Saturday, April 19, 2008

Exercises for Spastic Diplegia.

Here are some ideas for exercises if your child has spastic diplegia. I probably should say here that whatever you do, always make sure your child is protected from falls and other injuries.

For Crawling

1. Place a towel under your child's belly and hold onto the ends so that you are basically supporting their entire body. Have someone else move baby's hands and knees to show her how to move them in a reciprocal pattern. You will probably notice how your baby's hands clench up. This is normal, but be sure to work on showing her how to keep her hands open. Don't be too concerned about it because crawling is really the best exercise for that particular problem.
2. Buy a tunnel or throw a blanket over a table and encourage baby to crawl through it.
3. Always remember to get down on the floor and crawl with baby.


For WALKING
1. Using a hoola-hoop, have your child hang onto one end and walk while you are hanging on to the other end.
2. Have your child grasp 2 large sticks at about chest height, and walk, while you hold onto the upper ends of the sticks. (This can be done with knee walking.)
3. For a child who may be close to walking on his/her own: attach two ropes to solid pieces of furniture. Make them parallel and at a good height and width for your child. When children start walking for the first time, they often hold their arms out for balance, so put the ropes about at the height of where they can put out their arms and hold the ropes. Have the child walk in between the ropes.
4. Have your child walk with one hand against a wall.
5. Hold one of your child's hands to walk, later moving to just holding onto their clothes (i.e. if they wear overalls, you can hold onto the straps while they move forward. This will help gain a more centered balance).

GENERAL EXERCISE:
1. STAIRS! STAIRS! Great exercise and kids usually love to crawl up stairs.
2. STRETCHES! These are very important because your child's muscles are not growing fast enough to keep up with their growing bones (b/c they are not using them as much as nonCP babies do). A physical therapist should walk you through a stretching routine, but don't forget to give the ankles and wrists a good work out also. One such stretch that is really great: have your child stand holding onto a chair or table. Put a thick phonebook under the leg that is less tight. This will give that tighter leg a really good stretch while your child plays with a toy at the table. And it doesn't involve any work for the parent-yay!!
3. Make it bilateral. Make sure you are giving both sides an equal work out. Also make sure that you incorporate exercises that involve the arms stretching over midline. (I.e. place a toy to their left and have them reach across for it with their right arm.)
4. Transition exercises. A common symptom of CP is a delay in transitions-from sitting to hands and knees and back again, etc. It's important to have your child do a lot of weight-bearing on their arms, both in front and at the side. This will help them learn to go from lying on the floor to sitting.
5. Calm and quiet is the key. Some books say that rough-housing is good for kids with CP, but I beg to differ. The key is to relax and stretch muscles. So a highly stimulated environment will cause children to tighten up with excitement.

Some other tidbits that have helped me out in our exercise routine:
1. Set goals, really specific, small ones. Generally, our goal for therapy is to get Lara to walk. Since that is a long time coming, I have set some smaller goals for us. For instance, my small goal right now is to help Lara balance in kneeling position.
2. Set a time every night where you and your spouse/a friend, etc. work on exercises. As children get older, it really becomes nearly impossible to do these exercises on your own.
3. Make exercise fun. Lara really loves bench sitting and stair crawling, so every chance we get, that's what we do. We put her booster seat on the living room floor, and she will spend several minutes getting in and out of the chair.

SOUL NURTURING:
And just a word of encouragement. Always remember never to focus on your child's limitations. Don't focus your energies and thoughts on trying to get your child to walk as soon as possible or reach your next goal. ALWAYS focus your energies on simply enjoying your beautiful child! Always be positive and remember that your role as a mother is to nurture your baby's soul.

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