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Freddie Smiling During Treatment

Meet Freddie

“He’s able to self feed now and became more independent in simple daily activities.” - Matthew, Freddie's dad.
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“We’ve got a removable cast to take home after the programme which means it becomes a habit for Freddie to get used to use his weaker arm”
Matthew, Freddie’s dad.

The Challenge

Freddie has global developmental delay including weakness throughout his trunk and reduced sensory input. When Freddie is concentrating on controlling his trunk weakness during standing he is unable to control his right upper limb.

Due to decrease in his sensory input Freddie often drops items from his right hand without noticing. During his 4 week programme we aimed to increase Freddie’s control, strength and awareness of his grasp and release to allow him to complete this task in a variety of functional positions.

“For me the best part was observing the therapists so that I could pick up tips on what to do at home with Freddie.” - Louise, Freddie's mum.

The Goals

  • To achieve spontaneous grasp and release from table
  • Ability to cross midline with right hand
  • To achieve pincer grip
  • Ability to complete gross motor tasks in right hand whilst standing

Our Approach

01

Practise of grasp and release in a variety of different positions.

02

Grasp and release of different size and shape objects

03

Fine motor games to facilitate use of pincer grip

04

Practise of activities in standing

The Science-y Bit

Having the cast on for 24 hours a day for 4 weeks, has allowed Freddie to focus on only using his affected arm in activities, and increase his awareness of his right upper limb. This stimulates the formation of new pathways for movement, which “rewires” the brain - this means that a larger part of the brain becomes active when producing movement of the weaker arm.

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The high intensity and repetitive use of Freddie’s affected upper limb over a relatively short period of time had produced a lasting change. Freddie is now able to control grasp and release of many objects whilst sitting. The more he practices this in standing the more pathways will strengthen giving Freddie the ability to transfer this task to any functional position.

Nikki Owen portrait headshot

Nikki Owen - Paediatric Physiotherapist

“His grasp has improved and he is now able to complete a number of play activities that he found very difficult before he attended.”
Louise, Freddie's Mum.

The Results

Increase Upwards Arrow Icon50%

General Usage

Increase Upwards Arrow Icon66%

Arm Use

Increase Upwards Arrow Icon75%

Grasp-Release (items)

Increase Upwards Arrow Icon100%

Grasp Release

Increase Upwards Arrow Icon25%

Fine Motor Adjustment

Increase Upwards Arrow Icon66%

Coordination

The Achievements

  • Freddie increased quality and range of grasp allowing him to pick up a variety of different shape objects.
  • Freddie achieved pincer grip allowing him to pick up small items.
  • Freddie increased shoulder strength and stability allowing grasp and release objects from different heights and from across midline.
  • Freddie has increased awareness of right upper limb in standing allowing grasp of objects from the floor.
"I have found that now I’m back working with Freddie at home he is able to do more activities with his right arm than before”
Matthew, Freddie's Dad.

The Parents Feedback

'It is now our second time doing CIMT. The improvements in Frederick’s affected arm function mean that it is easier for us to do play therapy at home. He can now do a wider range of activities during constraint when sitting and some of the activities that he could only do in sitting he can now do in standing.'

“We are also now able to practice simple bimanual tasks at home – an area we previously found impossible. Frederick is showing more awareness of his affected arm and has started to bring it into use in very simple activities e.g. during action nursery rhymes and when dancing. CIMT team have made a big difference.” - Freddie’s parents.

The Therapists Feedback

“Freddie always works hard and enjoys completing tasks to earn the reward of racing cars down the ramp. Freddie’s parents have become experts in CIMT and know how to encourage and get the most out of him. With their hard work, dedication and positive outlook Freddie has continued to develop and achieve many new skills. ” - Nikki

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“We are proud to be part of Freddie’s journey and know he will go onto achieve great things.” - Nikki
Nikki Owen portrait headshot

Nikki Owen - Paediatric Physiotherapist

Freddie interacting with tablet during CIMT treatment.
"CIMT uses recognised techniques to assess the performance of the arm before and after the programme to show us the progress and intervention that’s been made.”
Matthew, Freddie’s dad.

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