abdominal binder

abdominal binder (Full Version)

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KatMac -> abdominal binder (March 5, 2006 9:45:00 AM)
I am seeing a 13 month old little boy who is diagnosed with hydrocephalus. He is now sitting independently, is not creeping or maintaining quadruped for more than a few seconds. He has had respiratory issues, is frequently congested, and presents with a high ribcage (very immature appearing ribcage) and pectus excavatum. He has quite a protruding belly. I am working on bringing his ribcage down and strengthening abdominals and a previous P.T. suggested an abdominal binder. What do you think about using the abdominal binder? How do you measure for one? Thanks for your input.

tc -> Re: abdominal binder (March 5, 2006 11:50:00 AM)
I have never even heard of a pediatric abdominal binder. Do you have a web link to this type of product? My first thought based on your info would be to try TheraTogs if you can, and for a cheaper option, try Kinesiotaping. Secondly, are there other issues, such as constipation, etc. that are causing the protruding belly vs. just poor muscle control? And does he have poor endurance and lung capacity? May need to focus on improving that as well. THis child may need to be managed in conjunction with consultation with MD to assist with constipation/lung problems and you could also assist with appropriate massage techniques to the abdomen, breathing strengthing increased endurannce , in combination with the abdominal strengthening, kinesiotaping and possible theratogs. Just some ideas of the top of my head. Good luck.

KatMac -> Re: abdominal binder (March 5, 2006 3:02:00 PM)
There are no constipation issues with this little guy. I think that his protruding belly is due to poor muscle control due to his respiratory issues.(and pectus excavatum, what do you think?) He is followed by a pulmonologist as well as neuro and will be undergoing genetic testing soon. I am very interested in your suggestion of massage and kinesiotape. Can you elaborate how you would use these?

tc -> Re: abdominal binder (March 9, 2006 2:24:00 PM)
Another idea is coordinating with a respiratory therapist on strengthinging exercises for breathgin, which would also help for you, I think. Regarding your above question, first of all, have you had any con-ed courses in massage or MFR or kinesiotaping (adult or pediatric)? That way I'll know how to better answer your question.

KatMac -> Re: abdominal binder (March 10, 2006 8:44:00 AM)
Yes, I have taken MFR and massage courses. I also completed a very rudimentary kinesiotaping course online.

tc -> Re: abdominal binder (March 12, 2006 6:50:00 PM)
sorry, i've been really crazy busy. i don't have time to go in depth right now with more thoughts, but i wanted to let you know that i still plan to try to answer your questions better. probably in a few days. :)

tc -> Re: abdominal binder (March 15, 2006 3:02:00 PM)
OK, here's some ideas for the KT: Taping Obliques: Child supine with hips flexed, anchor at ASIS and go up diagonally (with min tension) over belly button towards ribs 10-12. Apply opposite side to form x over abdomen. You can also use a Y-cut on the tape so the opening to the Y is right below the belly button and bring the tails over lateral ribs and lateral trunk. WIth either application, you want to laterally flex the child's trunk away from the end piece, that way you get more hold to the ribs and decrease flaring once they are back in midline. This type of taping is supposed to stabilize the ribs and help "connect" the upper and lower trunk. I'd also try the milk of magnesia under it since it can be a sensitive area. For the massage, if you have access to the Pediatric Massage book by Therapy Skills Builders, it's great. I'd start with any of the strokes, from the gentle pressure on abdomen. moving towards the one called "heart" with outward circles over chest area that can help decrease rib flaring. It's hard to describe all the steps, but if you don't have that book, use your imagination with your massage training to try to activate the muscles and if it seems to help, have the parents do it daily. Hope that's helpful. Let me know if it helps. ;)

Lilli E. -> Re: abdominal binder (March 16, 2006 9:45:00 PM)
When I took a course from Barbara Hypes she talked about using a neoprene weight lifter's belt, the kind with the strip of velcro and cutting it to the size of the child. It was used to give the child a little better posture (but still required the child to hold up their own trunk) during sitting and standing balance training and weight shifting. I understand from an orthopedic doctor at Shriner's here in Hawai'i that since bones are very pliable in young children the support should not be left on for more than just during exercise/balance training. Barbara also shows a technique of vibrating between each rib while a child is prone on a ball encouraging the child to vocalize (ooooooo) to increase the mobility of the ribcage.

KatMac -> Re: abdominal binder (March 19, 2006 5:04:00 AM)
Thanks for your input everybody. I actually had the massage book you mentioned and reviewed it. Thanks again.

tc -> Re: abdominal binder (March 5, 2006 11:50:00 AM)
I have never even heard of a pediatric abdominal binder. Do you have a web link to this type of product? My first thought based on your info would be to try TheraTogs if you can, and for a cheaper option, try Kinesiotaping. Secondly, are there other issues, such as constipation, etc. that are causing the protruding belly vs. just poor muscle control? And does he have poor endurance and lung capacity? May need to focus on improving that as well. THis child may need to be managed in conjunction with consultation with MD to assist with constipation/lung problems and you could also assist with appropriate massage techniques to the abdomen, breathing strengthing increased endurannce , in combination with the abdominal strengthening, kinesiotaping and possible theratogs. Just some ideas of the top of my head. Good luck.

KatMac -> Re: abdominal binder (March 5, 2006 3:02:00 PM)
There are no constipation issues with this little guy. I think that his protruding belly is due to poor muscle control due to his respiratory issues.(and pectus excavatum, what do you think?) He is followed by a pulmonologist as well as neuro and will be undergoing genetic testing soon. I am very interested in your suggestion of massage and kinesiotape. Can you elaborate how you would use these?

tc -> Re: abdominal binder (March 9, 2006 2:24:00 PM)
Another idea is coordinating with a respiratory therapist on strengthinging exercises for breathgin, which would also help for you, I think. Regarding your above question, first of all, have you had any con-ed courses in massage or MFR or kinesiotaping (adult or pediatric)? That way I'll know how to better answer your question.

KatMac -> Re: abdominal binder (March 10, 2006 8:44:00 AM)
Yes, I have taken MFR and massage courses. I also completed a very rudimentary kinesiotaping course online.

tc -> Re: abdominal binder (March 12, 2006 6:50:00 PM)
sorry, i've been really crazy busy. i don't have time to go in depth right now with more thoughts, but i wanted to let you know that i still plan to try to answer your questions better. probably in a few days. :)

tc -> Re: abdominal binder (March 15, 2006 3:02:00 PM)
OK, here's some ideas for the KT: Taping Obliques: Child supine with hips flexed, anchor at ASIS and go up diagonally (with min tension) over belly button towards ribs 10-12. Apply opposite side to form x over abdomen. You can also use a Y-cut on the tape so the opening to the Y is right below the belly button and bring the tails over lateral ribs and lateral trunk. WIth either application, you want to laterally flex the child's trunk away from the end piece, that way you get more hold to the ribs and decrease flaring once they are back in midline. This type of taping is supposed to stabilize the ribs and help "connect" the upper and lower trunk. I'd also try the milk of magnesia under it since it can be a sensitive area. For the massage, if you have access to the Pediatric Massage book by Therapy Skills Builders, it's great. I'd start with any of the strokes, from the gentle pressure on abdomen. moving towards the one called "heart" with outward circles over chest area that can help decrease rib flaring. It's hard to describe all the steps, but if you don't have that book, use your imagination with your massage training to try to activate the muscles and if it seems to help, have the parents do it daily. Hope that's helpful. Let me know if it helps. ;)

Lilli E. -> Re: abdominal binder (March 16, 2006 9:45:00 PM)
When I took a course from Barbara Hypes she talked about using a neoprene weight lifter's belt, the kind with the strip of velcro and cutting it to the size of the child. It was used to give the child a little better posture (but still required the child to hold up their own trunk) during sitting and standing balance training and weight shifting. I understand from an orthopedic doctor at Shriner's here in Hawai'i that since bones are very pliable in young children the support should not be left on for more than just during exercise/balance training. Barbara also shows a technique of vibrating between each rib while a child is prone on a ball encouraging the child to vocalize (ooooooo) to increase the mobility of the ribcage.

KatMac -> Re: abdominal binder (March 19, 2006 5:04:00 AM)
Thanks for your input everybody. I actually had the massage book you mentioned and reviewed it. Thanks again.

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