Hesperian Health Guides
Different Exercises for Different Needs
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Different kinds of exercises are needed to meet the special needs of different children. On the next two pages we give an example of each kind of exercise. Then we look at some of the different exercises in more detail.
|Purpose of exercise||Kind of exercise|
|To maintain or increase joint motion||1. Range-of-motion exercises (ROM)|
|2. Stretching exercises|
|To maintain or increase strength||3. Strengthening exercise with motion: exercises that work the muscles and move the joint against resistance|
|4. Strengthening exercises without motion: exercises that work the muscles without moving the joint|
|To improve position||5. Practice at holding things or doing things in good positions|
|To improve control||6. Practice doing certain movements and actions, to improve balance or control|
1. Range-of-motion exercises (ROM)
|Ram is 2 years old. Two weeks ago he became sick with polio and both legs became paralyzed.|
|Ram needs range-of-motion exercises to keep the full motion of his joints, so they will not develop contractures.||At least 2 times a day, his mother slowly bends, straightens, and moves all the joints as far as they normally go.||All these are exercises for his knee. For other ROM exercises he needs, see Complete Range-of-Motion Exercises—Upper Limbs.|
2. Stretching exercises
|Lola, who is now 4, had polio at age 2. She did not have any exercises to keep the range of motion in her joints, and now she has severe contractures especially of the knees.||Lola’s mother does stretching exercises several times a day, to straighten the joints a little more each day. Stretching exercises are like ROM exercises, but the joint is held with firm,steady pressure in a position that slowly stretches it.|
3. Strengthening exercises with motion
|Chon was 6 years old when he got his clothes and body wet with a poison his father used to kill weeds. A week later his legs became so weak he could not stand. Now, 2 months have passed, and Chon is a little stronger. But he still falls when he tries to stand.||To help strengthen the weak muscles in his thighs, Chon can raise and lower his leg like this—first without added weight and later with a sandbag on his ankle. As his leg gets stronger the weight can be increased.|
4. Strengthening exercises without motion
|Clara, who is 9 years old, has a very painful knee. It hurts her to move it and her thigh muscles have become so weak she cannot stand on the leg. She cannot do exercises like Chon does because it hurts her knee too much.||
Make this muscle as hard as you can. Good! Now keep it hard and count to 25.
|But Clara can do exercises to strengthen her leg without moving her knee. She holds it straight and tightens the muscles in her thigh.|
For more information see Exercises without motion.
5. Exercises to improve position
|Ernesto is 8 years old and has early signs of muscular dystrophy. Among other problems, he is developing a swayback.||Ask Ernesto to stand against a wall and to pull in his stomach so that his lower back comes as close to the wall as possible. Ask him to try to always stand that way, and praise him when he does.|
|Because swayback is often partly caused by weak stomach muscles, strengthening the stomach muscles by doing ‘sit-ups’ may also help. See if Ernesto can still do sit-ups—at least part way, and have him do them twice a day.|
|It is best to do sit-ups with the knees bent. (With legs straight, the hip-bending muscles may do more work than the stomach muscles.)|
6. Exercises to improve balance and control
|Celia is 3 and still cannot walk without being held up. She has poor balance. Many exercises and activities might help her improve her balance and control of her body. Here are 2 ideas for different stages in her development. For other possibilities, see Chapter 35 on Early Stimulation.||Play games with her to see if she can lift one leg, and then the other.||
After Celia has learned to walk alone, if she still seems unsteady, walking on a log or narrow board may help her to improve her balance.
|This will help her shift her weight from side to side and keep her balance.|
Often several kinds of exercises, involving different parts of the body, can be done through one activity—often an ordinary activity that children enjoy.
|For example, Kim, who is 8 years old, had polio as a baby. His right leg is weak, his knee does not quite straighten, and the heel cord of his right foot is getting tight. He is also developing a sway back.|
Note: Ordinary activities that exercise the whole body, like riding a bicycle or swimming, can provide many of the exercises that a child needs. But sometimes specific exercises using special methods are needed. Some special exercises are included in this chapter.