Last month, we introduced the concept of key movement issues: these are movement skills that develop spontaneously in children who are developing movement typically, and underlie all functional movement. People with cerebral palsy and similar conditions may experience some or all of these movement issues, which can impact on mobility, participation and communication.
This month’s focus area is weight-bearing. Weight-bearing is the ability to take your own weight through a body part. Weight-bearing occurs through many different parts of the body, depending on the position. For example, when sitting at a table, you might weight-bear through your feet, bottom, hips, elbows, and/or forearms, whereas in standing weight-bearing is through the feet. When someone has difficulty weight-bearing through a body part, we might see compensatory movements like standing on tip-toes, asymmetry, or avoiding activities like being on their tummy (prone) or crawling.
Weight-bearing helps with our stability so that we can much more easily use our arms and hands with quality movements to play and do table top activities like drawing and keyboarding.
Best weight-bearing is in alignment. This means that, in standing, the feet are under the knees and the knees under the hips. Weight-bearing in alignment is essential in developing strength and stability of joints, developing quality movement and maintaining muscle length.
Some strategies to help weight-bearing might include:
o Using leg wraps while standing in a standing frame to ensure good alignment
o Supportive shoes
o Using a table or surface to lean on to promote alignment in upper body.
o Check height of chair to ensure feet are flat on ground or footplate
o Aim for 90 degrees at ankles, knees and hips
o Aim for table height so elbows sit just below 90 degrees
o Use a pelvic strap or sticky mat on the chair to prevent sliding forward, promoting increased quality weight-bearing through hips and bottom instead of lower back.
In prone (tummy) or crawling:
o Use arm wraps to assist with stability and alignment
o Try weight-bearing through bent arms, with elbows under shoulders, if pushing up through straight arms is too much.
o This position can be very challenging, so make it fun with activities like wheelbarrows, scooter boards, looking at books, or listening to music.
For more information or ideas, contact your child’s therapist. If not a CPEC client, contact us via email at email@example.com or phone (03) 9560 0700.