Module 3: Positioning Your Child: Difference between revisions
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*Her body (spine) must be straight – support on her sides if needed with a rolled up towel to keep her straight | *Her body (spine) must be straight – support on her sides if needed with a rolled up towel to keep her straight | ||
'''Legs and feet''' | '''Legs and feet''' | ||
*Bend her hips – this helps to release tension in her lower back which is often arched, and it | *Bend her hips – this helps to release tension in her lower back which is often arched, and it | ||
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*Babies/small children can „hang‟ in a large towel (held by two adults) to relax tight muscles. | *Babies/small children can „hang‟ in a large towel (held by two adults) to relax tight muscles. | ||
=== Prone ( on their tummy ) === | === Prone ( on their tummy ) === | ||
{| width="200" align="center" cellpadding="1" cellspacing="1" | {| width="200" align="center" cellpadding="1" cellspacing="1" | ||
|- | |- | ||
| [[Image: | | [[Image:Poor prone.png|center]] | ||
| | | | ||
*[[Image: | *[[Image:Ideal prone.png|center]] | ||
|- | |- | ||
| | | | ||
*Body is not even, because her head is turned to breathe | *Body is not even, because her head is turned to breathe | ||
*There is no muscle work | *There is no muscle work | ||
*She can‟t see anything | *She can‟t see anything | ||
*Legs may be crossed | *Legs may be crossed | ||
*Hands are in a fist | *Hands are in a fist | ||
*She can‟t do anything | *She can‟t do anything | ||
| | | | ||
*Body is even | *Body is even | ||
*Promotes learning and development | *Promotes learning and development | ||
|} | |} | ||
<br> | |||
Prone Checklist: | |||
'''Head and body''' | |||
*In a straight line | |||
*Encourage her to lift her head and look at something in front of her on the floor. This is a good time to get a sibling, also lying on the floor, to play with her | |||
'''Legs and feet''' | |||
*Straight – push down on her bottom from side to side in a rocking motion to help her straighten her hips | |||
*You can put weighted bags over her hips | |||
'''Shoulders and arms''' | |||
*Her arms should be in line with or slightly in front of her shoulders (make sure the pillow or towel she is lying on comes all the way up to her armpits to help keep her arms forward) | |||
*If possible, encourage her to open her hands and push down on them (you may need to gently open them out for her; if too stiff to stay open, keep helping her each time you use this position) | |||
[[Image:Prone support.png|center]]'''MOST IMPORTANT''' about this position is that it is not for all children! Be careful when using this position for children who are always pushing back strongly with their heads. It is possible that it will reinforce the pushing back of the head, while the child is not actually learning to use her arms or control her head. | |||
=== Side Lying === | |||
Side lying checklist: | |||
'''Head and body''' | '''Head and body''' | ||
* | *Head supported on a pillow so her chin is level (in the middle, with her head and spine in a straight line) | ||
*Give good support at her back, from the top of her head to her feet | |||
'''Legs and feet''' | '''Legs and feet''' | ||
* | *Keep her bottom leg straight | ||
* | *Support her top leg bent at her knee with pillows or blankets so her knee is level with her hip – this is important to help prevent injury to her hip (dislocation) | ||
*Bending one leg and keeping the other straight helps to relax the stiffness in her legs | |||
'''Shoulders and arms''' | '''Shoulders and arms''' | ||
*Her | *Her lower shoulder and arm must be brought forward so they are not trapped underneath her | ||
*Keep both arms forward to bring her hands together – encourage her to use her hands by playing a game with her, or putting a toy nearby for her to touch and reach for | |||
[[Image: | {| width="200" align="center" cellpadding="1" cellspacing="1" | ||
|- | |||
| [[Image:Side_lying_day.png|center]] | |||
| [[Image:Side_lying_night.png|center]] | |||
|- | |||
| During the day this position should be changed from one side to the other, or to another position, every half an hour. | |||
| This is also a good position for a child to sleep in. | |||
|} |
Revision as of 15:48, 22 September 2016
Page Outcomes[edit | edit source]
When you have finished this page, you should be:
- More confident to position a child with cerebral palsy,
- Be able to show others better ways to position a child with cerebral palsy
Positioning and Handling[edit | edit source]
Here are some photos of poor positioning and handing of children with cerebral palsy
Good Handling and Positioning[edit | edit source]
Here are some of the benefits of good handling and positioning skills:
Now lets look at the problems with poor handling and positioning techniques:
And as children with disabilities gain access to wheelchairs, they very often spend long hours poorly positioned in the wheelchair, and still unable to move themselves. And they still develop a crooked back and other disabling deformities, including eventually breathing difficulties due to the chest space being so crooked and confined. You can see this in some of the pictures above
Now let‟s look at positioning a child, and what you can do to improve her position.
In the next section we will be looking at specific positions, both those that are 'poor' positions, and suggestions for „helpful‟ positions. For each position, we will use this checklist (see diagram below) to help us decide in an ordered way whether the child is in a poor or helpful position.
Lying[edit | edit source]
Supine (on their back)
This is a poor position because:
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This is a good position because:
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Supine Checklist:
Head and body
- If she can move her head on her own, make sure it is comfortable
- If she cannot move her head on her own, make sure it is in the middle and comfortable
- Her body (spine) must be straight – support on her sides if needed with a rolled up towel to keep her straight
Legs and feet
- Bend her hips – this helps to release tension in her lower back which is often arched, and it
- helps to relax stiffness in her legs. Place support under her knees to keep hips bent (not under her feet)
- Keep her legs open and uncrossed – use a pillow between if needed
- Feet should be as close to a standing position as possible – if her feet push down, talk to a therapist about the need for an ankle/foot orthosis
Shoulders and arms
- They should be forward and supported, especially if her arms pull back. This position also helps to relax her upper back, and allows her hands to open more easily.
- Lying in a hammock can help to relax tight muscles.
- Babies/small children can „hang‟ in a large towel (held by two adults) to relax tight muscles.
Prone ( on their tummy )[edit | edit source]
| |
|
|
Prone Checklist:
Head and body
- In a straight line
- Encourage her to lift her head and look at something in front of her on the floor. This is a good time to get a sibling, also lying on the floor, to play with her
Legs and feet
- Straight – push down on her bottom from side to side in a rocking motion to help her straighten her hips
- You can put weighted bags over her hips
Shoulders and arms
- Her arms should be in line with or slightly in front of her shoulders (make sure the pillow or towel she is lying on comes all the way up to her armpits to help keep her arms forward)
- If possible, encourage her to open her hands and push down on them (you may need to gently open them out for her; if too stiff to stay open, keep helping her each time you use this position)
MOST IMPORTANT about this position is that it is not for all children! Be careful when using this position for children who are always pushing back strongly with their heads. It is possible that it will reinforce the pushing back of the head, while the child is not actually learning to use her arms or control her head.
Side Lying[edit | edit source]
Side lying checklist:
Head and body
- Head supported on a pillow so her chin is level (in the middle, with her head and spine in a straight line)
- Give good support at her back, from the top of her head to her feet
Legs and feet
- Keep her bottom leg straight
- Support her top leg bent at her knee with pillows or blankets so her knee is level with her hip – this is important to help prevent injury to her hip (dislocation)
- Bending one leg and keeping the other straight helps to relax the stiffness in her legs
Shoulders and arms
- Her lower shoulder and arm must be brought forward so they are not trapped underneath her
- Keep both arms forward to bring her hands together – encourage her to use her hands by playing a game with her, or putting a toy nearby for her to touch and reach for
During the day this position should be changed from one side to the other, or to another position, every half an hour. | This is also a good position for a child to sleep in. |