Always nice to see you around as well.

Purely based on anecdote, I would say that most clinicians do not treat nor have goals that are activity-based. This a generalization, obviously. I don't have "data." : ) Anyone else in the States might say, "I don't know what Bobby Nabeyama speaks about cause everyone I know emphasizes function."

I beg to differ because I still see kids on physioballs everyday working of "trunk control" and "core strength." Also, I do see goals of "transitioning from half knee to stand." We had a prominent Listserve affiliated with the Pediatric Section of the American Physical Therapy Association (APTA) that did have high traffic. Every other day someone spoke of impairment-based treatments or goals while at the same time speaking of function. This appeared to me as clinicians were unaware whether they are treating on the impairment or activity/functional level. Pure ignorance.

Anyway, there are optimistic signs of changes as the literature has spoken more and more of activity-based treatment and goals. I assume that clinical practice always follows the literature. More and more NDT and SI courses are forced to or just speak of function, too.