IMPORTANCE OF “SUPINE TO SITTING THERAPY” FOR CEREBRAL PALSY
IMPORTANCE OF
“S U P I N E to S I T T I N G T H E R A P Y”
FOR CEREBRAL PALSY
Supine to sit is a therapy program, where the person comes to sitting position from supine lying position. Person has to come to sitting position by both his legs stabilized on the floor surface. The person is in supine position with knees extended; instruct the person to sit up by raising head, neck and trunk to sitting position.
2. Why it is an important therapy for cerebral palsy
Benefits of "Supine to Sitting" Therapy in Cerebral Palsy:
• In this the child uses core abdominal muscles to lift the weight of the body in the midline position.
• It is a primarily an exercise to gain control of the head and neck, enable movement of the trunk and reduce tightness in the back muscles so that the child can be brought into a sitting position with light assistance
• This includes strengthening and toning the muscles of the child’s abdomen, back and hips.
• It brings a sense of orientation in the child for balance by moving the body to the midline position.
• It prepares the child for proper sitting posture, stability and firmness, and gives the body the confidence to do high level of physical activity.
• It improves the child's physical position by activating the spine by loosening stiffness in the spine and hips and making the hips and back more flexible, thereby increasing mobility and relieving tension and stiffness.
• Increases the body flexibility, improves blood circulation and sitting balance concentration.
• By immobilizing both the feet on a flat surface, it reduces stiffness in the thighs, legs and lengthens the stiff muscles.
• By doing this therapy repeatedly, the child will be able to learn the balance of sitting independently.
• In addition to the trunk strength required, the supine-to-sit task involves substantial trunk coordination and balance
3. What is the procedure of doing this therapy?
The "Supine to Sitting Therapy" Method:
a. When performing this activity, the therapist should create a friendly space, and work in a slow and sustained manner, controlling body movements of child with proper form and technique.
b. Practice on a soft mat or place a towel under the hips for support. While doing this exercise, the child tends to keep both the legs completely straight on the surface firmly in straight positions in a V-shaped to bring the body forward by supporting both the hands.
c. Here the therapist is positioned between the spaces of the legs and holding both the hands of the child in a cross position makes the child sit from a lying position on the back. Here the therapist makes the child sit from supine position without turning his back. It is a physical exercise that uses the abdominal muscles to raise the head, neck and torso from a lying position and then helps to lie down again without moving the legs.
4. What are the reasons for doing this therapy?
Cerebral palsy is the result of damage to the developing brain or malformations in the brain. Injuries to different motor control centers give rise to different types of cerebral palsy.
It is very difficult for the children with cerebral palsy to come to sitting position from supine. There are many factors that are responsible according to the type of cerebral Palsy cases, for example,
a. In Spastic Cerebral Palsy - Due to damage to the Motor Cortex result in poor coordination of voluntary movement and cause muscle spastic and result in poor relaying of signals to other parts of the brain to control movement of limbs. It is characterized by:
• Muscle tightness on one or both sides of the body
• Unable to extend joints full range of motion
• Limited joint mobility
• Tight leg with scissor pattern
• Poor postural reflexes
• Abnormal reflex action
b. Athetoid cerebral palsy is a type of cerebral palsy characterized by athetosis, or uncontrolled movement. This lack of control usually leads a person with Athetoid cerebral palsy to make erratic movements, especially when the person is in motion and Fluctuating muscle tone. It is characterized by:
• Slow and involuntary muscle activity
• Unwanted activity may be small or large, rapid, irregularly repetitive, random or jerky
• Fluctuations in involuntary and uncontrollable activity sometimes affecting the whole body
c. In Hypotonic Cerebral Palsy - Hypotonic CP is a form of cerebral palsy that causes hypotonia, also known as low muscle tone. It also loosens up baby's muscles and these "floppy" muscles can make everyday activity tiring as well as difficult. This causes many children with Hypotonic cerebral palsy to reach physical and mental delayed developmental (crawling, standing, etc.) more slowly than their peers. It is characterized by:
• Decreased sensory processing in which the vestibular, proprioceptive and tactile systems fail to alert the brain of changes in body position.
• Poor head and neck control
• Decreased praxis or motor planning in which the body is unable to produce an appropriate motor response to activities
• There is a lack of balance in the body, both static and dynamic.
• Decreased coordination of upper and lower body movements
• Loosening of ligaments and joints
• Poor balance
• Impaired physical mobility
• Exhaustion
d. In Ataxic Cerebral Palsy – It is a developmental disorder that affects the precise movement (motor function) of a specific function of the muscle. Ataxic cerebral palsy is characterized by problems with balance and coordination. It is characterized by:
• Poor core muscle strength
• These issues are due to damage to the motor control centers of the developing brain.
• Children with Ataxic cerebral palsy have a hard time controlling their movements.
• They are unstable and struggle with precise movements, such as writing and holding small objects.
e. In Mixed Cerebral Palsy - Mixed cerebral palsy is a developmental disorder caused by brain damage that occurs before or shortly after birth. Those diagnosed with Mixed cerebral palsy have damage to motor control centers in several parts of the brain. Children who exhibit one or more types of cerebral palsy that exhibit movement problems are classified as mixed Cerebral Palsy. It is characterized by:
• Abnormal reflexes
• Jerky movement
• Problems with coordination
• Abnormal physical growth
• Body stiffness
• Abnormally stiff muscles
• Unusual gait
5. Conclusion:
"Supine to sitting therapy" is yet another important therapy technique in developing a sitting position in children with cerebral palsy. The Physiotherapist and Occupational Therapist contribute effort and measures to enhances better sitting position by supporting the child in different balance, body control, orientation to prepare for independent sitting position by controlling imbalances in the body and strengthening the organs required for sitting abilities.
