SPIO Compression Orthosis | Case Study: Young Child with Moderate Hypotonia
Uploaded by Riley Remington
This 4-year-old boy with moderate hypotonia shows a typical floor sitting posture with marked kyphotic slumping and posterior pelvic tilt. In a therapy situation, he responds well to manual activation and is able with mild to moderate support to activate his trunk muscles into extension, but is unable to achieve or maintain this activation while sitting independently. When perturbed in sitting on the therapist’s lap or a physio-ball, his righting and balance responses were slow and incomplete, with poor abdominal activation against falling backward or to the sides. All movement transitions into and out of sitting and up to standing were poorly graded and unstable and he was unable to sustain a squat position to reach down and pick up a toy off the floor without falling over.
When trialed with a Standard SPIO TLSO, he responded immediately, as seen in the comparison picture, with improved pelvic and upright trunk position. He was able to sustain this upright trunk position while playing in long sitting and his movement transitions were more stable with increased rotational components and improved balance and grading of movements. With brief coaching in therapy, he was able to reach down, pick up a toy off the floor and come back up to standing while maintaining his balance.
It was also clear that his base of support for balance in standing and walking with poor with severe foot/ankle pronation. He was trialed also with used DAFO SMOs, which showed an immediate improvement in ankle-knee-hip active balance strategies and further improved his trunk activation and upper body movement. We were fortunate to be able to loan him the SPIO and DAFOs temporarily to trial during the following week at home and proceed with ordering him a SPIO TLSO and Cascade Jump Start Leap Frog style SMOs. He continued in weekly therapy sessions at CTC and made nice steady improvements in upright function, including balance over 1-leg, sustained play in squatting, running and jumping. Our experience with similar children with hypotonia is that they often have sensory awareness issues as well.
Many are able to out-grow the need for double layer support over a varying period of time, but continue to do best in combined single layer upper and lower body SPIO compression to continue to refine their gross and fine motor skills and in many cases improve attention.
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