Hey ,

Watch how bamboo braces, playful songs, and simple techniques can unlock potential in this CEO session with Mary Massery, available for you to watch in the Hub

Patient Presentation

• 2.5-year-old with spastic diplegia born at 32 weeks gestation
• Increased tone in lower limbs and right upper limb, weak trunk
• Left strabismus, otherwise healthy respiratory and GI systems

Assessment Techniques Covered

• Visual observation of chest wall and spine alignment
• Palpation technique for paradoxical breathing
• Screening of vocal abilities and breath control
• Observation of weight-bearing in various positions
• Evaluation of trunk stability and pelvic tilt

Intervention Strategies and Practical Techniques

• Promoting upper extremity weight-bearing activities:

Four-point kneeling with bamboo brace support

Rocking forward and side-to-side in four-point position

Weight-bearing through straight arms while sitting on parent's lap

Encouraging voicing during weight-bearing activities

>> "Row, row, row your boat"

>> Asking questions requiring verbal responses eg. "What color do you see?"

• Facilitating proper trunk alignment with minimal posterior resistance at shoulders
• Incorporate activities that challenge trunk stability

Typing or playing on elevated surface

Reading books in supported sitting

• Focus on hip mobility and pelvic alignment

Resources and Tools Referenced

• Bamboo brace for upper extremity support
• Wedge for positioning in four-point kneeling
• DMO suit (Dynamic Movement Orthosis) - considered for future use
• Abdominal binder - recommended for trial before DMO suit
• Thera-band for trunk support (suggested modification)

And here's some brilliant take-a ways

• Intercostals play a vital role in posture. Prioritize strengthening intercostal muscles and improving chest expansion
• How to maximise use of voice and vocal cords to build proximal strength
• How to do handling at shoulder to get small postural adjustments from child.
• Consider using abdominal binder before transitioning to DMO suit

+ much, much more...

▶ Play

Sit down and be inspired!

Warm regards,

Mindy

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