Shoulder Girdle instability

[dairinwogan]

I am presently working with school age children mainly referred with delayed gross motor skills and developmental co-ordination problems. I wondering how others deal with and treat children with shouldder girdle instability resulting in poor proximal control and susequent fine motor difficulties e.g poor sitting posture and handwriting. Any cliniclally effective exercise programmes etc?

[shelly]

Originally Posted by dairinwogan

I am presently working with school age children mainly referred with delayed gross motor skills and developmental co-ordination problems. I wondering how others deal with and treat children with shouldder girdle instability resulting in poor proximal control and susequent fine motor difficulties e.g poor sitting posture and handwriting. Any cliniclally effective exercise programmes etc?

Hi,

Just a thought...Have you considered the benefits of Lycra body suits in improving upper limb function??? I have seen some amazing effects upon hand writing ability and improved hand function following increased proximal stability and proprioceptive feedback. I've seen some great results of suits manufactuired by companies such as Second Skin. I carried out some research and ability to eat/drink/handle cuttlery and write as a result of wearing such suits can be seen in many cases. Maybe you were after exs programmes specifically, so maybe my info is not much help, I dont know!!!

[equiphys]

Hi
i have had good success with fitball programs. starting in prone, walking out onto the hands only as far as they can stabilise, with tummy or pelvis still on the ball (or use a peanut roll if they are really weak) and doing a combination of timed static holds and walk-out/walk-in (with hands) reps/sets. Really concentrating on quality of the position and movement as they are doing it. The further they can progress out from the ball, the more they work on core stability.....better sitting stability for fine motor tasks. Make sure fitball is kid size. This may not be appropriate for the school setting unless they have time set aside for intervention. Otherwise, great home program if parent can be shown exactly what is requried.

[physiok]

Hi!
What type of developmental delay is this? I mean: how is the walking (what age is the child), sitting, long sitting balance and ctrl, general tone, muscle length and strength...
The precision in the hands is greatly influenced by the stability of the shoulder blades, ctrl and coordination of shoulder muscles and strength of the intrinsic muscles of the hand.
Blades stabilizers are often used to hold the upper thorax in hypotonic children, resulting in protracted shoulders with limited AROM end of the range in F and poor coordination, the iliopsoas is then used to hold the LB causing lordosis and loose abdominal muscles, as well as poor balance in sitting. These children usually walk without lifting their knees and can't run fast, they are often intoeing too.

Do a precise assessment of all these and if you still need some help with the treatment I could give you some ideas.

[sunandha]

hi..
i think wheel barrow walking vcan increase proximal stability to a great extent coz weight bearing activities wil definitely result in cocontraction which can increase proximal stability..
otherwise try joint approximation with the shouldre abducted to 90 degrees