Pediatric Sensorimotor Development and Rehabilitation Techniques

Posted on Nov 23, 2024 in Physical Education

Hula: Synthesized Human Motor

Objective: Capacity Development Subject Interaction in an Integrated Environment

Interactions: Cognitive, emotional, symbolic, and sensorimotor.

Key Concepts:

  • Personality Development: Concrete environments and experiences shape personality.
  • Human Development Indicators: Coordination, tonic function, body schema (tonic activity, balance, and body awareness).

Rehabilitation Approaches

Bobath Concept

Aim: To provide movement patterns for optimal motor performance and functional abilities, recovering motor control.

Learning Resistance: Adult motor memory; provide sufficient information for memory recall. Programs allow variability and integrated relearning.

Basic Handling Points:

  • Address abnormal postural tone and postural control deficiency (e.g., Cerebral Palsy).
  • Utilize any possible strategy for automatic movement.
  • Form the basis for movement exercises.

Normal Bases: Trunk stability as the foundation for all body movement. Automatic reactions are linked to posture and normal movement. Activate normal patterns at structured osteoarticular, myofascial, and neural functional ranges.

General Objective: Achieve maximum integration of personal, social, working, and family life.

Specific Objectives: Address pain and improve functional ranges based on assessment patterns.

Taping

Provides stability, limits or contains movement, inhibits undesired movement, and aids in biomechanical alignment. Enhances joint stability and muscle activation, facilitating movement recovery.

Sensory Integration

Addresses challenges in sensory processing that can affect learning and behavior.

Definition: The organization and use of sensations flowing to the brain, providing information about the body and surrounding conditions.

Vojta Concept

Applied in cases of suspected brain damage, motor problems in children and adolescents, trauma, or orthopedic conditions.

Developmental Milestones (DM): Depend on nervous system maturation, genetic code, and environmental feedback. Sensorimotor development involves tactile, proprioceptive, kinesthetic, visual, and vestibular systems. Children learn through repetitive movements and develop awareness of movement sensations.

Feedback Definition: During movement, the central nervous system (CNS) receives information on receptor status changes. This response allows the CNS to control, continue, modify, correct, and complete movements.

Locking Hip and Pelvis

Maintaining a prone position to prevent weight shifting and reach objects without falling. In quadruped, movement should resemble a rabbit, keeping hip flexion for stability. Indian sitting may be used to avoid lateral falls. Limited lateral weight shifting.

Developmental Stages and Observations

1 Month 4 Weeks

  • Generalized flexor pattern.
  • Hip flexion in prone position, facilitating head movement.
  • In supine, neck flexors are lengthened without activity.

2 Months

  • Hypotonia, flexion, and asymmetry.
  • Improved extension in prone and head rotation, but difficulty maintaining midline during active extension.
  • Shoulder abduction (weight-bearing on hands).

3 Months

  • Orientation to midline (head, eyes, trunk, hands).
  • Chest lift in prone (forearm support).
  • “Frog legs” position (hip and knee flexion, abduction, external rotation).
  • Supported sitting.
  • Play position: Head lifting, shoulder elevation, curved trunk.
  • Bipedal position: Foot and knee support with strong abduction and external rotation.

4 Months

  • Lateral neck flexion in supine.
  • Antigravity trunk reinforcement with scapular abduction and extension (lumbar extension, pelvic anteversion, lumbopelvic rhythm).
  • Antigravity flexor activity in arms, enabling rolling.
  • Bringing hips and legs forward to sitting in supine, maintaining midline head control.
  • Supported standing with hand assistance.

5 Months

  • Lateral righting and weight shifting reactions in prone.
  • Balance maintained with extended arms (full trunk extension), providing feedback for joint stability and weight support.
  • Movement towards one forearm for weight-bearing and reaching with one arm.
  • Rolling from supine by drawing feet laterally.
  • Increased flexor control in lateral decubitus.
  • Seated with curved arms forward, still extending.

6 Months

  • In supine: Head flexion, arm reaching, leg extension, and hip flexion to reach feet.
  • Rolling from supine to prone, initiated by head or leg movement, followed by full body extension.
  • In prone: Bending and extending legs while maintaining hip flexion.
  • Sitting: Straight back (hip extensor component active).
  • Bipedal: Weight control with abducted legs, able to bounce upwards.

Hyperextended Neck

Typical Development: Coordinated neck flexor and extensor action for head control in supine, allowing chin tuck and extensor muscle lengthening.

Atypical Development: Lack of neck flexion, inability to bring head to midline or tuck chin. Head lifting in prone but with hyperextension.

Compensations: Shoulder elevation for head stabilization, restricting scapular mobility and hindering normal postural development. Hyperextended head in sitting, limited mouth opening, and possible mandibular protrusion.

Treatment: Stretching neck extensor muscles, activating flexors, restoring scapular mobility, improving head control and alignment, and correcting oral function.

Head and Neck Symmetry

Typical Development: Head and neck brought to midline. Reduced influence of Asymmetrical Tonic Neck Reflex (ATNR). Symmetrical limb movements, hand joining, and body awareness.

Atypical Development: Head and neck control dominated by ATNR due to lack of flexor development.