Friday, May 11, 2012

Muscle Baby

   Allie's new favorite thing is to ride on Dada's shoulders.  She gets up there and cannot stop laughing.  She often belly laughs to the point where she is hunching over Jonathan's head and she loves to stick her fingers in his ear and watch him jump.  

Allie had a kick-butt constraint therapy session yesterday.  She saw her therapist, lifted up Righty to give her a high-five, and then was using her right hand to do all sorts of things that I didn't think possible.  Her therapist even pointed out that Allie is getting some muscle definition in her right shoulder because she is using it so much.

I am very encouraged that she is able to do so much.  Her therapist and I were sitting there amazed that Allie was picking up bracelets, chewing on them, blowing kisses, pushing buttons, and doing all sorts of other things with a hand that a few months ago was a tight little immobile fist.  She has come a long way.

We have been trying many different forms for e-stim.  We focused on her bicep for a couple sessions but it didn't seem to do much.  Allie is gaining control of her bicep on her own so she would fight the forced bicep motion.

Then we tried e-stim on her forearm to help get some extension (think of the motion that you would do if someone was walking towards you and you wanted to tell him to stop).  This too didn't seem to do much because Allie's wrist is typically pretty straight, which is a great thing because it makes her cerebral palsy less noticeable than if her wrist was constantly in flexion (bent down as if you were trying to touch your wrist with your middle finger).  Wrist flexion is pretty common with cerebral palsy.  Being able to control wrist extension is important.  Think of how your wrist moves when you try to pick something up; it almost always extends a little bit to make the palm of your hand more open.  Allie is starting to do a little wrist extension when she is trying to pick things up with Righty, but mostly her wrist is rigid as if she has a ruler strapped onto her forearm that goes to her knuckles.

Yesterday, we tried estim on her forearm and her thumb to create a little wrist extension and help open her thumb and pointer finger.  It worked beautifully.  Allie was able to get her hand more open than it normally is when she grabs things herself.  I think we finally found a good spot.

We also ordered a new splint for her called a Benik (see the picture to the right).  Her's will be dark purple---very fashionable.  This splint will help Allie get a more passive stretch for her thumb and will help put her wrist in a more relaxed position.  It is starting to turn in a little bit (known as a radial deviation).  Basically, her default position is with her wrist bent to the side so that her thumb is a little closer to the side of her forearm than it should be.  I know that my wrists often do this when I am typing on a smaller keyboard and after a while it gets pretty uncomfortable.  Our goal is to get Allie used to having her hand in an ideal position so that the muscles don't tighten up and make it more difficult to correct later.

Other than that, we are trying to get her into a crash course physical therapy walking class for the summer.  We really want her up and walking independently by the time she has to move into her new daycare class this August.  She is totally capable of doing it now but she can't seem to make the connection from walking with our assistance to independent cruising.  I'm sure one day she will just get up and walk away from us (I'm envisioning this happening during an occupational therapy session where we try to get her to put silly pegs in silly holes---she really gets annoyed with us then).  But, until then, we will just keep walking her around.  Her daycare teachers keep telling us how sore their backs are from hunching over to walk Allie places.  They are the best teachers ever for constantly trying!

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