29 July 2011

Assistive devices, splinting and AFOs

By Natan Gendelman | http://www.enabledkids.ca | http://www.healthinmotionrehab.com

As we’ve indicated before, cerebral palsy is a neurological condition which results from damage to a certain area of the brain. When this occurs, a child’s ability to control specific parts of his body is affected, leading to impaired function and mobility. Since the brain is not sending the appropriate signals to parts of his body, a child will try to function in any way that he can and fight the condition that he is in. In turn, this will cause hyper tone, as we have written about before in our previous blogs.

In the case of a child, having hyper tone may cause certain patterns to occur during development. High tone in the trunk, for example, will lead to high tone in his hands, arms and legs, as well as to improper sensorial development. Now, what happens is that it becomes difficult for him to learn to walk properly, perform grabbing motions, or even bend his hands in the first place. For kids with cerebral palsy, this can result in the emergence of certain patterns like forming crab hands without bending them, or performing robot-like movements where the whole body is moved at once. When these methods of moving are left unchecked, they can have severe consequences on a child’s condition, and what he will be able to accomplish.

The effects of splinting and other devices

With this in mind, many people try to address these problems through the use of assistive devices, splints and AFOs (ankle-foot orthoses). Splints and other assistive devices are often used to maintain an appropriate range of movement in a child’s joint. However, it’s important to note that their usage may cause a chain reaction to occur in a child’s condition. When a child has a splint applied, his brain is not taught the appropriate function to go with the movement. Therefore, while his limb may be held in the correct position, his muscles will be stretched passively--that is, without the child’s active participation. This sends a message to the brain that the device is a foreign body, causing his body to try and fight it. As a result, that is why a lot of therapists find that a child’s tone will go up the moment a splint is taken off.

Making the decision

So, the question is: should we be using splints? Like I’ve said before, each situation has to be dealt with as a separate case which depends on the child’s condition, his ability to move and function, and--very importantly--his age. One key factor which will affect his need for these devices is his weight bearing and movement. A crucial part of joint development, weight bearing plays a necessary role in several movements which are part of a child’s function including sitting, crawling, standing, and walking. If a child places weight on his feet and hands in the process, he will not need a splint because his function will be corrected by his own weight. As he progresses from his knees to standing and then walking, the child then learns how to shift his weight properly. However, if a child is not moving at all, then--again, depending on the case--the use of a splint or other device may prove to be the most beneficial option.

For these reasons, it is important to understand and consider your child’s needs and condition before choosing and implementing splints, AFOs and other devices. Remember, their use will immediately limit certain movements for your child. As a result, it’s a good idea to think twice, do your research and learn how to use them safely and wisely.

If you have any questions or comments about this article, feel free to leave me a message down below or send an email to natan@enabledkids.ca. Thanks everyone, and I hope to hear from you soon!

27 July 2011

Personal Injury

Until it happens to them, people do not realise exactly how a personal injury from a car accident can affect your life. Aspects such as your work, your family, and the quality of your life could be dramatically affected. Obviously, major injuries to your head and spine can be life changing, but even the reproductions minor injuries can have the same effects.

Some of the most common injuries the face car accident victims are:


Fractures

Possibly the easiest injury to get from a car accident would be a bone fracture or breakage. This can happen to any bone in the body, and car range from a hairline fracture to a full breaking of the bone. This could take months of recovery for the worst of the factures with potentially many operations after the accident.

Traumatic Brain Injury (TBI)

When any force is exerted on the head, damaging the brain, this is known as Traumatic brain injury (TBI), and is usual the results of excessive acceleration or deceleration. The brain becomes deprived of oxygen, and if this were to continue for a prolonged amount of time, potentially irreversible damage will be caused to vital areas of the brain, or even death. These victims could then be in for a long process of rehabilitation therapy, leading on to a permanent carer for them.

Spinal Cord Injuries

The spinal cord is a very delicate part of the human body, and any sudden impact could seriously damage it. Whether the spine is only partially damaged, or severely damaged, the position of the impact could land the victim with a life changing disability.

Whiplash

Whereas fractures are probably the easiest injury to get from a car crash, whiplash is the most common one. This is caused by a sudden “jerk” of the neck, like a whip movement – hence the name, and is usually caused by a car impacting the rear of another. This was first seen as a minor injury, but it has the potential to be a permanent one, and for the victim, leading to limited mobility, as well as being very painful.

If any of the above has happened to you or someone you know, then it is vital that you see a doctor, and then your next port of call should be the solicitors to see if it is worth claiming compensation.

18 July 2011

The Small Places: Is Personalisation inadvertently criminalising car...

The Small Places: Is Personalisation inadvertently criminalising car...: "A while back, whilst researching the requirements for registration as a domiciliary care provider with the Care Quality Commission (CQC), I ..."