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ICRAITRRU60 - VALERIO DI STEFANO or
82 chapter 8
Exercises to prevent contractures
Just as cats, dogs, and many other animals stretch their
bodies after they wake up, children often enjoy stretching
their limbs and testing their strength. This is one of the
purposes of play.
Daily stretching keeps the joints able to move smoothly
and freely through their full range of motion.
Unfortunately, some children, because of illness, paralysis or weakness, are not able
to stretch all parts of their bodies easily during their play and daily activities. If some part
of their body is not regularly stretched or moved through its full range, contractures may
develop.
To maintain full, easy movement of their joints and
limbs, these children therefore need daily exercises that
move the affected parts of their bodies through their full
range of motion.
Range-of-motion
exercises for the
shoulder.
Range-of-motion exercises for each body joint are discussed in Chapter 42.
As much as possible,
the child herself should try
to move the affected part
through its range of motion.
Often the limb will be too
weak and help is needed. But
be sure the child moves it as
much as she can herself.
Have the child move the part
as far as she can without help.
Then help her to move it the
rest of the way.
Where there is muscle imbalance, strengthening the weaker muscles can help prevent
contractures. Examples of muscle strengthening exercises are on pages 138 to 143 and 388
to 392.
As much as possible, try to make exercises fun.
A child whose
feet tend to
bend inward
like this,
may benefit
from exercises
that bend
them outward,
like this.
Walking on boards
in a V-shape may
provide similar
stretching
and be
more fun.
But going with father
on the V-shaped
paths to the bean
fields may be even
more fun—and it
stretches his ankles
more, because it is a
long way.
FOUR WAYS TO APPROACH STRETCHING EXERCISES: To prevent (or help correct)
contractures, exercises can be done in 4 different ways, depending on the needs and
ability of the child. These 4 ways, shown on the next page, progress from exercises
where the child depends completely on help, to exercises that she does on her own as a
part of everyday activity.
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