Wednesday, November 11, 2009

Notes from Physical Therapy (Birth to 3)

These again are mostly for me, but I like to keep a record of what we did and their homework.


Developmental Team Objectives
1.) Head Control/alignment/trunk control
2.) Sitting
3.) Propping on arms on tummy
4.) rolling
5.) Manipulating objects with hands

1.) Sitting with support & reaching
2.) Tummy time
3.) on back, kicking & reaching
4.) neck stretching/righting reactions

Progress since last visit:
Eli's neck motion is improving. He sits with minimal support at the belly. He reaches and grasps objects and just started transferring from one hand to the other and brings objects to his mouth. Tolerates tummy time for 20 min or so. Rolls occasionally from tummy to back.

During visit today:
In sitting, he still needs support at belly and is able to hold his head and shoulders erect fairly well. Neck held typically tilted 20 degrees to his left. He has full passive neck rotation and actively turns his head to the left 60 degrees in sitting position. Neck righting when tipped to right for 20-30 sec. when on tummy. Holds up his head to 60 degrees. Turns his head both directions but better to the right. On back reaches up overhead for objects.

Suggested activities for daily routine:
1.) Daily neck stretching- turning to left, tipping to right. Encourages him to turn his head actively throughout the day in all positions.
2.) Sitting or being held vertically. Tip him slowly left to encourages him to tip his head to the right in order to stay vertical, to strengthen right neck side bending muscles.
3.) Sitting to play with support as needed to stay with erect trunk. Encourages manipulation of objects with hands and head turning, side to side, especially left.
4.) On tummy encourage pushing up onto arms by lifting toys us. Encourage head turning to both sides, especially left. Help him lift his head and roll to back when tired of tummy time.
5.) On back help him find his feet. Encourage grabbing his feet and kicking at toys with them.


Developmental Objectives:
1.) Head/trunk control
2.) Sitting
3.) Propping on arms on tummy
4.) Rolling
5.) Manipulating objects

1.) Tummy time
2.) On back, kicking and reaching
3.) Supported sitting, reaching
4.) Neck rang of motion
5.) Hamstring stretching.

Progress since last visit:
Emerson will roll tummy to back, sometimes and has rolled back to tummy twice. Reaching and grasping objects with either hand and bringing objects to mouth. Full neck range of motion. Tolerates tummy time some.

During today's visit:
Emerson sits with moderate support. She tends to slouch with rounded back and head slumped forward, through not as much as previously. She is able to sit erect briefly with support. She reaches and grasps objects. On Tummy time she lifts her head to 60 degrees for up to 1 min. at a time. Little weight through elbow. Will push up onto hands with lots of helps o back, able to reach overhead for objects with either/both hands.

Suggested activities for daily routine:
1.) Encourage lots of tummy time 30-60 min a day total. Encourage her to lift her head higher and press onto her hands. Keep working on turning her head side to side to follow objects.
2.) Sitting hep her stay erect position when possible by giving support at her trunk. Have her reach for and play with objects.
3.) Add hamstring stretching one leg straight down, bring the other legs straight up until she looks uncomfortable (Not in pain). Try for 30 sec. 3 times a day on each leg. This is to help her be able to sit up straighter.
4.) On back help her find her feet, bring them to her and help her grab onto them. Put noisy toys on her feet to encourage her to kick them around.

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