so what am I supposed to be "doing" at home?

[admin]

We've been in OT once a week for two years now. DD has good recovery and function and has never needed any surgical interevention.

What should I still be doing at home with her? Since OT doesnt and has never done actual excercises with her there has never been anything to replicate at home. We are lax in ROM at this age as its such a fight. What do you do with your kids as they get older? Her specialist said the biggest concern he has is the humeral joint flattening and so we work on the external rotation ROM but am I missing something?

[babyryd]

I have the same question. My son's injury is just 2 mos old, but we've been going to OT 3x/wk and the therapist really doesn't do much with him while we're there. He's had 3 splints made for his hand/wrist which is my other question. We were told he should wear his splint and sling/shoulder immobilizer 24 hrs/day except for ROM. He's on a pan splint and his hand already looks like it's atrophied and flattened quite a bit. Is it normal for TBPI children to wear splint/sling all day and night? One surgeon questioned his wearing the pan splint so often, so we've been alternating at night. Should he be wearing a splint/sling constantly?

[BrokenWingedAngel85]

Hi,
I think the exercises vary from child to child, but here are some of the exercises we do with our 9 - month - old:

1. I help him to bend his arm so that his forearm and his upper arm form a 90 degree angle, using my hand opening his fingers (think of a police officer stopping traffic).

2. Opening his hand with mine and using my other hand to pin down his elbow, I stretch his arm over his head. I hold it there for a few seconds, and then stretch his arm across his body. Of course, I do not stretch far enough to make him uncomfortable.

3. Massaging the arm also helps. I start at the scapula and work my way slowly down to his fingers. This is repeated several times a day.
Because your child is older, she may not like this very much. If not, maybe you could just try it at bedtime, when she's tired.

4. Lying on his tummy helps to strengthen Daniel's arm. We put lots of toys around him and encourage him to reach for them. Even if he only reaches with his strong arm, he still has to put weight on his injured arm, which helps to strengthen it.

5. You can also try swimming, which has become one of Daniel's favorite pastimes! Given your child's age, this may be the easiest one to get her to do. If your child cannot swim independently, holding her in the water and letting her splash should work just fine. I've noticed that after Daniel goes swimming, he is much better able to tolerate his exercises. Any body of water will work, but check your local area for a warm therapeutic pool; that seems to work best for us.

Also, ask your therapist if there is anything else you can do. If your therapist isn't helpful, maybe your child's pediatrician can help. Good luck!

Johanna

[admin]

need to get rid of that ot.

[Steff]

My OT says my son is to wear his ulnar gutter splint about half the day. We put it on him overnight and on and off for a few hours while awake, but when he is up and active (he's only 12 weeks old) the splint's off and I stretch his arm/wrist, do ROM, tummy time, and try to get him to feel and grab things with the affected hand. Of course I can't do this all day, so he probably gets 3 hours a day of me messing with his arm between naps. He's had the splint for 5 weeks now and there is a big difference in the amount of ulnar deviation he has. Now it's only noticeable when he tries to grip something as the stronger muscles overpower the weak ones, but at rest his wrist is in neutral and his hand is very strong. I don't think constant immobilization would be good for anything but fractures or post-op. If your baby has contractures then longer splinting might be needed, but still, he's got to use those muscles or they will certainly atrophy, and a few minutes of ROM a day isn't enough to keep them strong. Just my 2 cents.

[admin]

Steff splints are great however nothing takes the place of a good Ot or Pt.

[Steff]

Certainly. We go to OT twice a week, although I feel like she is there more for regular assessments and ideas than the actual ROM and stretching, because that has to happen on a daily basis. My OT has shown us all sorts of things I wouldn't have thought to do to try to make Mason more aware of his BPI side. She is also a source of "positive energy" for us because she remains so optimistic and always points out something new that wasn't there before, even if it's something so subtle than I haven't yet noticed it.

[admin]

Can you describe in more detail what the ulnar splint is? I'm just curious if this is what we recently picked up with for my son at his first visit with the specialiist.

Ours has three straps. One goes across his palm. The whole thing goes up to about his forearm and just holds his arm neutral.

We wear ours at night only. Maybe one of his naps during the day.

Chrystal