A Balancing Act
Posted Sep 28, 2015 by Jacquie Robison
~ two jump ropes (or 4' length of rope)
In May 2012, at almost three years old, Sofia began to use a reverse walker. This was a huge milestone for her and for us as a family. She had worked hard on stepping in physical therapy — typically with either someone holding her hips, or with an adapted pediatric harness over a treadmill. During those sessions, the focus was on not having her legs cross each other — the ‘scissoring’ motion that is typical of lots of kiddos with CP.
When we talk about moving her body, I’ve always tried to explain it with images and concepts that make sense to a young person. With stepping, we talked about how important it is to ‘keep your legs and feet in their own lane.’ I used cars driving on the road as an example. I asked, “if cars are in both lanes and one crosses over into the other lane, what happens?” She replied “a big crash”. I agreed, and went on to say that I didn’t want her to have a big crash, so she had to concentrate on swinging her legs and feet straight ahead, so they wouldn’t get tangled up.
Great, open conversation with her medical team — whether her pediatrician, orthopedist, podiatrist, physical therapists or occupational therapist — has been a huge component in her continued progress and inspiring me to think of ways to assist it. I ask tons of questions, read all kinds of information, and share back with them what I observe as I spend time with her. Because, while they are expert in their areas of discipline, I know that my biggest value is that I’m expert in Sofia.
Over time, one thing I noticed was that she would often rely more on her arms to swing her legs, versus shifting weight from one leg to the other. When I asked about this, folks on her team explained that it is common for it to take a while for the child to really activate the legs and test whether their body can do it on its own. They talked about the fact that sometimes holding on to something provides a sense of security and safety.
The primary question essentially became, “How can we give her touch guidance, but create a system where she really has to use her legs to step?”
The secondary one became, “How can we make it fun?”
An online story highlighting a program teaching people with traumatic brain injury to step again gave me an idea. In it, they used a ballet bar to reteach an adult to step. For Sofia, I modified it to use two skipping ropes running parallel and tethered to points at each end. The skipping ropes would give some support, but they wouldn’t hold her up if she pushed down on them.
We drew a big ‘CIRCUS’ sign and made some popcorn. I told her we were about to have a big top adventure and she was the main attraction — a tightrope walker! Welcome to our circus.