“Home Exercise Program” – doesn’t sound fun.
“Range of Motion” – doesn’t sound fun.
“The Wheels on the Bus” – I can get on board with that.
We start out with the child lying on his or her back with the caregiver comfortably situated by the child’s feet. The motions can be done passively, with the caregiver guiding the child’s limbs; actively, with the child performing the motions; or in an active assisted manner, with the child and caregiver working as a team to move through the motions. Repeat each verse two times, to ensure that at least 10 repetitions of each motion are performed.
The wheels on the bus go round and round… (reciprocal leg motion)
Holding the child’s lower legs, move legs gently in a bicycling motion. This alternating movement is important for developing coordination, and can be challenging for children with significant spasticity.
The kids on the bus go up and down… (bridges)
Bend the child’s knees and place feet flat on the floor. Placing your hands under the child’s bottom, lift the bottom up off the floor and lower it back down in time with the song. Make sure the bottom up/down motion is all that is happening and the child isn’t using the motion to scoot on his or her back. This can help strengthen the core, the bottom, and the thigh muscles.
The doors on the bus go open and shut… (hip rotation)
Keeping the knees bent with feet flat on the floor, spread the child’s knees apart like the covers of a book or butterfly wings and bring them back together. This is a good stretch for the inner thighs of children with high muscle tone, and provides a way to work on hip strength and stability for children with low muscle tone.
The horn on the bus goes beep beep beep… (reverse crunch)
Starting in that knees bent, feet flat position, keep the knees together and bring the feet up so that hips and knees are at 90 degrees, then return feet to the floor. The intention is to activate the lower abdominal muscles.
The driver on the bus says move on back… (leg press)
Place the child’s feet against your chest, and as you straighten the child’s legs, lean back to give the impression that he or she is pushing you backward. Then, return to the starting position. Make it dramatic, and you’re sure to get a smile. This motion is comparable to doing squats.
The wipers on the bus go swish swish swish… (trunk rotation)
Keeping the child’s knees bent, pick the feet up off the floor, keep the knees together, and (gently!) twist the child’s body from side to side so that both knees point right, then left, and continue to alternate. This loosens the hips and trunk, preparing the body for rolling. It’s also usually good for eliciting a giggle.
The babies on the bus go wah, wah, wah… (hamstring stretch)
Place child’s left leg flat on the floor. Bend the right hip to 90 degrees, then straighten the knee as far as you can until you feel resistance. Hold this position for one verse while entertaining the child by pretending to dry your poor crying eyes with his or her foot. Repeat with other leg.
The parents on the bus go shh, shh, shh… (heel cord stretch)
With the hip and knee bent, grasp the child’s right calf with one hand and the heel with your other hand. Keeping the foot in line with the lower leg (don’t let ankle roll in or out), stretch the calf by bringing the top of the foot up toward the shin. I’ll let you figure out how to maneuver your hands to get a finger up to your lips for shh-ing. Hold for one verse, then repeat with other leg.
As with any exercise program, check with your physician or Physical Therapist regarding appropriate activities, particularly if there are any concerns about your child’s hips or spine. And – I’m not saying it’s an ideal program, but a fun program that you do is better than an ideal program that you don’t do.
Did you try this activity with your little one? Did they give it two thumbs up?