Co-ordination Disorders in Children (Part 3)

Therapeutic approaches for coordination disorders(CD)

Sensory IntegrationandOccupational Therapy approaches  that can support the child with Coordination Disorder and their carers include:

1.           Observing the child during play and formal assessment to determine the child’s abilities with gross motor (whole body) tasks and then making recommendations for management.

2.           Devise goals: Setting functional goals in collaboration with the child, parents and teachers so that therapy has a common focus beneficial to everyone involved.

3.           Educating parents, carers and teachers about coordination disorder,  age appropriate skills a child should be demonstrating and providing management strategies/ideas to assist the child in the home, at school and in the community.

4.           Physical skills: Providing ways/ideas to promote physical activity and participation in team/group activities.

5.           Underlying skills: Developing the underlying skills necessary to support whole body (gross motor) and hand dexterity (fine motor) skills, such as providing activities to support:

1.           Balance and coordination

2.           Strength and endurance

3.           Attention and alertness

4.           Body awareness

5.           Movement planning

6.           Direct skill teaching through a task based approach.

7.           Confidence: Building self-confidence to enable a child to willingly participate (it is common for these children to shut down when they perceive the task to be too hard) in activities by:

 

1.         Providing the child with education about why they may be experiencing difficulties with movement, their strengths as well as their                weaknesses and providing them with and teaching them strategies to overcome obstacles they may face.

2.        Breaking down specific physical skills into one or two step components to teach the skill and then gradually adding in new components until  the skill is doable in its entirety (e.g. skipping – start with a step, then a hop).

3.           Providing opportunities and strategies to master the same skill in differing environments (e.g. home versus school versus. therapy session).

4.           Presenting the activities at the ‘just right challenge’ level to provide success and then gradually increasing the demands of a mastered skill.

8.         Educating parents and carers on ways to simplify tasks to the smallest possible components and use simple and concise language.

9.         Non-verbal cues: Using physical and visual models or instructions, wherever possible, not just verbal.

10.       Sensory processing: Improving sensory processing to ensure appropriate attention and arousal to attempt the tasks as well as ensuring the body is receiving and interpreting the correct messages from the muscles in terms of their position and relationship to each other.

11.       Multi-sensory approach: Using a multi-sensory approach to learning new skills.

12.       Modelling tasks visually and using hands-on adjustment techniques to aid body awareness for the child.

 

By

S.Mariappan

Sensory Integeration Therapist

Life Healthcare Rehabilitation Clinic Pl

moses.lhc@gmail.com 

Balance Exercises for 50+ (Part 4)

Exercise 4: WEIGHT ­SHIFT ON BALANCE BOARD WHILE SQUATTING AND THEN REACHING UPWARDS

                                                                                

Starting Position

Stand on a balance board with feet shoulder width apart. Hold a stick with both hands in front of you.

Movement

1. Squat down by bending your knees and hips, let the stick touch the front of your thigh. 

2. Straighten your body.

3. Reaching upwards out to the right. Squat down again and then

straighten up reaching upwards out to the left. Repeat the movement

from one side to the other. Repeat - 5 to 10 times

Exercise 5: ROCKING MOVEMENT SEATED ON AN EXERCISE BALL

Starting Position

Sit on an exercise ball with your back straight, both feet flat on the floor.

Movement

Shift your weight from one buttock to the other, let the ball follow the body movement. Repeat the movement from one side to the other for 20 times.

Exercise 5: SEATED BALANCE AND KNEE EXTENSION EXERCISE ON AN EXERCISE BALL

Starting Position

Sit on an exercise ball, with arms by your side, hold your hands on the

ball for support.

Movement

Lift your left leg to hip height or straighten it and place it on the floor in

front of you. Keep your back straight. Bend your leg and lower your

foot to the floor. Repeat 8­12 times. Repeat with your right leg.

Exercise 6: SQUAT ON A BALANCE BOARD WITH A STICK ON THE SHOULDERS

  

Starting Position

Stand on a balance board with feet shoulder width apart . Hold a stick with both hands and bring it on to your shoulders.

Movement

Bend your hips and knees and squat down to a sitting position. At the same time, allow your trunk to lean forward while keeping your back straight. Return to the starting position. Repeat - 20 times

Continue Part 5,.

Co-ordination - Part 2 (Coordination Disorders In Children)

Effects of Coordination Disorders in children

Children described using the term coordination difficulties cannot have their difficulties with movement explained by a general medical condition (Cerebral Palsy, Hemiplegia or Muscular Dystrophy) and the criteria should not meet Pervasive Developmental Disorder (PDD)

Children who have  coordination disorder may also have one or more of these co-morbid conditions: 

·       Attention deficit hyperactivity disorder (ADHD) (inattention, hyperactivity, impulsive behaviour)

·         Autism spectrum disorder.

·         Dyscalculia (difficulty with numbers).

·         Dysgraphia (an inability to write neatly or draw).

·         Dyslexia (difficulty with reading and spelling).

·         Hypotonia (low muscle tone).

·         Nonverbal learning disorder.

·         Sensory processing disorder.

·         Specific language impairment (SLI).

·         Visual perception deficits.

Management strategies that support the child with Developmental Coordination Disorder (DCD) (at preschool, school and/or home):

·   Encouragement to persist and attempt tasks.

·   Provide opportunities to succeed by simplifying activities.

·   Teach new skills in a step by step manner and keep the environment as predictable as possible during teaching.

·   Introduce new skills or environments on an individual basis before introducing peers.

·   Use simple language and instructions.

·   Provide visual as well as verbal cues.

·   Provide extra time to complete tasks.

·   Recognize and reinforce the child’s strengths.

·   Appropriate set up for school desk.

·   Set realistic and achievable goals for all task performance and completion.

·   Make participation, not competition.

    Identifying a kid with Co-ordination difficulty is crucial in the management of the condition. Proper identification at appropriate age would give better result and contribute to the overall development of the child. Identifying a child at school/Preschool level is highly recommended. Teachers working at school level should have training to identify such kids.

   If you suspect that your child might have coordination problems, it is wise to meet a Physiotherapist/ Physician/ Pediatrician. 

 

 

By

S.Mariappan

Sensory Integeration Therapist

Life Healthcare Rehabilitation Clinic Pl

moses.lhc@gmail.com 

Co-ordination

CO-ORDINATION

 

What is coordination?

Coordination usually refers to whether a child can get the arms and legs to work together in a coordinated, effective way.

 

Why coordination is important to children’s?

During playing games, taking part in sport or doing schoolwork, coordination skills are important for your child. In many tasks which require coordinated movement also require the child to have good motor planning to time their movements accurately.

 

Types of coordination and its importance

There are 2 types of gross motor coordination. They are bilateral coordination and eye -hand coordination.

 

Bilateral Coordination Skills

Bilateral Coordination is the ability to use both sides of the body together in a coordinated way. Children with poor bilateral integration may struggle with gross motor games or with fine motor tasks which require both hands to work together well. Examples include jumping, skipping, cutting with scissors, using a knife and fork, and tying shoelaces.

 

Eye Hand Coordination

This is the ability of the eyes to guide the hands in movement. For example, Catching a ball and being able to hit a ball with a bat ,  but many parents don’t realize that good hand-eye coordination can also help a child’s handwriting. Children need eye-hand coordination to guide their pencil between the lines and ensure their letters don’t go over the lines or touch each other.

By Mariappan Moses

    Life Healthcare Rehabilitation PL

    moses.lhc@gmail.com 

Cerebral Palsy

Cerebral palsy is a broad condition and a major reason for disability in Pediatric population.  In India 3 out of 1000 live birth is affected with cerebral palsy. Many of these cases were found in rural community, where rehabilitation is still need to reach.

The cause of Cerebral palsy is not known but lot of risk factors identified, some of them are;

1.      Prematurity

2.     Very low birth weight (lesser than 2.5kg)

3.     Virus infection

4.     Chemical or substance abuse during pregnance

5.     Trauma

6.     Complications of labor and delivery 

Cerebral palsy manifests with various symptoms, based on which it is divided into several types;

1.      Spastic

2.     Flaccid

3.     Ataxic

4.     Athetoid

Apart from the above these childrens may have some more additional problems

Like; Seizures, Vision, hearing, speech problems, Learning disabilities, behavior problems, Intellectual disability, Respiratory problems, Bowel and bladder problems, Bone abnormalities, scoliosis etc.

Identifying Child with Cerebral Palsy:

Cerebral palsy is usually identified by delay in milestone, that is, it takes longer duration to learn turning in lying, sit up from lying, stand from sitting position, balance in standing and make steps. All will get delayed. Sometimes the child might not achieve certain milestone, which dependent upon the extent of nerve damage.

Doctor will identify a Child with Cerebral palsy by age 6 months to 1 year. Parent may seek help if there is a delay in milestone. Brighter side is, almost half of the children’s with Milestone will grow out of this by age 2.

Cerebral palsy is a lifelong condition; in current scientific development it is not possible to completely cure the condition. The management should focus on minimizing the deformity and improving the Childs ability to cope with the growing demands of the society. For an effective management it needs a Multidisciplinary team that includes Physiotherapist, Speech therapist, Occupational therapist, Orthotist, Opthalmologist, Neurologist, Pediatrition and Dentist.

 Information in this particular blog is meant to reach those communities and if I could get meaningful queries on cerebral palsy and its management by this blog, I will be more than happy.

Balance Exercises for 50 + (Part 3)

Exercise 4:  Postural Control

Equipment: BALANCE BOARD

Postural control of the trunk during a sideways weight shift

Starting Position
Stand sideways to the balance board, keep your arms behind your
back or hanging by your sides.

Movement
Step with one foot onto the balance board the other foot remains on
the floor. Move your weight to the foot that is on the board and at the
same time bend your knee and hips rhythmically 8­10 times. Keep the
leg on the floor straight. Bring the leg back next to the other leg.
Repeat with the other leg.

Repeat 20 times

Exercise 4:  STEPPING SIDE TO SIDE ON BALANCE BOARD

Body control/balance/weight shift while stepping sideways

Starting Position
Stand on a balance board with feet shoulder width apart, keep your
arms behind your back or hanging by your sides.

Movement
Shift your body weight to one leg and bring your other leg to meet it.
Continue stepping side to side on the board. Let your upper body
follow the movement.

Repeat 20 times

Follow in Part 4

Anxiety

How to Identify Anxiety?

How to treat Anxiety?

Anxiety disorders are the most common form of emotional disorder and can affect anyone at any age. Other ways people experience anxiety include nightmares, panic attacks, and painful thoughts or memories that you can’t control. You may have a general feeling of fear and worry, or you may fear a specific place or event.

In the case of an anxiety disorder in an adult, the feeling of fear may be with you all the time. It is intense and sometimes debilitating. An anxiety attack is a feeling of overwhelming apprehension, worry, distress, or fear. For many people, an anxiety attack builds slowly. It may worsen as a stressful event approaches.

 But, anxiety in children can also become chronic and persistent, developing into an anxiety disorder. Uncontrolled anxiety may begin to interfere with daily activities, and children may avoid interacting with their peers or family members.

Symptoms of an anxiety disorder might include jitteriness, irritability, sleeplessness, feelings of fear, shame, feelings of isolation, headache, stomachache, fast heartbeat, sweating, dizziness, muscle tension, rapid breathing, panic, nervousness, difficulty concentrating, irrational anger, restlessness.

There are more 8 types of anxiety disorders. Also anxiety is a key domain of several different disorders. These include:

• Panic disorder: experiencing recurring panic attacks at unexpected times. 

• Generalized anxiety disorder 

• Phobia: excessive fear of a specific object, situation, or activity

• Social anxiety disorder: extreme fear of being judged by others in social situations

• Obsessive-compulsive disorder: recurring irrational thoughts that lead you to perform specific, repeated behaviors

• Separation anxiety disorder: fear of being away from home or loved ones

• Illness anxiety disorder: anxiety about your health (formerly called hypochondria)

• Post-traumatic stress disorder (PTSD): anxiety following a traumatic event

People need not feel is as mental illness but it’s a disorder which can be treated by the clinical therapist. Proper tests and assessments are available to know the levels of anxiety which are followed by therapies based on the type and level of anxiety in an individual.  Clinical prognosis helps in early stages of the disorder.

Some of the important therapies provided by our clinical psychologist would be CBT, DBT, Exposure therapy, Psychoanalytic therapy, bibiliotherapy, Acceptance and commitment therapy, Art therapy, Family therapy, Interpersonal therapy, etc.

The goal of all types of therapies for anxiety is to help you learn how to overcome your fear and calm your emotional reactions. Individual therapy will help to the improve quality. 

By     Ananthi, 

         Clinical Psychologist

         Life Healthcare Rehabilitation clinic PL

        

         ananthi.lhc@gmail.com

Balance Exercises for 50+ (PART 2)

Balance Exercises are Skills that need to be trained in the presence of Physiotherapist and also after undergoing thorough Medical check up.

In coming parts more exercises will be introduced, for safe practice. 

Equipment needed

1.       Balance board or Staircase can be used

2.       Long Stick

3.       Physio ball or a stool can be used

Exercise 1:   Stepping on Balance Board/or can use Staircase

-          Stand on the floor facing the balance board.

-          Step up to the center of the balance board with your left foot and bring your right foot up next to your left foot. Step down backwards with the left foot, bring the right foot down next to the left one. Let your arms follow the movement. Now repeat starting with the right foot.

-          Repeat the exercise 20 times.

Exercise 2:    Cross ­step with knee lift on a Balance Board

-          Stand on the floor facing the balance board.

-          Step on the left edge of the balance board with your right foot.

-          Lift your left knee up in front of you. Step down backwards with the left foot, bring the right foot down next to the left one. Continue by  stepping on the right edge of the board with your left foot. Let your arms follow your movement.

-          Repeat the exercise 20 times.

Exercise 3:   Cross step with knee lift on a Balance Board

Stand on the floor facing the balance board.

Step on the right edge of the balance board with your left foot and lift your right knee up in front of you. Step down backwards with the right foot, bring the left foot down next to the right one. Continue the step series by stepping on the left edge of the board with your right foot. Let your arms follow your movement.

Repeat the exercise 20 times

(Follow Part 3)

Balance Exercises for 50+ (PART 1)

Falls are the major cause for disability in Elderly population. About 80% of disability in Old age is due to falls. In India exercising after 40 or 50 is not socially possible as many adults opt to spend more time with family than personal well being. Scientifically speaking doing mild to moderate exercises to improve balance will ultimately improve quality of life, delay Arthritis gives sense of well being, help cardio respiratory function, reduces medical bill, controls diabetes etc.

What is balance exercise, why we do it? What we achieve? Aims :

-          to learn body control in different starting positions, on different surfaces and support surfaces and to keep the centre of gravity in a controlled manner within the base of support

-           to develop coordination of senses, nerve system, joints and muscles and co­operation of the muscles

-           to repeat light and easy exercises many times

Balance control in different body postures is vital for mobility. The central nervous system regulates the cooperation of muscles in a purposeful manner and produces different movement responses in order to maintain balance. As you get older the bodily systems regulating your balance deteriorate. For instance the sense of sight, sense of balance and sense of feeling and the orders given to the muscles by the motor nerves get slower. Also muscle strength weakens as your muscle mass reduces. The amount of daily physical activity and movement declines often with age. All these together weaken the balance control during standing and increase the risk of falls.

Balance exercises can be done almost anywhere and in almost anyway. They can be performed while doing any type of physical activity e.g. As warm up exercises or as break exercises. Exercise is a skill development, any skill develops with repetition.  Also exercising demands concentration and it is best done in a peaceful place, in an unhurried situation. Exercising while tired physically strained or during an acute illness is not beneficial.

Balance Exercises include several Individual exercise movement which can be added together to make a exercise regime as per individual. Balance Exercises are practiced 3 to 4 times a weak and taught simple/medium/severe as per individual ability. The exercise will be repeated for as long as 8 weeks to attain better result.

A medical examination needs to be performed on the person prior to participating in gym training or the person is not allowed to participate at all if the person has one of the following diseases or symptom:

1.       Severe heart and cardiovascular diseases/symptoms

2.       a heart attack (less than 6 Months ago)

3.       coronary artery disease with chest pain

4.       heart valve disease, cardiomyopathy or other condition that leads to heart failure uncontrolled high blood pressure (over 160/100 mmHg)

5.       arrhythmias which increase or worsen during physical exertion

6.       severe anemia (hemoglobin under 100 g/l)

7.       Severe symptoms during physical exertion

8.       anxiety, dizziness, fainting spells, pain

9.       Serious unstable medical condition/illness

10.   insulin dependent diabetes, untreated hyperthyreosis, rheumatic diseases, psychosis

Balance exercise May also be structured by therapist for particular persons need. Group balance exercise program or generalized Balance exercise program targeting a particular group of people is also effective.

Equipment needed

1.       Balance board or Staircase can be used

2.       Long Stick

3.       Physio ball or a stool can be used