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Jumping
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Jumping - July 27, 2000 2:51:00 PM
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Meredith Swittenberg
Posts: 6
Joined: April 2, 2000
From: Charlotte, NC USA
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I was wondering if any of you have any suggestions on helping low tone kids learn to jump. I realize trunk stability is a prerequisite, as is LE strength and pelvic stability. I have 3 kids--one 3 1/2 year old with Down's, one 6 year old hemiplegic and one 4 year old "developmental delay"--who are just not getting it with the techniques I've used (fast marching in place on trampoline, HHA on trampoline, jumping off tall mats, stepping over objects and introducing speed to the task). I'm beginning to get pretty discouraged! Any suggestions?
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Re: Jumping - July 28, 2000 12:22:00 AM
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Andrew M. Ball, MS, PT
Posts: 500
Joined: October 8, 1999
From: Chapel Hill, NC, USA
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Ummmmm, be careful with the child with Down Syndrome. Encouraging jumping could fatally hurt him or her. There is no really good poitically correct way to say that.
Personally, I'm not a big fan of trying to get kids with Down Syndrome to jump. In fact, I usually downright contraindicate it. The Atlanto-Axial joint is VERY unstable in about 15% of kids with DS, and just a wee bit unstable in all the rest. That means that the wrong move, shock, or jump could drive the dens (aka odontiod process of the second vertebrae) right into the brainstem, and that would be your fault.
Kids with DS are usually cleared for PT with a cervical spine X-ray at 2 1/2 years of age and then annually after that, but even then, I'd seriously caution against jumping, bouncing on ball, jumping on the bed or couch, etc. They may do these things anyway, but I'm not going to encourage it. And tumbing (e.g. somersaults) is a DEFINATE NO, NO!
I'm also very big on teaching parents how to clonus test in kids with DS. Why you ask? DS is not an upper motor neuron disorder you say? That's true, but if the dens is putting pressure on the brainstem (like after a fall or during a growth spurt) then clonus will emerge. This is often the first sign that that child NEEDS TO BE TAKEN TO THE ER OR NEUROLOGIST IMMEDIATELY . . . somthing PT's can catch . . . and somthing very often missed.
As far as the other kids are concerned, I've found that the trampoline works very well for kids with developmental delay NOS and kids with CP . . . just a long road. Try activities that will strengthen muscles needed for the plyometric of jumping (e.g. quads and gluts right?), like in sitting, pushing a scooter board backwards while racing the PT . . . or reaching overhead while in a hurdler stretch position. Then follow up with the functional activity on the trampoline.
It's late, I'm going to bed, and I hope that helps.
Drew
[This message has been edited by Andrew M. Ball, MS, PT (edited July 28, 2000).]
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Re: Jumping - July 28, 2000 3:38:00 AM
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Meredith Swittenberg
Posts: 6
Joined: April 2, 2000
From: Charlotte, NC USA
Status: offline
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Thanks for the input! This DS kid is so high level that sometimes I tend to overlook the physiological nature of his issues. The hurdler's stretch exercise will be good with my other kids.
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Re: Jumping - July 28, 2000 4:07:00 AM
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Dana D
Posts: 142
Joined: September 18, 1999
Status: offline
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The only other suggestion I've tried that you did not mention was using "bubble wrap".. For some reason, a coupld of my kids did not get jumping... and I had them stand on bubble wrap. With hand held assist and occassional downward input at the pelvis through their knees and legs to encourage the jumping, they began to do it! They loved to hear the popping sound and it motivated them to keep trying to jump... With bubble wrap, this one girl learned to jump in place and is now broad jumping about 6 inches.. (not that bubble wrap is the magic cure, but it is fun for them [IMG]http://www.rehabedge.com/forums/smile.gif[/IMG] Give it a try next time you open a box and have some left over wrap [IMG]http://www.rehabedge.com/forums/smile.gif[/IMG] Good luck!
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Re: Jumping - July 28, 2000 4:40:00 AM
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Andrew M. Ball, MS, PT
Posts: 500
Joined: October 8, 1999
From: Chapel Hill, NC, USA
Status: offline
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That's a GREAT idea Dana. I usually use the Air-Foam mats in order to get the same effect, but the bubble wrap is a better, and cheaper idea.
In colder parts of the county --- I learned this when practicing in Rochester, NY (aka the city of freezing tushies) --- Bubbles freeze when it gets cold out, and kids just LOVE to jump on them. It's a great motivator.
Drew
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Re: Jumping - July 28, 2000 5:49:00 AM
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gerry
Posts: 235
Joined: July 6, 1999
From: Montgomery, AL, USA
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I love the bubble-wrap idea! It goes to show the importance of motivation. We all do better when we have a reason to do something. Purposeful movement is more likely to occur, and of better quality than non-purposeful movement.
Another idea; prone on the scooter board pushin off a wall with power to see how far you can glide. If you have a Total Gym type of product available, you can decrease the inclination and see if they can "jump" enough to slide up the ramp to reach an object.
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Re: Jumping - August 2, 2000 3:53:00 AM
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Dana D
Posts: 142
Joined: September 18, 1999
Status: offline
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This idea came to mind yesterday while I was treating... Have the child squat to retrieve a toy and then stand up, reach and even go on their toes to put it in a bucket... and then encourage them to speed up... This is the motion the body goes through when jumping... a bit exaggerated, but very similar...
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Re: Jumping - August 2, 2000 2:09:00 PM
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Meredith Swittenberg
Posts: 6
Joined: April 2, 2000
From: Charlotte, NC USA
Status: offline
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Thanks for the great ideas y'all! I'm going to give them all a try. Unfortunately, my case load is turning into all low back pain and very few peds patients.
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Re: Jumping - August 2, 2000 2:38:00 PM
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charanderson
Posts: 25
Joined: December 27, 1999
From: Newbury Park, Ca, U.S.A.
Status: offline
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I really appreciate this topic. Getting kids to jump has long been a source of frustration for me. Perhaps, Andrew, you can address the possible neurological rationale as to why some kids, who otherwise look like they should be able to, have trouble with the lift off? There is something about "clearing air" as I call it that is challenging. With some low tone kids, I wonder if there is a somatosensory
component that makes it difficult to "push" the force up through the joints in push off.
Am I making any sense?
Charlene
[URL=http://www.Rexall.com/SportsPerformance]http://www.Rexall.com/SportsPerformance[/URL]
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