1.Disruption of the more fixed abnormal posture.
(1) Correction of the asymmetrical posture of the pelvis and lower limbs of the child.
Perform mandatory flexion of the lower limbs (supine) to correct the asymmetrical posture of the pelvis and lower limbs: the child lies on his back with both lower limbs flexed at the knee and hip, the trainer holds one hand on one knee and one hand on the rear hip, pulling on the shortening of the body stem and correcting the rotational posture of the pelvis. Note that the pelvis is rotated backward and downward to minimize hyperextension of the lumbar region and spasm of the lumbar muscles. The child is lying on his back, both lower limbs are bent at the knees and hips, the trainer is close to the bottom of the child’s feet and holds the child’s pelvis and lower limbs with both hands, allowing the child’s lower body to rotate to the side to improve the mobility of the pelvis.
(2) Correction of the child’s trunk hyperextension and abnormal posture of the upper limbs.
The child is placed in a supine ball-holding position with a soft pillow under the head, and the head is controlled in a neutral position; the trainer helps the child maintain a symmetrical posture, and trains the child to lift the head to induce a head-turning response; the trainer helps the child to cross both upper limbs on the opposite shoulder, using this posture to inhibit the spasm of the extensor muscles, gradually allowing the child to learn to control the posture by himself, and then allows the child to maintain the training in a relaxed state The trainer holds the child’s hands crossed and keeps the child’s upper limbs extended in front of the body and the elbows of one upper limb flexed in front of the chest. While maintaining the training posture, the child’s body stem is compressed, so that the two sides of the posture are continuously alternated to improve the child’s body axial rotation ability and head turning response ability; the child is trained to maintain a symmetrical posture in the sitting position, symmetrical posture training in the lateral recumbent position and sleep in the lateral recumbent position.
2. Head raising training and head and neck stability training.
(1) Prone position: training on wedge-shaped mat and training bed can promote head lifting and induce hand support.
(2) Cross-legged sitting position: The trainer kneels behind the child, holds the child’s jaw with one hand and presses downward slightly with the hand on the top of the child’s head, which can strengthen the stability of the head and neck.
(3) Use massage techniques to massage both sides of the neck and the back of the neck.
3.Improve the separateness and selective motility of the two upper limbs and the normal sensation of the two hands, and improve hand function.
(1) Children who have raised their heads can be kept in a cross-legged sitting position, and the trainer can apply pressure with the chest against the back of the child’s head to make the neck and shoulders bend forward slightly, which can improve the ability to move the neck upright and the midline position of the limbs.
(2) For children who can sit alone, one upper limb can be fixed and the other upper limb can be induced to grasp objects or support to improve sitting balance and upper limb separation movement.
(3) For children with hand support, the trainer can apply pressure on the shoulder to strengthen the stability of the upper limb and shoulder.
(4) Use massage balls and abacus to train the normal sensation of both hands, and also use objects with different temperatures and softness (such as soft brushes, velvet dolls, sand, etc.) for sensory stimulation training.
(5) To prevent the shortening of the trunk, let the child put both upper limbs in an externally rotated and upraised position.
4.Improve the stability of the pelvic girdle and the two lower limbs, strengthen the muscles of the low back, and establish the balance function.
(1) Bridge exercise: practice bilateral lower limb support first, and change to one lower limb support after stability is strengthened.
(2) Kneeling balance exercise: the trainer fixes and presses downward in the pelvis of the child to strengthen the stability of the pelvic belt, kneeling on the leg first, and then single-leg kneeling exercise after the stability is strengthened, and also strengthen the interactive movement training of both lower limbs.
(3) Support station exercises: fix the hip, knee and ankle joints, and use the standing promotion board.
(4) Walking exercises using parallel bars, walking ladders and walkers, provided that the solo standing can be completed and the abnormal posture has been corrected.
Of course, for children with inward crossed lower limbs and pointed feet, we must first correct the inward crossed and pointed feet before practicing solo standing and walking.