Have you ever wondered how all the different interventions available for CP fit together to be most efficient? It's like a completing a puzzle and there are so many pieces available. I often come across families and teams who use "a little bit of everything" in their approach. While each "bit" of intervention in of itself might be very beneficial, it may not be so if not fully implemented. It could be a little NMES, a little vibration therapy, occasional use of posture garments and braces, some CO OP strategies and much more. Each of these interventions have merit, but my question is if they work with occasional use?
To try to make it easier to fit all these intervention in, I created a systematic framework, where each of the interventions fit in. The important word here is SYSTEMATIC. It is about fitting the pieces together into something that works and fits into the child's and family's daily routines. Each puzzle piece is beautiful and useful but in order to complete the puzzle, it matters where the pieces go.
"Doing the right thing, at the right time and in the right order"
Fitting the available interventions into each category and doing it all in the right order is what is going to make the difference. Interventions are tools in the therapy toolbox. We all have different interventions in our toolboxes that are excellent. It is the order in which they are implemented that will make them work! And it is making sure that each category is checked off before moving on within the framework.
For example, in my Alignment toolbox I have:
TheraTogs
Dynamic Movement Orthosis
Splints and Braces
...and much more because I have to ensure best possible body alignment in order for everything else to work....FORM PRECEDES FUNCTION
In my Awareness toolbox I have:
Sensory techniques
Auditory/visual
Compression
Spinal Neuromodulation
sEMG Biofeedback - "AHA Moments"
......and much more because without body Awareness motor learning becomes very difficult
In my Activation toolbox I have:
Targeted sEMG Biofeedback
NMES
EMG Triggered Stimulation
Different types of feedback
...and much more because when the child learns efficient muscle activation/relaxation, functional tasks become easier
In my Strength toolbox I have:
Functional strength training
NMES
Aqua training
Power and speed training
Endurance training
.....and much more because muscles are weak from disuse. BUT, when the other components of this framework is in place, functional daily activities are often enough to improve strength and endurance
All of my interventions are used within a CO OP type coaching model, but more about that later...!