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Basic Fundamentals in the Rehabilitation of Children with Cerebral Palsy

Basic Fundamentals in the Rehabilitation of Children with Cerebral Palsy

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Published by gavinbroomes
A brief rant for the families of ABR (Advanced Biomechanical Rehabilitation) on how to approach long-term rehabilitation protocol. Visit www.thescienceofphysicalrehabilitation.blogspot.com for more
A brief rant for the families of ABR (Advanced Biomechanical Rehabilitation) on how to approach long-term rehabilitation protocol. Visit www.thescienceofphysicalrehabilitation.blogspot.com for more

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Published by: gavinbroomes on Aug 02, 2011
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08/02/2011

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Trainer’s Corner: Back to Basics
by: Gavin Broomes
I think the title “Trainer’s Corner” is very applicable for two reasons: 1) This friendlypost is coming directly from one of your trainers, and 2) It is analogous to aboxer’s trainer. A boxer’s trainer will do his best to provide the boxer with allthe skills necessary to succeed. Your ABR trainers are charged with a similartask, so the analogy should resonate pretty well.
Round 1:
Before going out into the ABR world, you should have a solid grasp of thefundamentals. In the ABR context, these fundamentals are numerous andsometimes overwhelming…however I will bring you through some of themstep by step (round per round). During the majority of my evaluations, thereis a common thread that weaves its way all the way through each familyunit…they forget that this is a
PROCESS
. Process is “a systematic series of actions directed to some goal”…therefore by definition it should be clear thatthings have to go in sequence and in phases. The fact that you cannot skipover phases is not an arbitrary decision, rather a reality you have tounderstand and integrate.Each phase is designed in preparation for the next phase and is structurallypredetermined by the human motor developmental pattern…not by ABR. Weare bound to this developmental path by mother- nature so any questionsthat relate to more complex developmental skills should be automaticallyanswered.
 
In the past, I have found it useful to help parents differentiate between
chronological age
and
developmental age
. To be more precise, in healthyindividuals the chronological age comes with some predictabledevelopmental milestones. In effect, you can accurately estimate thechronological age by knowing (seeing) the developmental phase they are in.In the above image, the developmental age (stage of development) is typicallyachieved at a certain age (for example: sits without support between 5-8months). This type of chart can be somewhat confusing to many parents.Statements like “he / she is 4 years old so we have to stand them to helpthem develop the hips” come from this well-ingrained developmental chart.However, as mentioned before, if the previous stages have not yet beenachieved (lifting and holding the head, rolling over, from prone position liftschest with arm support, etc..) then any discussion (or statements) regardingmore advanced skills is unproductive. Therefore, more emphasis and focuson the developmental age will be, not only helpful in understanding the bigpicture, but more accurate in assessing your child’s current progress.If you have ever seen any of the Rocky movies, you can appreciate the image of thegrizzled trainer, Mickey, yelling at Rocky and trying to motivate him througha seemingly insurmountable challenge. Although I obviously won’t yell andscream, the intensity is still there: “Get back to basics!! Remember thefundamentals, Rock!” The road is long and there will be challenges…

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