What exactly is "Physical Therapy"
Why do People with Angelman Syndrome need Physical Therapy?
Typical Stage-Related Physical Therapy Options for the Person with Angelman Syndrome
What exactly is "Physical Therapy"?
Physical Therapy is central to building, developing, and maintaining functional movement throughout a person's lifespan. The ability to move freely and comfortably has an enormous effect on our physical, psychological, emotional, and social well being. The Physical Therapist provides services to help an individual move their body in a safe and effective way. The PT coordinates with the patient, the patient's medical providers, the patient's family, and other relevant persons to design a physical therapy program where movement potential is assessed and goals are agreed upon. These goals will change over time, but it is useful to have a short-term and a long-term roadmap to help guide the patient as to adapt as the needs of the person receiving physical therapy change.
TopWhy do People with Angelman Syndrome need Physical Therapy?
Angelman Syndrome delays the development of gross and fine motor skills. Gross motor skills generally involve the use of our largest muscles, like those in the legs, arms and back, while fine motor skills involve smaller muscles, like the muscles in our hands that we use for activities of daily living like eating and dressing. Individuals with AS also have a balance and movement disorder that can cause The infant with AS will not meet typical motor milestones and will likely experience delays in rolling over, sitting up, crawling, reaching for items, pulling up to stand, "cruising" on furniture, grasping items, and walking. Because of this delay, it is important that physical therapy options be explored and started as early as possible. Beginning physical therapy at a young age can facilitate the child in learning how to "plan" gross motor movements, strengthen and tone muscle groups, as well as help to deal with sensory integration issues that may otherwise prevent the child from trying something new.
The goal of physical therapy should be to help the individual with AS live as normal and Independent a life as possible. For the infant with AS, this might focus on developing muscle strength and regulating muscle tone so that the baby can sit, crawl, interact with toys and share in the world around them. As the child grows, the PT can help develop skills needed for walking, help teach the child to participate in their daily care, and teach his/her family how to lift and assist the child to maximize independence and minimize the risk of injury. After a child has developed walking, the balance disorder and muscle tone issues that are common in AS usually make other ordinary movements more difficult like walking up and down stairs, bending down and standing back up, and crossing thresholds. The PT can help the child develop these skills and help develop play skills like kicking and throwing balls, pedaling a bicycle and running.
TopTypical Stage-Related Physical Therapy Options for the Person with Angelman Syndrome
Beginning Physical Therapy for the Infant and Young Child:
Physical therapy for the infant and young child might focus on sensory integration, helping the child to "feel" his/her world. Techniques that might be employed include occupational therapy-like methods, including therapeutic brushing, deep pressure therapy, and swinging. These types of activities can help the child distinguish between different types of sensory inputs in the world around him. Being able to distinguish between a tickle on the hand, versus a tickle on the foot, can be an important tool to help the child identify their body in space. The physical therapist may also do various stretching exercises for the child, as well as initiate game playing to encourage the child to move toward an object. Showing the child "how" to roll, how to get into the positions for rolling, are important steps along the way to mobility.
Working on Mobility and Sensory Integration:
There is a wide spectrum of function in Angelman Syndrome, and it is important to note that the goals for PT should be set to match the abilities of the child. This is crucial so that unrealistic expectations are not set, which will only result in frustration and failure for the caregiver and the child. If physical therapy is instituted at this age range, the physical therapist will assess the functionality of movement, and may recommend a combined occupational therapy and physical therapy treatment program. This may include sensory integration modalities, as well as helping the child to "motor plan". For the typical person, it is sometimes difficult to recognize the many little steps that necessary to do one thing. For example, in order to "cruise", the child will need to first be able to stand, bear weight on their legs, and be able to move from one side to another. These "little steps" involved in reaching the goal of "cruising" are what the physical therapist will work on. For the non-ambulatory child, the physical therapist might work on providing joint compression, helping the child get into positions necessary for movement, and providing plenty of play-based opportunities that encourage general movement.
Developing Motor Planning and adding more Physical Therapy Options:
Again, depending on where the child is at functionally, the physical therapist will continue to help the child maintain and build on gross motor movement. Typically, we see gross motor movement develop before fine motor movement. So there is a dual goal involved in helping the child to strengthen their gross motor movements, that being that fine motor movement activities should also be enhanced and can also be worked on (such as putting a puzzle together, dropping balls into a jar, and similar type activities). For the ambulatory child, the physical therapy activities might include Hippotherapy, which is therapeutic horseback riding. This can begin as early as 3 years of age, and is a wonderful integrative therapy that the child can enjoy for many years. Swimming is another fun and socially integrative therapy, helping to deal with tone issues as well as strengthen muscle groups.
Development and Maintenance of Functional Movement:
The physical therapist may work on bone strengthening exercises, to help maintain physical functionality. Walking, swimming, horseback riding, and game playing are all wonderful on-going activities that can enhance the physical well-being of the person.
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This piece was authored by Elke Sprow and Erin Sheldon.
TopThe Content above is for informational purposes only, it is not a substitute for professional medical and or therapeutic advice, diagnosis, and/or treatment. Do not attempt to implement therapies without first seeking the advice of a professional therapist or medical provider as treatment has many consequences that must be medically and therapeutically addressed.