United Brachial Plexus Network, Inc.

Wondering if anyone can tell me what type of therapy you are doing for your little ones at home? My daughter is 10 months old and is doing well but I struggle EVERY day with ROM exercises with her. She has pretty much resisted since she was 4 months old. Some days she will let me stretch her other days, not a chance! This is a HUGE stress on me because I know I should be doing ROM frequently throughout the day, but I am truly lucky if I can do them even once a day. She is that strong and resists that much! She does have full passive range, so it's not that she can't physically do it, she just doesn't want too. She is crawling now and just started climbing the stairs and she can also pull herself to a standing position and slowly cruise along the furniture. I realize all of this is good for strengthening but what else can or should I be doing?????

The BPI therapist we have seen in the past, has only ever recommended doing ROM once a day since birth, which I never agreed with, so most of what we do is on our own and not instructed or guided by anyone (outside of the ROM exercises). It's extremely frustrating. Even the other non-BPI PT we see doesn't stretch her, she does another type of therapy (IMT), but I still wonder if we should be doing more in formal therapy as well as at home!

I know I am hitting a low point again and am very concerned that I am not doing enough for my daughter.

Any input or helpful tips would be greatly appreciated, as usual!

Thanks,
Shellie

Hi Shelly
I have a 17 month old and rom can be challenging! I have always done rom 3 times a day. As soon as she gets up, in the afternoon and once after dinner. The best thing to do make it a part of a routine just like eating lunch or dinner.

The only other thing that has worked when its been one of her fussier days is to plop her down in front of the tv with a favorite show and stretch her out then. Not a good habit to get into but it may be better than having to go for a surgery because she has tightened up.
Good Luck!

I feel exactly the same - that I'm not doing enough. Jason, 8 months (lobpi) also cries when I do ROM (although I'm quite sure it doesn't hurt, since he doesn't always cry, he just seems to have become stubborn lately). I try to incorporate his left arm into play, etc., but he really fights it. Pulls his left arm away from toys, uses his right arm to take anything I put in his left hand (he has a little bit of grip in his left hand). I've started to say, "why is rightie so mean to leftie? Rightie needs to share."

If your baby is crawling it sounds like she must be doing pretty well...? Does she put weight on her weak arm? Does she have hand to mouth? Our OT has recommended that I really try to get Jason to put weight on his left arm. I put toys out of his reach then help him lean on his left arm to reach with his right or I put a book on his left side and have him lean that way to look at it.

He also HATES tummy time, which is so important! I've tried putting his favorite toys in front of him, read his favorite books, I've even resorted to TV (which I have been avoiding overall). He can last about 4 minutes before he screams. Another thing our OT recommended is encouraging him to push things (light, empty containers) off his high chair with his left arm and also to play with many different textures: jello, cooked rice, applesauce, water to splash in a shallow bowl (those suction bowls are good). Stuff we probably normally wouldn't encourage, but of course, I'd be thrilled if Jason can do it with his left arm!

We have also been trying to get Jason to roll a ball with both hands. Leap Frog toys has an alphabet ball that plays songs or the alphabet as it rolls. We also use toys that vibrate to help with sensation. Fisher Price has vibrating kitty and doggy toys.

Anyway, I have lots of stuff to do with Jason, but since he resists so much, at the end of each day I look back and think I didn't "make" him do enough.

What is IMT? Sorry this is so long, but I hope it helps.

Hi Shelly,

My 20 month old was also very strong, and has had great recovery, as a result we stopped doing ROM around 10 or 11 months. We continue to do therapy, and occasionally I check her range, and she is always loose, so that is not a stress to me. (This is not my recommendation, just what worked for us)

Some of the therapies we were doing at 10 months - I think it was around then that we started using pop-beads. Hold them over her head and if she can reach for them, have her pull the beads off one at a time.

Our therapist had these tubes that look like the bendy part of a straw, I found them at the Learning Express. We held the tube out to her to get her to reach for it and pull it to her (it stretches and makes a cool sound, like a bendy straw). We started with it low, so she would be pulling it in front of her, and we worked our way up so she would be pulling from over her head.

I'm sorry if these are a little old for your daughter, I can't remember exactly what we were doing at 10 months.....but these are play things that we did all the time, and still do, although now she is trying to put the pop-beads back together.

Anything that encourages reaching and pulling to strengthen her arm and shoulder. Pulling to stand is great, my little one didn't do that until 11.5 months.

Good luck, I remember the frustration too, it gets better.

Julie

Shellie, I get this catalog and it has great things in it!!

http://www.theraproducts.com/

Thanks Julie for the great suggestions, we actually have some of those pop beads that I haven't pulled out yet and I know that bendy straw type thing, I will try to find one!

Mandie, I will definately check out that website and get a catelog, thanks for the info.

KMD, I have tried the TV thing and anything else for distraction, but unfortunately, neither of my children have ever sat still long enough for anything, let alone therapy! But I will keep trying, thanks for your input!

Again thanks for your help

Shellie

Reading this was weird. It sounds just like me. My son is 11 months old and had surgery 2 months ago and we are just starting the rom back up and boy, does he fight me. Most of the time I end up having to do half now and half later. It is a very frustrating time. But, I am sure many of you will agree with me on this... Does our babies personalities, strenghths and smiles not make up for everything else. Just remember to keep smiling and that God would never throw anything your way that you couldn't handle.

Jason's mom,

sorry I didn't respond on my earlier post....your post hadn't posted yet.

IMT is a different type of therapy and can best be described by the website where it originated
www.centerimt.com
It's basically different positions held for 90 seconds at a time to help the energy flow through the muscles and tissues properly, which cannot happen if there was trauma to the areas. It has really helped my daughter with some movements that were restricted due to the compression injury from birth.
Obviously if something is not yet innervated it won't do anything, but some of the positions the therapy works on helps all areas....muscles, tissues, blood vessels, nerve pathways, etc...it's a whole body therapy approach.

Anyway, the website can explain it better than I. We tried it because I knew it couldn't hurt any and with these injuries, it's not just about the arm, so much more is affected.

Thanks for your therapy tips, hope Jason continues to have a great recovery, and keep promoting tummy time as much as he will tolerate. Target had a water filled mat with a small pillow (mini boppy style) to support under the shoulders and there are floating fishes in the water to encourage the kids to reach and touch the fish. Ashley used hers for a while until we accidentally popped the bag! It was a good tummy time play toy!

Oh and yes, Ashley has hand to mouth (elbow still somewhat up) and she weight bears on her left arm. She commando crawled for about 2.5 months than started the regular crawl about 1.5 months ago. She is doing very well in that aspect of her recovery!

Thank you everyone for your responses....I deeply appreciate all comments and suggestions.

Take care and God Bless our little angels!