SECTION
2
CHILDREN
Ch05.qxd 5/6/2006 11:56 AM Page 83
Ch05.qxd 5/6/2006 11:56 AM Page 84
85
CHAPTER
5
Positioning and Handling to FosterMotor Function
OBJECTIVES
After reading this chapter,the student will be able to
1.
Understand the importance of using positioning and handling as interventions when treatingchildren with neurologic deficits.
2.
Describe the use of positioning and handling as interventions to improve function in childrenwith neurologic deficits.
3.
List handling tips that can be used when treating children with neurologic deficits.
4.
Explain transitional movements used in treating children with neurologic deficits.
5.
Identify the goals for use of adaptive equipment with children who have neurologic deficits.
INTRODUCTION
The purpose of this chapter is to detail some of the mostfrequent positioning and handling used as interventionswhen working with children who have neurologic deficits.Basic interventions such as positioning are used for manyreasons: (1) to meet general patient goals such as improvinghead or trunk control; (2) to accommodate a lack of mus-cular support; (3) to provide proper postural alignment; and(4) to decrease high muscle tone. Handling techniques canbe used to improve the child’s performance of functionaltasks such as sitting, walking, and reaching by promotingpostural alignment prior to movement. Other specific sen-sory interventions such as tapping a muscle belly, tactilecuing, or pressure are tailored to specific impairments thechild may have. Impairments include such things as diffi-culty in recruiting a muscle contraction for movement initi-ation, lack of pelvic control for midline positioning, or inability to control certain body segments during changes of position. The ultimate goal of any type of therapeutic inter-vention is functional movement.
CHILDREN WITH NEUROLOGIC DEFICITS
Children with neurologic deficits may exhibit delays in motor development and impairments in muscle tone, sensation,range of motion, strength, and coordination. These childrenare at risk for musculoskeletal deformities and contracturesand often have or are prone to develop limitations in per-forming functional activities. Functional limitations intransfers, locomotion, manipulation, and activities of dailyliving may result from impairments. A list of impairmentsand functional limitations commonly identified by a physi-cal therapy evaluation is found in Table 5-1. Some or all of these impairments may be evident in any child with neuro-logic deficits. The functional limitations may be related tothe impairments documented by the physical therapist dur-ing an initial examination and evaluation such as deficits instrength, range of motion, and coordination. A lack of pos-tural reactions, balance, and motor milestone acquisitioncan be expected, given the specific pathologic features of the neurologic disorder. Specific disorders are presented inmore depth in Chapters 6, 7, and 8.
GENERAL PHYSICAL THERAPY GOALS
The guiding goal of therapeutic intervention in workingwith children with neurologic deficits is to improve func-tion. The physical therapist and physical therapist assistantteam must strive to provide interventions designed to makethe child as independent as possible. Specific movementgoals vary, depending on the type of neurologic deficits.Children with low tone and joint hypermobility need to bestabilized, whereas children with increased tone and limited joint range need mobility. Joint extensibility may be limitedby increased tone. A wider range of motion may enable thechild with too much tone to change positions independ-ently. Children must be able to move from one position toanother with control. Movement from one position toanother is called
transitional movement
. Important movementtransitions to be mastered include moving from a supineposition to a prone position; moving from a supine or prone position to a sitting position; and moving from a
Ch05.qxd 5/6/2006 11:56 AM Page 85
of 00
CHAPTER 5 93 for Neurologic Interventions for PT
4,535 Reads
Info and Rating
| Category: | |
| Rating: | (2 Ratings) |
| Upload Date: | 02/17/2009 |
| Copyright: | Attribution Non-commercial |
| Tags: |
Leave a Comment
hvala!
you are doin a nice thing here helping us with all these infos. Thanks a lot
could you please send me a copy of this? dixon4uall@yahoo.com