Wall Activities for Scapulo-Humeral Dissociation

 

You are playing a game on a flat surface during a PT session and everything is going well, but have you thought about the benefits of playing it on the wall instead?  

When we actively reach above shoulder level with hands on the wall, the scapular stabilizing muscles  (lower trapezius and serratus anterior muscles) hold the scapula in place while other muscles work off that stable foundation to elevate the arm (humerus).  Holding in this position dissociates the movement of the scapula from that of the humerus.  Dissociation of this kind naturally evolves in babies at about 5-6 months as they are on their stomachs and beginning to bear weight on extended arms.  Most children older than a year don’t enjoy a prone position any longer and will protest.  Don’t worry, you can get some of the same movement by playing a game on the wall or other vertical surface instead.  Check that you have optimal alignment in all other segments of the body:  rib cage, low back, hips, knees and ankles.
Continue reading “Wall Activities for Scapulo-Humeral Dissociation”

HOW does she move? Pulling the ICF-CY Together by Describing Motor Function.


Ivan is always on the move, always running from here to there. He never walks slowly, never slows down.  Moving quickly and never standing still can represent difficulty with static balance.

How does a person move?  What is the quality? Do they have habitual postures, asymmetrical positions,  particular movement patterns?  In this discussion relating to the International Classification of Functioning, Disability & Health- Children & Youth (ICF-CY), we explore an added domain of Posture and Movement (otherwise known as Motor Functions).  As discussed in a previous post, this is an addition to the traditional ICF-CY made by the Neuro-Developmental Treatment Association.  This domain highlights common postures and movement patterns that run through many activities.  Continue reading “HOW does she move? Pulling the ICF-CY Together by Describing Motor Function.”

What Makes a Good Quality Squat?

The couch creaks and slides every time she sits down.  “I have no control once I start to bend my legs!”, she says.  

Controlled squatting allows babies to get down to the mattress after pulling to stand in their crib.  It allows children to sit down in a chair with control.  It is the ready position,  allowing a low basketball dribble or ease while moving wet clothes from the washing machine into the dryer.    If we don’t have the required alignment, strength and endurance,  falls and crashes start to happen.  Squat with good alignment and build the strength and endurance to squat and recover over and over again in daily life. Continue reading “What Makes a Good Quality Squat?”

One Child’s Response to “What is Your Favorite Thing to Do?”

 

Exciting changes are happening in the field of pediatric physical therapy.  While participation was once off the list of important things, it is now at the very top of the list.  Also, while therapists were once the consultants, we are now the collaborators with parents and the children themselves.  I find this is so refreshing! Continue reading “One Child’s Response to “What is Your Favorite Thing to Do?””

Exploring the ICF-CY: What are Personal Factors?

The International Classification of Functioning, Disability and Health-Children & Youth (ICF-CY) is a framework for describing and organizing information on functioning and disability.  The ICF is a useful tool in the field of pediatric physical therapy, where we are moving toward treating the whole child.

This post will discuss what constitutes personal factors.  Personal factors are independent of the health condition but can often influence how a person functions.  These factors are specific to social and cultural customs of each country.  While all the other categories have codes, this one does not yet have specific codes.  Continue reading “Exploring the ICF-CY: What are Personal Factors?”

Exploring the ICF-CY: What are Environmental Factors?

The International Classification of Functioning, Disability and Health-Children & Youth (ICF-CY) is a framework for describing and organizing information on functioning and disability.

This post is the tenth in the ICF series and explores what constitutes an environmental factor.  Environmental factors have an impact on all components of functioning in the ICF.    They affect the experience of participation and can be either facilitators or barriers to an individual’s participation. Continue reading “Exploring the ICF-CY: What are Environmental Factors?”

Exploring the ICF-CY: What is Participation?

Screen shot 2016-08-26 at 9.56.26 PMThe International Classification of Functioning, Disability and Health-Children & Youth (ICF-CY) is a framework for describing and organizing information on functioning and disability.  The ICF is a useful tool in the field of pediatric physical therapy, where the child defines how they want to use their function within the context of their own life.

In my opinion, the Participation category is the most fun part of the ICF!  This is really where we begin to see the whole child, their likes and their interests and well as what they want to do with their skills.   Participation is using an activity to interact with others or with the environment.  When the activity is walking, participation is walking on the beach with friends, or walking in the grocery store to help with the shopping.  Participation is one of the most motivating and satisfying levels of functioning.  New activities should be put into participation as soon as possible to build motor control.  These happen in many different environments:  Home, friends’ homes, schools, libraries and parks.  Continue reading “Exploring the ICF-CY: What is Participation?”

Exploring the ICF-CY: What is Activity?

ACTIVITY WORDLE

The International Classification of Functioning, Disability & Health- Children & Youth (ICF-CY) is a framework for describing and organizing information on functioning and disability.

In this post we explore another category of the ICF-CY….activity!  This is the heart and soul of physical therapy, at least in the clinic or during a home visit.  The activity section of the ICF-CY describes what a person can do in a standard environment or their regular environment.  Activity is defined as the execution of a task or action.    The activity section includes the following:

  • developmental skills that babies learn in the first year of life,
  • gross motor skills at any age
  • fine motor skills at any age
  • activities of daily living/self-care
  • gait
  • communication

Continue reading “Exploring the ICF-CY: What is Activity?”

Exploring the ICF-CY: Identifying Body Structures & Body Functions

Impairment Wordle

The International Classification of Functioning, Disability & Health- Children & Youth (ICF-CY) is a framework for describing and organizing information on functioning and disability.

icf

This post will be focusing on body structures and body function.  This portion of the ICF-CY describes what is happening at the structural level of a person’s body.   Often when reviewing a chart one sees that hearing and vision have been screened and passed.   This is an example of functioning.  Although the ICF-CY is designed to be as neutral as possible, physical therapists and medical teams must also discuss impairments which often relate to disability.   Impairment is the description of body structures that are diminished, weakened or damaged.  Management often involves a full medical team. For instance, a team consisting of an orthopedist, a physiatrist and a physical therapist  (and parents) will all coordinate different aspects of care for a child with with hip subluxation.

Here is a list of body structures and body functions that are often discussed within the ICF framework. especially as they relate to children and youth:
Continue reading “Exploring the ICF-CY: Identifying Body Structures & Body Functions”

What Does the NDTA Enablement Model Add to the ICF?

In this post I will continue to discuss the framework of the ICF.  However, hoping not to confuse things,  today I am going to briefly talk about NDTA interpretation of the ICF -which is called the NDTA Enablement Model.  This model  adds one category: POSTURE, ALIGNMENT AND MOVEMENT.    This  answers the question of how a child moves.  If you are passionate about alignment and quality of movement, you are going to love thinking about what to put into this section.

Continue reading “What Does the NDTA Enablement Model Add to the ICF?”