1.Introduce some methods of training head lifting
For those whose head is tilted back, press both shoulders and help his head tilt forward. For seated children with head back, put his two upper arms in front, press his chest so that his head tends to the front, put his double lower limbs into your open knees and make his double hip flexion. For those who cannot lift their head, the head will hang backwards when pulled up from the supine position, so hold his shoulders and slowly pick him up. Turning his head to the side when you pick him up will help him to hold his head forward. Place a small pillow under his chest, or a towel roll so that he lies prone on it, teasing him with his voice, making him lift his head a little, gradually increasing its holding time.
2.How to train the child to support the lift?
Because only after obtaining the support function can he sit up by himself and carry out four crawling movements, so it is one of the important training contents. -Elbow stance, if the hip joint is flexed and the waist is raised, you can press the arm from above to make the hip joint extend. -If the joint extension force is insufficient in the carpal position, you can give support from the front or the back to keep it. To maintain the wrist stance endurance, a pillow can be placed under the chest. Attention should be paid to the symmetrical support of both shoulders, and the fingers must be extended. Children with thoracic palsy often clench their fists, especially once the thumb is extended, the other four fingers will be extended. Train one or both elbows to support weight. Parents of older children can lift the two lower limbs with their hands and tell him to support weight with one arm. For spastic cerebral palsy, the two strands can be stretched and opened wide, keeping the two lower limbs in externally rotated position to do so. If the ball is rolled forward, the child will make a protective support action with both arms stretched out and both hands supporting the ground. In order to improve the ability to support the upper limbs, the child can be gradually induced to bear weight on all fours. Early parents can help fix both elbow joints, or fix the pelvis at the back, and let the child swing back and forth on the basis of stability.
3.What are the training methods for children with poor rolling over (rolling)?
Rolling over is mainly done by strong head uplift, elbow support and full body twist. Make the child lie on his back or side on a large towel, a large bath towel, or a hammock, so that he can tilt and turn over. In the supine position, fully flex one knee to the opposing side or extend the upper extremity to the opposing side until it can be turned over. For children with tense limbs, first lift his hindquarters off the ground and roll his hands and feet like a ball from one side to the other, so that his body relaxes and can be rolled from side to side. Train him to roll over from the side-lying position, move his legs and twist his body. At the same time, hold the forearm, encourage him to turn his head and turn his forearm over.
4.How to train your child to sit?
Sit with his legs apart on your knee, move your knee so that he gently tilts to one side and encourage him to stabilize himself. Or press down on his hips to help him sit up, tilting him to the other side. Hold his hips from behind and gently push him to one side, allowing him to grasp himself and turn to sit in a different direction. Tilt him to the other side and sit sideways to one side. Encourage him to reach with one hand in a different direction. Help him to straighten his other hand so that he can support himself.
5.What are other ways to make the child sit steadily? What is the best chair to sit in?
You can ask him to sit with his legs crossed so that he can lean forward and straighten his waist when he sits. Cross-legged sitting is good for those with spastic hip splits. If he is too soft, use one hand to hold his chest and the other hand to hold the waist to sit. It is good for torsade de pointes. For older children you can sit him on your lap with both knees straight. To straighten his back, hold his hips and press downward. If the child has high muscle tone, the parent can try to keep the hips in forward flexion behind the child’s back. If the knees are flexed at the same time, use your hands to reach under the child’s armpits to fix the knees and straighten both lower limbs. The child can sit on a chair with a backrest, the height of the chair is: hip, knee, ankle are flexed 90, both feet can land for the standard. If the head and body can not control, can be made with armrests of the chair, in order to prevent the shoulders to spread back and both legs over-extension.
6.What capabilities are available to ensure that children can move and walk?
Human movement is done rhythmically with the cooperation of various motor functions. If basic abilities are lacking, abnormal four-crawl posture and strange gait will appear when walking. Therefore understanding and using the following three abilities is beneficial to children’s training: the ability to adjust posture: when tilted by a strong push, it will instantly support with hands to prevent head and face injuries and play a protective role. The ability to lift: from belly crawl to elbow support to lift the upper body, developed to support the weight with the arms, so that the head off the ground to lift, and further bend the knees four crawl, grasp the station, all in preparation for standing, walking. Concern for the ability to move around things: people have to accept the environment and promote development through sensory organ stimulation. Starting from the pursuit of vision, followed by reaching out to grasp things, turning over, four crawl forward to get things, grasp the station to help walk, to achieve physical and mental development. The three abilities are nested with each other to complete a training exercise. Take crawling as an example, according to the age of months to complete the belly crawl, four crawl, knee stand and other movements, to stand and walk to prepare.
7.My child can’t crawl forward, how should I train?
Choose a site that is easy to turn around, make it prone, place the toy away from him and ask him to grab it with one hand, if the lower limb on the same side cannot be flexed, help him to do so. Start by swinging the toy to tease, and then turn in the opposite direction and ask him to catch. When the rollover is finished, gently press the body to limit its movement. If you can complete the abdominal crawling action, lengthen the distance, with sound toys or activity toys to tease, for reaching out to catch the game. When you can crawl, move the toy forward and help it bend the knee, and ask the child to stomp on the palm of the helper’s hand to crawl forward. Hold the heel tightly, the toe outward to make the lower limbs externally rotated, to induce its flexion. Then use the palm of the hand on the bottom of the foot to call him strong stirrups, the corresponding two elbows alternately forward.
8.My child cannot kneel, how should I train him?
Due to poor balance, coupled with flexor tension, children often place their hips on both lower legs when sitting. For this abnormal posture, parents should ask the child to bring both knees in and together, so that the trunk and thighs form a straight line. At first, parents can fix the pelvis behind them, and gradually they can let the child kneel in front of the table by himself. Eventually, the child will be able to control the iliac joints to form a straight kneeling position, laying the foundation for standing alone. The mother demonstrates the kneeling position of the child, starts to teach the child to stand on the armrests and knees, and gradually releases the hands. At this point, both hands must be extended to the side. Take care that the hips do not protrude back and that the hip joints are fully extended. The father uses his hands and left knee to hold down the hips and press the child’s lower leg so that the hip joint does not flex and the hips protrude back. Exercise knee extension can let the child sit on the edge of the bed, or high chair to stretch the leg, put a panda or human figure on the back of the foot, pillows and other things, tell the child to stretch the knee and lift the foot without falling down to play, and try to encourage it to lift upward. Or the mother pressed with her hand, a little resistance, practice telling it to stretch when responsible for doing flexion and extension movements.
9.How to train to stand up and stand?
To stand up, you must learn to use the leg muscles, especially the hip and knee extensors, and the leg stomach muscles to exert force and place the line of gravity that supports the upper body weight between the two feet. To stand up in squatting and sitting positions, you can ask him to sit on a small stool, hold the knee in front, pay attention to correcting the pointed foot and scissor leg, and ask him to practice standing, which can train standing balance, casualness of the lower limbs, as well as correcting the scissor step and pointed foot of spastic cerebral palsy. Grasp the standing, or hold the platform to stand, experience the feeling of standing position. The helper can hold the hip to help maintain balance and encourage not to be afraid. Then practice standing with one hand or alternating hands to get toys, and slowly practice spreading the supporting hand when alternating. It is not enough to be able to stand, but you must learn to stand up by yourself. Tell the child to sit on a stool and fix his knees to do the standing training repeatedly, from a few seconds to a few minutes. At the same time, change the stool and wooden box, set up the child’s favorite toys, and ask him to stand up to get them.
10.What if my child can’t take a step?
Train the support response of all sides of the child, you can gently support the knee from behind, swing forward, backward, left and right in a big way to keep the body balanced. And train the heel to be able to move and stand with a steady foot following the ground. The practice of standing balance, the center of gravity in the heel when moving forward, lift the toes when moving backward to maintain balance. When taking a step, the weight first moves to one foot and destroys the balance, so that the other foot takes a step. So first one leg should be prepared to bear the weight and shift the center of gravity forward while the other foot takes a step. Repeated practice when walking, but also to train to the side, the rear to take.
11.What should I do if my child cannot stand on one knee or one leg?
When standing on one leg, the upper body often falls sideways. Make the side lying, put a wide pillow on the rib and abdomen, or use the cushion to lie on the side. Then press the waist and make him/her split the thighs by himself/herself and upwards. You can’t help to do it by pressing the waist with one hand and lifting the legs upwards with the other hand to split them, which can exercise the transverse abdominal muscles and splitting muscles and help to stride. When a child with cerebral palsy stands on one leg, the adductor muscle plays a more important role than the abductor muscle, making the torso lose balance and tilt. Therefore, the helper should support the pelvis to train the abductors. The method of single knee stance is to let the child kneel on one knee, and the helper can use both hands to support the other leg to stand up, so as to train the separation of the left and right lower limbs, the separation of the muscles of the lower limbs and the function of the abductor muscles. The training of forward and backward stepping stance is for the helper to fix and rotate the pelvis with his hands, while making the child step with his left and right feet, moving the weight back and forth so that he can experience the feeling of moving. At the same time, the child is made to step forward on one leg and maintain a standing position on one leg.
12.How can I train my child to stand but not to walk?
When walking, the two legs have to interact and support the weight with one leg, so if the child cannot stand on one leg, he cannot walk. In particular, children with spastic cerebral palsy often have one knee extended and the other knee extended with it. For this reason, mothers should practice interactive femoral and knee flexion and extension by holding the knee of the supine child earlier, which also facilitates the completion of the interactive hand-foot movement in the four-crawl position, or the high-crawl position. When the child can interact with his legs, he can be taught to ride a tricycle, and those who cannot pedal can have their legs tied up and fixed. You can also pedal the sewing machine and so on to practice. You can also use a roller car, or a wooden tricycle. Wobble when walking can use the balance bar to practice stepping, you can also build two bamboo poles, or bolt two ropes to support the walk, the height should be appropriate. Practice walking with a hand-held cart, pay attention to the car can not be too fast, the front to press on the heavy things, can be used in the family.
13.My child can walk, but the two knees collide, the posture is not good, how to correct?
Make sure to cultivate good posture, ask the child to look at himself in front of the mirror to correct abnormal posture. If a child with spastic cerebral palsy has two knees colliding with each other, ask him to practice on a board with a crack in the middle. For those who take big steps, ask him to practice walking a ladder that is put down, step by step accurately, and the cross bar can be made live to adjust the width. To cope with daily life, train slowly the distance and speed of walking. Training across the threshold child, slowly increase the height and width, later on the short steps, and then on the real steps to hold the handrail up and down practice. Children with spasticity in general, the mother pulling hands to walk, hard pulling or lifting the excessive are not conducive to children walking.
14.How to use crutches and walkers?
In order to get a good pattern can also use crutches, walkers to help walking. Walk by yourself slowly, step by step, with the goal set at 2-3 meters. This will prevent falls or poor posture. a. Training walking with an appropriate walking cart; after walking in this position, you can switch to crutches. b. An inappropriate walking cart can lead to incorrect walking posture of the affected child, and although it can help heavy older children to move, no progress can be obtained. c. Walking with crutches: column crutches can be walked for long distances for children with spasticity, but premature walking with crutches can cause the body to flex, the length of the crutches, and the height of the grip should be as instructed by the doctor. The height of the grip should be according to the doctor’s instructions.
15.What position should be maintained when feeding with a spoon?
When feeding a child, keep the child in a reclined sitting position with the head slightly tilted forward and the spoon fed into the mouth from the front and bottom with the hand slightly pressed against the chest. Do not allow the child’s head to be tilted back uncontrollably and the spoon to enter from above so that the child cannot swallow smoothly.
16.How to feed the child sitting down?
When the child is sitting on your lap, place your leg under the child’s knee so that the hip is bent at a greater angle to avoid the tendency to overextend. The food should be directly in front of the child, lower than the head position.