We have talked a lot about muscle weakness because spastic, low tone, long and short muscles are all weak!
We indirectly address strength through the interventions in all the other areas I have already discussed because once the muscles are in alignment, there is awareness and the ability to activate, the child can strengthen specific muscles. There is no way to strengthen a muscle that is out of alignment, that has poor awareness and ability to activate!
Our ultimate goal is to improve the client’s function so if he or she performs functional tasks in optimal alignment, has good awareness and ability to activate specific muscles then they will strengthen by just moving with good FORM!!
We rarely prescribe strength training exercises to our young clients except using a pool. Instead we teach strength training in the form of properly performed functional activities.
For higher functioning teens and adults there is a distinct advantage to teaching them to work out in a gym along with their peers under the supervision of a skilled trainer. One reason is that they have often had PT their entire life and they are ready for new and age appropriate training challenges. We give our teens and adults the option of sessions with a trainer that works closely with us. In conjunction with the trainer we will create a specific strength training program to take home. It is important to remember that just like any of us, gym work outs need to be performed with good form and on a regular basis in order to be beneficial.
A note about spasticity management as it relates to strength:
We often work with children who have had Botox injections or have had orthopedic or neurosurgical interventions to address spasticity. Making sure that weak muscles are strengthened is crucial in optimizing benefits of these types of interventions. Intervention is beneficial both as a preparation for surgery and as post surgical rehabilitation.