When we were looking at a specialist centre for Charlie last summer we were torn between the neuroplastic Bobath centre and Targeted Training at The Movement Centre. As described in the Bobath post we decided on the low-intensity learning approach as we tried to augment the building blocks of Charlie’s general physical skills, particularly due to his age. We still use the ethos and therapy we learned at Bobath on a day-to-day basis.
We have now reached a point where we need to specifically attend to Charlie’s weaknesses whilst we try to build on his strengths. Despite his strength and ability in his arms and the obvious high tone in his legs we are increasingly finding his weak postural control is holding back the hard work he puts into balancing, stepping and even sitting. He finds sitting on the floor very difficult if not in the dreaded ‘w-stance’ or ‘sadlers stance’; he can’t sit on his bum without his back curving and curling dramatically. Even when sat in his car chair or wheelchair he slumps to the side or hangs his head forward when holding things in front of him. When standing and trying to balance he has his chest forward and bum back; is that due to the high-tone/short hamstring pulling back or the weakness of his core and upper back?
The Movement Centre was recommended to us by numerous sides- Mr Davies, Charlie’s Orthopaedic Consultant; Dan, Charlie’s Private Physio (PT Kids) and a number of children who have been through its service, including Bailey Matthews (#bemorebailey). Our new NHS physio also supported its potential benefit.
The Movement Centre is a charitable centre that works on a private referral system although they do try to apply for funding through CCGs (Care Commissioning Groups- GP NHS fundholders) which is only sometimes successful. Fortunately due to the sterling efforts of Charlie’s Challenge we are in a position to self-fund (£6250 eeek!) which does mean we can get assessed and started quicker- as much as anything so Charlie can get some of its benefit before school in September.
The Movement Centre specialises in Targeted Training; its ethos and practice is based on how a typical child develops postural control from the head down (cephalocaudal) and from the body out (proximodistal). Targeted Therapy assumes that a child with a neuro- or muscular impairment (like global development delay or CP) may miss the milestones associated with head and postural control and attempt their physical development out-of-sync, they often miss ‘tummy-time’ sometimes never catching up.
Targeted Training uses a specially designed frame to help support the child’s body just under the assessed highest point of weakness- moving down the back over a period of time (9-12months) following assessments. The frame supports the body and activities are performed for 30-45mins a day with the head and arms up and moving; developing the musculature of the neck and shoulders and moving down to the lumbar spine and then the hips and upper legs.
Our only concern initially was that Charlie had a Jenx monkey Stander when he was small to encourage him to be upright and he hated it! Hopefully now Charlie is older and we can explain the reason we would be using a frame and he might also see the benefit himself.
The Movement Centre suggest that Targeted Therapy can improve head control, gait control and in some cases a great control of the legs. The fantastic thing for the scientist in me is that the Empirical data supports the claims. Over a period of 9-12m and 6-8 visits we hope Charlie may sit a little better or stand a little straighter- we’re realistic, he may not walk completely unassisted but hey, we’re hopefully providing the opportunity for him to develop those skill where he MIGHT!
We’re heading to Oswestry in May so fingers crossed…