Restraint Therapy

[Kathleen Z]

I just wanted to post in defense of Kristie's position because I feel that people are misunderstanding some people's choice to use restraint therapy. If a child has no muscle innervation, then restraint therapy is cruel and not at all helpful.
However, if a child has a mild injury, has innervation to the targeted muscle, and just doesn't like to use the injured arm, I think that it's a perfectly fine therapy to use to encourage the child to see what it's like to use the injured arm. The key is to make sure that the child has the physical capability to use the targeted muscle first -- ie, you've seen him use it occassionally on his own.
If you can encourage the child to use his injured arm now when he's very young, then you are helping him immensely as he grows.

[Kristie]

Thanks Kathleen!! I appericate your words!! I couldn't have said it better myself. I am glad to know that you understood my thoughts.
Smile,
Kristie

[Jameson2]

you just want someone to pat you on the back for making a mistake in judement mild injury or not it still is torchure to restrian the arm that works leaving the BPI arm to do all the work.as i said before it is discurageing and frusterating to have to go through restriant therapy a baby or small child might not be able to express these fealings so im doing it for them

Jameson

[marymom]

hey is this tereasa in tuscon's jameson?
just curious but what do you think about therapy at all ...you know, producing kind of...resentments? or do you enjoy it? Do you even do it- or do you do stuff at home? Do you have nice therapists/ mean therapists or does it all suck or is it "all good" take it easy- mary

[marymom]

I try to create situations wherein Max is persuaded to use his injured side...
I dont make him tho-
too much manipulation, coercion, someone telling you to do something you just dont wanna do-can definately affect ones temperment-

[Jameson2]

i agree marymom but going all out and tying the unaffected arm is very cruel

[browning93]

I used this type of therapy on my daughter for 15 minutes a day for about a year and still do a couple of times a week. The only problem was I had to sit with her on the floor and do things with her to get her to try to use her left hand. No standing since she doesn't have the natural reflex to catch herself. She had inter costal nerve grafts at 11 months and started using TES at 2 years. This was a great way for me to monitor and delight in her improvement. I bought rugrats and frog material and some prequilted fabric for inner lining and velcro and made a sling like you'd use for a broken arm only with no shoulder strap. Make the rectangle "sling" and have a strap on the top and on the bottom side coming out of the side seam on the side of the elbow of the unaffected arm. Have them long enough to wrap around the body and attach on the hand side.It was impossible for her to wiggle out of it. With only TES and no formal therapy for the last 2 years(she's now 5) it forced her to try. That's all I asked of her.To TRY. Some days you can tell when they're more frustrated, but the smile on her face when she did something she couldn't do before made it all worth it. That 15 minutes a day was all I bothered her though. I felt that was enough. I know I wouldn't want to have "use your other hand" be the focus of my whole life. I actually believe we got more out of that time than if I nagged her day in and day out. For someone who had NO hand function at all before nerve grafts, to a child who can tie her shoes, have a normal pointing index finger and now a grasp and movement in all fingers,I can truly say we are proud and amazed.I also believed it made her more determined, because now she comes to me on her own and says, Look what I can do!" when she accomplishes another movement she didn't have before.And she does it on her own now, I don't have to nag. I think those 15 minutes a day were worth every one for training and discipline. On the way to school yesterday she said, Look Mom, I can bend my pinkie! I was so proud of her. It was a new movement.A small one, but a new one none the less.

[browning93]

I forgot to mention she was only 2 1/2 when we started this and we played in the floor together anyway since she's an only child. That made it easier. I don't think it would work in a much older child. The sooner you start the better.

[browning93]

I also noted in reading some of the other replies that if the nerve isn't there and you can't move it, you can't "make it or try to do it". That's true when there hasn't been any intervention. But with the new nerve grafts, TES and other surgeries it's my understanding that in very young children the body grows new nerve networks and nerves unable to function before with new nerves attached become reinnervated. The child is not used to these movements in the affected limb and wiil always use the unaffected limb first. That's why it becomes neccessary to do something to make them try to use it and become aware of it. If there is new nerve why waste it. The old saying If you don't use it you lose it comes to mind. If my daughter had no intervention and her arm was still like a limp noodle because of the original 3 avulsions and 2 neuromas, I wouldn't even consider pushing her with anykind of therapy because it just wasn't there.