fbpx

Tag: Physical Therapy

Serial Casting

Serial Casting- Casting That’s Not for Broken Bones

Dynamic serial casting is a conservative treatment method in which skilled physical therapists apply and remove a series of lightweight casts to a patient’s leg(s) in order to improve foot alignment and increase range of motion. The goal of serial casting is to improve range of motion in order to prevent chronic skeletal issues, reduce falls, improve function and efficiency, improve the child’s walking pattern, decrease current pain or prevent future pain, and improve alignment for future orthotic use. Serial casting can help to delay or prevent the need for surgical intervention. 

The casting process is performed by skilled physical or occupational therapists. A soft, semi-flexible casting material is applied over stockinette that is padded to protect bony prominences (natural bony points such as the ankle bones) and wrapped in a layer of cotton wrap. The joint is carefully positioned in a neutral position to maximize alignment and gently stretch the soft tissue, with the position maintained throughout the casting process. The child wears and walks (and squats, walks up and down stairs, and stands) on the cast for several days (typically 4 days on and 3 days off), with increased movement and weight bearing allowing for increased gains throughout the casting process. This process is repeated every week for 6-12 weeks until the desired range of motion gains have been made. Notable and measurable gains can be noted in just a few casts, too! 

Conditions that can be addressed with serial casting:

*This is not an exclusive list, as serial casting can benefit a wide variety of patients. Patients who are younger typically make quicker gains throughout the serial casting process; however, patients of any age can participate (and have participated) in serial casting. 

  • Cerebral Palsy
  • Idiopathic Toe Walking
  • Club Foot
  • Charcot-Marie-Tooth
  • Traumatic Brain Injury
  • Duchenne Muscular Dystrophy
  • Spasticity (abnormal muscle tone)
  • Contractures

This noninvasive process is designed to make gains while having limited impact on the child’s typical daily activities. Children can play, stand, and walk within their home, school, and community and participate in after school activities and sports (with the exception of swimming and water play). It is typically not a stand alone treatment method. Casting typically coincides with or is followed by ongoing physical or occupational therapy, and a referral for a pediatric orthotic evaluation to continue to maximize the gains made throughout the serial casting process.  

Check out BDI’s Serial Casting page or ask your child’s BDI physical therapist for more information.

Cassidy Bannon, PT, DPT

 

Reflex Integration

Reflex Integration

What are reflexes?

Reflexes are automatic responses that occur out of someone’s control in response to an external stimulus or facilitated movement.  Reflexes are necessary automatic movements that are essential for survival as a baby and are what helps a baby develop movement. 

Each reflex is present and integrated at different parts of development.  An example is the rooting reflex, when the baby’s cheek is stroked the baby will turn their head in the direction of the stimulus and open their mouth automatically. This reflex allows the baby to find their mother’s breast and is essential for feeding.  This reflex will usually integrate around 4 months of age once the infant starts to develop volitional control and has learned how to respond IND when they smell, feel and see mother’s breast.  

Unintegrated Reflexes

Reflexes can become problematic when they are delayed or unintegrated. In the case of the rooting reflex, if it is not present at birth it can impact IND feeding response or if present after feeding can impact speech, eating, and response to facial touching.  Common things you might see in your child if this reflex is not integrated include trouble pronouncing words, difficult breaking thumb sucking, messy eatering, or has poor tolerance to kissing or touching their face. 

Unintegrated Reflex Red Flags

There are many reflexes and each has a vital role and can have a huge impact on development if delayed or not integrated at the right time.  Some of the red flags to look for include

  • difficulty or delayed gross motor skills
  • difficulty or delayed fine motor skills
  • emotional lability
  • poor tolerance to new situations
  • difficulty with learning/writing
  • poor vision
  • poor attention
  • bed wetting
  • difficulty with potty training
  • abnormal muscle tone
  • poor tolerance to certain movements.

Next Steps

If you have any of these concerns you should try physical and/or occupational therapy to perform movements that are designed to help with reflex integration.  In addition, your therapist will be able to work on the functional or emotional skills your child is having difficulty with to improve their IND and participation.

Find Answers & Get Started

Continue reading

Elbow

Hypermobility in Children

What is Hypermobility?

Hypermobility is a term used to describe joints that move more than normal and can place the joints in increased stress.  

How can Hypermobility affect my child?

Risk of Injury

Increased joint movement can cause joints, ligaments, and tendons to be at higher risk of injury.  Joints are less stable and can strain all the structures attempting to make the joint more stable.  In addition to joints moving more than normal the signals to the brain about where the body is in space can be impaired due to the ligaments requiring increased stretch before the message is sent to the brain making it harder for children to know where they are in space and making it harder for them to correct the joint position prior to exposure to extremes of  range of motion.  

 

What are the common signs of hypermobility in children?

Knee HyperextensionElbow HyperextensionHands to the Floor with

Straight Knees

Flat Feet
ELBOWHands to floorflat feet

NOTE: These are all postures that can occur in typically developing children with no cause for concern.  However, when multiple joints are impacted and your child twists their ankles or knees frequently, or reports leg pain this may be a sign to follow-up with your physician. 

Who can help my child?

BDI Pediatric Physical Therapists create a strengthening and proprioception program that can improve your child’s participation in recreational activities as well as lower their risk of injuries. Exercises consist of 

  • strengthening the muscles around the joints
  • working on postural control
  • sport specific training 

 

Next Steps

Do you think your child is at risk for injury due to hypermobility?  Schedule a free screening with one of our pediatric physical therapists.  When hypermobility is identified and treated with a proper development regimen, your child will report less pain, improve balance, strength, and functional performance.  In addition, your child can prevent future pain. 

Written by: Lisa M. Wood, PT, DPT

Posture Intervention

Posture Intervention

Questions about BDI Posture?

[receiver]

708-478-1820

[calendar]

Schedule a Free Screening

Why does posture matter?

Sit up straight! Posture is much more complicated than just sitting up straight. In order to function our best, we need the best possible posture to support that function. Posture is how the body is aligned in everything we do. Good posture is essential for sitting, standing, moving, and even sleeping. Poor posture causes poor movement patterns which leads to short and long term functional deficits. 

What are posture red flags?

Assess posture in static and dynamic positions. Take note of your child’s posture when they are sitting/standing and playing. Look for these red flags. 

  • Slouching
  • Leaning 
  • Asymmetry 
  • Flat or excessive curvature of back
  • Protruding abdomen
  • Forward head
  • Rounded shoulders
  • Head tilt
  • Shoulder elevation  or more forward on one side
  • Inability to stand or sit still 

Who is at risk for postural deficits?

Everyone but especially children! Posture is a life long journey, always needing improvement and is essential for good health. Certainly more screen time is not helping our postural alignment and it’s often unavoidable. Unfortunately poor posture during screen time is especially detrimental to children who have not fully developed. Children have weaker muscles and tissue connections as well as soft bones that are more prone to the effects of gravity. A diagnosis of  Good postural alignment will help decrease the risk of future pain and injury. 

How does posture affect children with special needs?

Children with special needs are at most risk for postural deficits due to possible weakness, tightness and movement challenges. Poor posture can cause breathing, visual and digestion deficits. Joint mobility issues are often compounded by postural misalignment. Posture is not easy to correct on the strongest of kids,  a lot of energy goes into maintaining good posture. Helping to support the child in good alignment will allow them more energy to reach their full potential. Proper postural alignment is essential to ensure the best possible outcome for kids with special needs. 

Who can help? 

Our physical therapists are trained to evaluate posture in all positions for the best possible functional outcome. They will assess your child’s spinal position in static and dynamic activities to help correct positional dysfunctions to improve their motor patterns. Modifications may be needed to improve alignment and PT’s have the expertise to suggest might what work best for your child.  Physical Therapists give personalized exercises, stretches and tips to improve postural endurance and alignment. 

If you have any questions or concerns about your child’s posture, schedule a free screening with one of our physical therapists to help determine a cause and help correct postural misalignments.

Find Answers & Get Started


Continue reading

Aqua Therapy

Pediatric Aqua Therapy

  • aqua 1

  • Aqua 2

  • aqua 3

  • aqua 4

  • aqua 5

  • aqua 6

  • aqua 7

  • aqua 8

  • aqua 9

  • aqua 10

  • aqua 11

  • aqua 12

  • aqua 13

Aqua Therapy Questions?

Give us a call anytime at (708)478-1820 or schedule a free screening or consultation below.

Schedule a screening

What is Aqua Therapy?

Aqua Therapy is a fun way to develop your child’s motor skills! The unique properties of water enhance therapeutic activities. The use of water in therapy can:

  • Provide a reduced gravity environment to help children explore and practice movements
  • Develop skills they are not yet able to perform on land
  • Provide resistance to active movement through all planes of motion
  • Facilitate gains in strength for all major muscle groups.
  • Increase tactile, vestibular, and proprioceptive input that enhances body awareness and motor learning

Benefits of Aqua Therapy?

  • Increase in mobility and range of motion
  • Balance and coordination
  • Increase in trunk stability and postural alignment
  • Perceptual and spatial awareness
  • Muscular strength and endurance
  • Joint mobility
  • Muscle flexibility
  • Head & trunk control
  • Blood supply to muscles
  • Attention span & sensory motor integration
  • Respiratory rate
  • Circulation
  • Symmetry, strength and endurance
  • Decrease in pain
  • Decrease in muscle spasms
  • Decrease in abnormal tone and rigid muscles
  • Decrease in joint compression
  • Stress and tension release
  • The psychological benefits include improved self esteem, confidence, and motivation!

Your Aqua Therapists

BDI Playhouse Children’s Therapy’s aqua therapists are licensed physical and occupational therapists with experience in aquatic pediatric therapy. They have attended aquatic therapy courses, and have received certificates in Water Safety and CPR. They utilize aquatic and landbased techniques, including myofascial release, neuro-developmental treatment, sensory motor integration and functional motor skills in their treatment sessions with children who have orthopedic, neurologic and/or sensory motor challenges.

Aqua Therapy Locations and Materials

What do I need to bring to my child’s Aqua Therapy session?

  • Towels
  • Lock for locker (optional)
  • Bottle of water
  • Water diapers or rubber pants (for incontinence)
  • Non-skid slippers or water shoes

Locations:

Getting Started With Aquatic Therapy

Find answers here

Still not sure? Schedule a free consultation here

Download or print this page

Great Feedback from Great Families

Our son received physical therapy both in the office and in the pool for his torticollis. While we were incredibly happy to have our son ‘graduate,’ we were also so sad to say goodbye to our amazing physical therapist. She was dedicated, thorough, and caring; we are so grateful for this positive experience!”

Continue reading