In children with cerebral palsy, their early movement patterns are learned with a damaged, immature brain. It becomes their “normal” way of moving. When challenged to move differently, surprising things happen.
His normal movement pattern, turning his right leg inwards with a shortened stride length on that side, feels “normal” to him. Despite years of therapy and hard work at home, that right foot turns in when he walks. Then Pia Stampe, PT asked him to use a cane for balance and to try to walk backwards. He had never been asked to try to do that. Alex stops and spontaneously notices that this novel action resulted in his right leg straightening up.
It shows his brain is actually able to generate a better gait pattern with a novel challenge. Walking backwards takes him out of habit and his whole brain has to work out how to solve the problem of how to do it. Walking forwards is harder as he has a firmly ingrained habitual way of walking. If he practices walking backwards, with support and then on a treadmill, he will be able to create a new walking habit. It will take time and lots of practice to make a new way of moving feel “normal” to the person with CP.
It was interesting to see that some researchers have studied the effect of backwards walking on a treadmill. Make sure there is an adult nearby to prevent a fall when you first start this type of exercise with a child or teenager.
Try this out at home. Take a short video of your child( or patient) walking forward and then backwards. Some balance support, like running the hand along a wall is advised at the start.
Thank you, Karen for your post.
Every time I see a glimpse of a great, out of habit, movement pattern, it sets the tone for what we ( the child, parent and therapist) can expect of the child: that become the goal. The older children, 6 to 8 years, understand what the goal is and they want it because they know they CAN and the parents realize what is possible.
On a whiteboard in my gym, I have a quote from a 49 year old gentleman with CP, who have come for intensives: ” don’t practice until you get it right; practice until you cannot get it wrong”. This past week I was working with an 8 year old boy who experienced and realized what he was capable of and he suddenly stopped and pointed to the board and said: ” so THAT is what I have to do”
As a therapist, those are the best moments!!
This is so inspiring. My grand daughter is 7 and has CP, we pray that one day she will be able to walk.