Tie up the good arm: usefull or bad

[brandonsmom]

I want to clarify what I meant by always. After my son's Mod Quad, Iwould immobilize long enough to give him a popsicle and make him eat with his affected hand. he loved and soon it just got to be a habit. give him something in his affected hand and up to the mouth it went. He never-ever got frustrated....he would laugh when we put it on......Gayle

[3sweetiepies]

I do not think this is a cruel therapy unless your child has a severe injury and cannot use the affected hand in any way. For my child, it would be considered cruel because my child cannot use the affected hand at all, the only thing he can do is "wedge" items in his fingers. For other children who have good use of the affected hand or arm, I think it might be affective. I judge no one on either side of this discussion. We all have to find ways to help our kids, if it works for you, great, if it doesn;t great- try something else. We are dealing with a controversial injury, it stands to reason that some of the therapies will be controversial as well.

[admin]

Kate,

I have seen her use only her injured arm w/o assistance from her uninjured arm a huge number of times. We do it daily, and this way is enough for me. I don't need to see her being okay with anything like this b/c I shouldn't take a chance to begin with. What would it do for me if she was okay with it anyway...it would make me feel no guilt, thats about all. To me, there is no need for such a thing b/c I get everything achieved (as far as therapy)holding it back and using my vocal cords instead of casts, slings or splints.
~Krista~
~Krista~

[B.V.]

I had a friend whose child had a bad eye so they covered the good eye with an eye patch to help exercise the bad eye. Is this not the same type idea?
Would this be considered cruel or inhumane? or would it be considered a helpful form of therapy.

[brandonsmom]

B.V.
Well Put short and sweet!
Gayle

[admin]

I am sorry, but I see no camparison with the eye patch and the cast/sling/splint restraint therapy. The eye is a completely different type of muscle where therapy would be extremely hard to perform. The available treatments for a lazy eye are the patch or eye drops that will blur the stronger eye for a certain amount of time. (I am a tiny bit familiar with this b/c of friend's child with this condition.)
How can you compare these two when we have a million other forms of therapy available for our children's arms. Heck, if restraint therapy was THE ONLY THING on earth to help my child then obviously I would have to try it. BUT the answer is simple to me...it IS NOT necessary and NEVER will be. At least in MY world.
~Krista~

[CW1992]

Hey all,
I'm going to join in too. First, I personally have never used restraint therapy - I knew that my daughter was trying as hard as she could already. Every parent knows what will work with their own child - and if they feel this therapy is working and the child is not frustrated then they should do what they feel is best....

Anyway - something to consider. Brittney could not lift her left arm straight up at all when she was younger. She tried so hard to. If I would have tied her uninjured arm down I know that she would have gotten so frustrated and would have been forced to try to do something that she was not capable of. She used to arch her back as far back as she could in order to lift her injured arm high and so I think that restraining her uninjured arm would have caused other issues of hers to become worse - where regular play and ROM was teaching the right muscles how to work. I used alot of creative play and arms taking turns and that worked. I also feel that the age of the child makes a big difference. A baby is learning trust, so restraint therapy would not be good I'd think. An older child who understands WHY Mom is doing what she is doing might think of it as just a different type of therapy like Gayle's son. I would personally never force restraint therapy on a child that could not communicate with me enough to understand why - that is just me and my experience with my child and her injury.
Christy

[Kristie]

I am not sure that I have anything positive to add to this conversation any further but...

I do agree with Kate comment and post that it is contained within: "This is a particular technique that needs to be carefully applied to any individual child"
In MY opinion it is harsh to say that it is cruel to do something if you don't know the whole story. Some kids this therapy could be cruel... for others it could be the difference between surgery or not.

As both BV and I mentioned this is similar to eye patching. No it is not the same muscle but it is still muscles and some get good results using it. It is different( from what I understand) eye patching is not typically done for 24/7 on a regular basis.

When my son started to walk actually tie up his arm in his shirt or strapping it down was no longer safe. But I found that with the cast on he still had use of his arm for balance, He could still move the whole arm (swaying dancing, banging into things with it~ it was a great line of defense for him!). He wasn't able to feed himself with that hand, play with cars, or color but he would figure out how to do it with the other arm.

Several have said that they would do this with an older child. For us after he became independent (dressing himself, potty trained, ect) we stopped doing this. He didn't become frustrated by it but it seemed to make him unable to complete the tasks he was once doing. When he was younger it did not interfere with as much of his daily indepedence.

And just for the record... when he had his cast on we did three times as much therapy (formal and at home) instead of less. So if anyone was thinking that this replaced doing therapy they would be way way off.

I am totally ok with people feeling that it would be a cruel thing for them to do to their child. Because as stated there are some kids that if this were done to them it would be cruel. There are ways to express this without putting someone down for trying to help their child in whatever way they can. I don't think people insinuating that I am not compassionate is fair or right. We need to be careful of blanket statements.

Besides if someone thinks it is cruel no matter what then how can they not think I am cruel and lacking of campassion if I chose to use a form of what they could consider improper therapy? People get hurt over these kinds of things because it borders on making judgements of another's parenting... you know that judging someone's parenting is one of thoseof no no topics like religion and politics. You just don't go there unless you are ready for an agrument. Or if you know the person really well.

Enough for now!
Blessings,
Kristie

[katep]

I personally don't think any of us are disagreeing much at all on this topic. The parents against it are envisioning one scenario - that of a frustrated, unhappy child who is being forced to do something that is not beneficial or needed. The parents who use it - including me - see a child who is able to adapt to the restrictions quite easily and still "function" relatively normally.

Obviously, it depends on the injury and the personality of the child. If what we saw with our child is what the parents who are anti-restraint therapy anticipate... we wouldn't do it. I agree, it would be cruel.

Joshua's PT is in the process of making a hand splint for him, for use on his right, uninjured hand. This is directly because of the gains we saw in him after being recentlly hospitalized for three days with an IV in his right hand, along with having his right hand splinted. He went from always "assisting" with his left hand to holding his sippy cup with his left and assisting with his right. After a day of this "restraint therapy" he was able to fetch the bottle from wherever it ended up in his crib - even up next to his ear, which took more strength and dexterity in his injured hand than we thought he had. I could go on and on... but he never expressed frustration or any angst at all about the situation. He's at a an age (just past 2) where sometimes life is just a little odd, but he doesn't think much of it.

So we plan to replicate this extra effort on using his left hand with a splint made for his right, uninjured hand. We want the right hand to be able to "help" but not dominate. He has a funny habit of putting his right hand behind him whenever he's concentrating on using his left (probably from us holding it out of the way or saying "use your other hand"!) and we need a way to promote bimanual tasks using *both* hands more evenly and together. Subtly restricting the use of his right with a splint is pretty much the only way to accomplish this at this time.

I'd be happy to make a videotape of his "sessions" for any parent who is concerned about him

Kate