Thursday, March 7, 2013

The Luxury of Using "Traditional" Rehab Materials in Schools

Even though I'm personally very thrifty (AKA downright cheap) about what materials I use for work purposes, our therapy department can occasionally order costly materials which you normally see in physical rehab clinics and these items work wonderfully for building up strength and endurance for better hand function in school.  I feel it also helps upright posture and deeper breathing, at least while performing the exercises.

Using Theraband to build trunk and UE strength and stability requires direct training and frequent monitoring by the OT.  Students are not practiced in maintaining a symmetrical posture while exercising and they won't benefit as much from the activity if they're wobbling all over the room and performing the exercises way too fast.  If unsupervised, it's also easy for students to perform the finger exercises with the Digiflex in a sloppy fashion and race through the repetitions.  I only suggest a home program with these materials if the students have been working with me for months and months.  Also, I usually provide a video of the student performing the exercises after I've brought the parents in for training with their student.  Yes, yes, I do get written parent permission to take the photos for training purposes.

This year I've collaborated with two physical education teachers who work with students in special education, for adapted PE or special PE.  Oftentimes, teachers have therapy bands on hand and they are very happy to work together to provide additional strengthening exercises for the students.  The PE teachers are given a handout with drawings, photos and text describing the exercises we've practiced with the students.

A whole different reason for using the traditional materials is for students to experience heavy proprioceptive work provided during resistive exercises.  This is coupled with the slow, audible counting when holding the pose at the end of range and the deeper breathing required during the exercises.  Additionally, the concentration required to perform the exercises correctly helps the students practice better focus, at least for a few seconds.
 I learned this trick from a middle school PE teacher--stretch out the band on the floor, stand in the middle and then pick up both ends.
 Starting position, elbows extended.
 Raise elbows and try to keep shoulders level.  Count to ___ outloud.
 New exercise:  Stand on far right side of the stretched-out band.
 Use your left hand to pick up the band.  This is the starting position for elbow flexion or shoulder flexion.
 Finger pads right on top of the Digiflex "keys."  The black cushion looks like a whale, so tell them to put the whale tail close to their thumb.
 If the student's arm swings around during the exercise, tell her to hold her elbow.
  Keep those fingers on the keys!

I always do the exercises along with the students, to demo correct form and to avoid having to go to the gym...

No comments: