Dynamic Movement Intervention (DMI)

What is DMI?

Dynamic Movement Intervention (DMI) is a treatment technique used by physiotherapists and occupational therapists to treat children with gross motor delays. The therapist uses different handling techniques to elicit automatic postural responses that help your child progress their motor skills and developmental milestones. This technique incorporates research on neuro-rehabilitation and works to simulate neuroplasticity in your child, to help with the development of their motor milestones.

During a therapy session with DMI, an assessment will take place to determine appropriate exercises that challenge your child’s physical and neurological system. Exercises focus on achieving proper alignment and work towards creating core stability for functional movements like sitting, crawling and walking. Exercises against gravity are introduced with progressions to increase the challenge and provoke desired movement patterns. Improved balance is a common goal in DMI. 

Who is DMI useful for?

DMI is appropriate for children with delayed motor skills, from rolling to walking, due to a variety of diagnoses including; 

  • Down Syndrome
  • Cerebral Palsy
  • Global Developmental Delay
  • Hypotonia
  • Genetic Disorders/Chromosomal Abnormalities
  • Spinal cord lesions, or acquired brain injuries. 
  • It is also beneficial for children with risk factors for delay such as those born prematurely

If you are interested in DMI therapy and wondering if it is appropriate for your child, you can gain more information below or reach out to book a session with our DMI trained therapist, Kate Heays.

 

 

Where can I learn more?

https://dmitherapy.com/

Learn more about Kate Heays.

How can I book a session?

Click HERE to book a session with our therapist Kate Heays who has her Level C training in DMI!

Written By: Kate Heays

Welcome to PlayWorks Physio, where we know that play is the key to unlocking a child’s full potential! Our paediatric physiotherapy services are all about making therapy sessions fun, engaging, and effective. Say goodbye to boring exercises, because at PlayWorks Physio, we believe that play truly works wonders! So, let’s dive in and explore how our approach to paediatric physiotherapy is different from traditional adult physiotherapy.

Play, Play, Play – It’s How We Roll!

At PlayWorks Physio, we’ve got a secret trick for helping kids heal – play! Our physiotherapists are experts in incorporating play into therapy sessions to make them enjoyable and motivating for kids. We use games, activities, and creative exercises that are tailored to each child’s age, interests, and developmental stage. From building obstacle courses to playing with balls and bubbles, our therapy sessions are like playdates where kids can have a blast while improving their motor skills, strength, balance, and coordination.

Childhood Adventures: From Crawling to Conquering!

At PlayWorks Physio, we understand that every child’s journey is unique. Our paediatric physiotherapy services are designed to address the specific developmental stages and milestones that kids go through, from crawling to conquering new physical challenges. We work closely with parents and caregivers to create a customized treatment plan that takes into consideration their child’s growth, development, and goals. Whether it’s helping a baby learn to crawl, a toddler walk, or a young athlete recover from an injury, our physiotherapists are there to provide expert care and guidance every step of the way.

Teamwork Makes the Dream Work: We’re In This Together!

At PlayWorks Physio, we believe that teamwork makes the dream work! We work closely with parents and caregivers to create a collaborative and family-centered approach to therapy. We provide education, support, and resources to empower parents and caregivers to actively participate in their child’s therapy at home and in their daily activities. We’re all about building a strong partnership with families to ensure that kids receive the best care possible.

Expert Fun-Makers: Our Physiotherapists Rock!

Our physiotherapists at PlayWorks Physio are not only experts in child development and behaviour, but they’re also expert fun-makers! They know how to engage kids, create a positive environment, and turn therapy sessions into enjoyable adventures. Our physiotherapists have a bag of tricks that includes creative exercises, playful activities, and lots of high-fives to keep kids motivated and excited about their therapy journey. We’re not your typical boring therapy sessions – we’re all about having fun while achieving therapy goals!

So, if you’re looking for a paediatric physiotherapy clinic that knows how to make healing fun, PlayWorks Physio is the place to be! Our play-based approach, child-centered care, family-centered approach, and expert fun-makers are what set us apart. CLICK HERE to join our team and embark on a play-filled adventure towards your child’s optimal physical development and well-being. Let’s play and thrive together!

 

#PlayWorksPhysio #PlayAndThrive #ChildhoodAdventures #TeamworkMakesTheDreamWork #ExpertFunMakers #PhysiotherapyForKids #PlayTherapyApproach #ChildHealth #FamilyCenteredCare #PaediatricPhysiotherapy #BecausePlayWorks

5 tips for choosing shoes for your toddler

 

Choosing shoes for your toddler can be overwhelming! There are so many brands and styles to choose from. The shoes you put your toddler in can impact their foot development, arch development and overall comfort. Here are 5 important tips to consider the next time you are choosing shoes for your little one:

 

  1. A wide toe box. You want to ensure that the front part of the shoe (the toe box) is wide enough to fully allow your child’s foot to splay/spread out when they are walking. This is important for their balance and both the structural and muscular development of their feet.
  2. A flexible sole. You should be able to easily bend the shoe when you are pushing from the toe and the heel. This will allow their feet to move more naturally while they are walking and promote the development of their arches by allowing their intrinsic foot muscles to engage.
  3. Firm heel cup. The heel cup should be firm – if you pinch the heel of the shoe, it should maintain shape. This will provide adequate support for your child’s feet.
  4. The right size. It’s important to have shoes that fit your child properly, resist the urge to buy shoes that are too big!  The “flex point” of the shoe should line up with where their foot bends when walking. If a shoe is too big, then these two spots will not align. Their feet will be less supported in a larger shoe and can also lead to more tripping and ankle injuries.
  5. Secured. Having shoes with velcro or laces are ideal to make sure they fit snugly on your child’s feet. This will prevent “toe gripping” and decrease tripping. Toe gripping happens when shoes are too big or aren’t secured onto the foot well enough. It can lead to instability and over time lead to foot or leg pain.

 

Proper footwear is so important, especially in the early years! If you have any questions please reach out, we are always happy to help! 

 

Did you know that almost everyone is born with flat and flexible feet? In their first year, babies’ feet grow extremely fast – about 2.5cm! As children get older and start walking, their feet are still flat because the bones, muscles and ligaments are not yet fully developed.

 

Foot development

The main arch of the foot, the medial longitudinal arch, begins to form at 3-4 years of age. This arch continues to develop throughout the first 10 years of life and many studies state that the mature foot posture is not obtained until 7-10 years of age (Uden et al., 2017). This means that we should expect our children’s feet to be flat during their first 3-4 years and to then start developing an arch over the next 7 or so years.

 

Factors that can affect foot development

  • Poor fitting shoes: too small, too big, too rigid
  • Not enough barefoot time at home

 

What about those Flat Feet?

Flat feet aren’t always problematic. As you can see from above, younger kids tend to have naturally flatter feet and therefore treatment is not always necessary. If your child goes up on their tiptoes you should be able to see their arch form. This is considered “flexible flat feet”. These should not be painful. Ultimately painful flat feet in kids are a problem and non-painful, flat feet in children (or adults!) are not a problem and do not need to be treated unless they are accompanied by any of the points listed below.

 

Here are some reasons why we see kids at PlayWorks Physio for flat feet:

  • Their walking pattern is different. For example, if they do not push off from their big toe, instead they use the inside of the foot
  • Complaints of foot, ankle or knee pain
  • Bunion development on the inside of the foot
  • Frequent rolling of their ankles
  • Complaints of their feet getting tired or sore after activity
  • Excessive pronation (collapsing inwards) of feet

 

Things you can do to encourage proper foot development in your kids

  • Find properly fitting shoes. Look for shoes with a supportive heel cup and flexible sole. CLICK HERE  to learn how to pick the best shoes for your child.
  • Have your child barefoot when safe/appropriate. This helps develop the muscles, ligaments and tendons of their feet and will contribute to arch development.
  • Play around with walking on different types of surfaces. For example: grass, hills, trails, gravel, sand etc.

 

If you have any questions about your child’s foot development, email us at hello@playworksphysio.com

 

Written by: The PlayWorks Team

 

References: Uden et al. Journal of Foot and Ankle Research (2017) 10:37

What is Torticollis ? 

Torticollis is the term used to describe the tightening of a muscle in baby’s neck. It is the shortening of one of the neck muscles, the sternocleidomastoid (SCM), which results in the baby’s head tilting slightly to the side and rotating in the opposite direction. 

What are some causes of torticollis?

  • Position of baby in utero (higher risk with twins or pregnancies with growth restrictions)
  • A long/difficult labour and delivery which can cause muscle spasms in baby’s neck
  • A preference of looking one direction over the other, eventually leading to the muscle shortening
  • Having a flat spot on the head may cause the baby to always rest in this position and over time, tightens the muscle

These are some conditions that appear like torticollis and are important to rule out: 

  • Vision difficulties
  • Hearing difficulties 
  • Reflux or GERD 
  • Viral infections 
  • Improper alignment of the spine 

How will torticollis impact my child?

Imagine your baby trying to develop their gross-motor milestones while their head is always tilted and looking one way. They will have difficulty with the following:

  • Learning to roll both directions
  • Learning how to sit independently
  • Discovering where the center of their body is (discovering midline)

Furthermore, torticollis can often lead to plagiocephaly – a flat spot on baby’s head, because of a preference to always rest in one position. See our plagiocephaly post here: Help! My baby has a flat head!

The neat thing about torticollis and plagiocephaly is it can be corrected quite easily, especially from a young age. EARLY INTERVENTION is key, and easiest to treat. 

What to expect during an assessment with your paediatric physiotherapist:

  • We will see how your baby’s neck moves to determine if there are any restrictions
  • Rule out the more complicated causes of torticollis
  • Provide tips to help to correct this and if warranted, give you stretches and strengthening exercises appropriate for the stage of your baby’s development
  • Depending on baby’s age and severity of the torticollis, we may also track your baby’s head shape to ensure they’re not developing a flat spot

Remember, the EARLIER the BETTER. It’s much easier to work on positioning and stretching exercises with younger babies, and that can allow us to introduce strength exercises at the optimal time. 

If you have any questions, please contact us at hello@playworksphysio.com! We’re able to provide assessments over video call until we get over the COVID-19 hurdle. You do not need a referral for physiotherapy.

Written by: Karly Dagys, Physiotherapist

My baby has a flat head…

Is this a common issue?

YES, this is a very common issue with babies. Flattening can be caused by the following:

  • Your baby has a preference of looking in one direction, resulting from tight neck muscles
  • Your baby prefers looking in a certain direction but there are no neck restrictions
  • Your baby is a good sleeper and doesn’t move much when sleeping

 3 Types of Flattening

Plagiocephaly is flattening on one side of the head from your baby preferring to look left or right. It is often associated with tight neck muscles (torticollis). Things you may notice:

  • Flattening on the back when washing your baby’s hair
  • One cheek appears larger
  • One side of your baby’s forehead is more prominent than the other
  • One eye is slightly larger than the other

Brachycephaly is flattening directly on the back of your baby’s head and is often seen with babies who sleep for long stretches without turning their head to either side. It causes baby’s head to be wider than average.

Scaphycephaly is the rarest type of head shape issues we see and is when the head is more narrow than average. It is most commonly seen in babies who spent long periods of time in the NICU because their heads are being turned from one side to the other.

How will a flat head impact my child?

  • Depending on the severity of flattening, your child may have difficulty fitting helmets, because these are made for the average shaped head.
  • Plagiocephaly can result in a forward shift of the facial bones, which can be purely aesthetic or in severe cases can lead to jaw issues.

What can we do?

  • A paediatric physiotherapist can measure your baby’s head to determine if there are any concerns and provide you with education to best manage your baby’s head shape.
  • When recommended, we can refer you and your baby to an orthoptist for helmeting. This is dependent on your baby’s age and the severity of flattening.

When is it best to seek help?

  • The earlier the better! This provides more time to track your baby’s head growth and improvements in flattening. The earlier you come in the more likely we can address the flattening conservatively (with positioning, education and stretches if needed).
  • If a helmet referral is required, seeking help earlier is better to optimize the amount of change obtained with the helmet.

 If you have any questions about your baby’s head shape, feel free to contact us!

 

Written by: Maegan Mak

 

 

Our first post was on infant motor milestone assessment and one of the things we also screen for in this assessment is torticollis, the shortening of neck muscles that causes a preference in the direction baby looks.

Understanding Toricollis.

Torticollis: shortening of one of the neck muscles, usually the sternocleidomastoid (SCM), resulting in the baby’s head tilting slightly to the side and rotating in the opposite direction.

Do you need a doctor’s referral?

We see these referrals from doctors, chiropractors, midwives and parents who have noticed that their baby looks one way more than the other. You do not need a doctor’s referral to book an appointment. If you have extended benefits that cover physiotherapy, you can use these to cover your session.

What does a torticollis assessment involve?

When you come into physiotherapy for this issue we assess how much baby moves their head on their own to each side and also how much we are able to passively move their head. If there are any restrictions we can teach you some stretches and strengthening exercises, as well as positioning techniques that would be best for your child.

We find this a great opportunity for the you to gain education on positioning, gross motor milestones and ask any questions you may have about development of your baby. When we are assessing a baby for torticollis we are always monitoring their gross motor skills and development for their age. If there are any concerns, we can have the you work on these areas as well!

Often times the families were unaware of the skills noted as needing improvement, or they noticed and were unsure of who to ask. This “one on one” time with your family is beneficial to decrease the stress for you and allow any questions to be answered. If we are unable to answer your questions we can refer you to someone who would be more knowledgeable in that area.

When is the best time to get assessed?

The earlier torticollis is identified the easier it is to resolve. Early identification also reduces the likelihood of secondary issues of torticollis such as plagiocephaly. If you are unsure if your baby should be assessed, feel free to call or email us and we can answer any questions!

Understanding Your baby’s development.

We are so glad you asked. It can be confusing for new parents to understand exactly where their child’s development is currently at. Luckily, we can help break it down into understandable milestones and processes, eliminating the guesswork and give you a greater understanding of your child’s health and motor skill development.

What are Motor Milestones?

Infant motor milestones are a specific skill that we expect babies to reach around a certain age range. Often times parents will be aware of the major milestones such as rolling, crawling and walking, but not know the ones in between. I find parents have lots of questions about what they should be expecting to see next, what ways they can help their babies achieve various milestones and what toys are appropriate for their baby’s specific age.

What does a physio assessment look at?

In these sessions, I observe how the baby moves and assess where they are for their age. From here I educate the parents on where their baby is compared to other babies of the same age. If the baby is behind in any gross motor skills I describe what they should be doing and specific tips to help them achieve this. If the baby is on track, we discuss what to expect next and different ideas of how to facilitate devolvement of that particular skill. We practice the movements and exercises together to ensure the parents are comfortable with doing them at home.

Another area covered in the infant motor milestone session is positioning for their baby.

Many of the babies I see will spend majority of the time on their back, a portion on their tummy, a bit of time in a seat of some sort and then being held by family members. There are different ways to hold babies, pick babies up and different ways for them to be on the floor which all assist in their development. This is information that parents are usually happy learning about and implement into their daily routine immediately!

What parents say…

I hear time and time again how being a new parent is overwhelming and it’s difficult to know what information from the internet is correct. Families love coming in to learn about where their baby is at from a physical stand point and learn strategies to help them reach their next milestones. They appreciate the one on one time spent with them and the safe environment to ask questions about their baby. Often times, moms will say, “I wish I knew about this sooner!”

What about baby toys?

On top of the gross motor skills, I often get asked about what sorts of toys are worth purchasing and which toys provide the most benefit for their baby’s development. I find that it’s not so much about the toy but about the different ways they can use the item. As a pediatric physiotherapist, I can identify several different purposes and benefits of an average toy. If families already have certain toys or equipment I will give them different strategies on how to use it to gain a specific developmental milestone. If they are looking to purchase new toys then I give suggestions on ones that are good for development at their baby’s specific age. Parents find this beneficial because they don’t want to spend money on a toy that will be used for a short period of time or one that that doesn’t promote different areas of development. Space is a large issue for many families as well, and they do not want to fill their space with unnecessary toys or equipment.

Stay Tuned!

Infant motor milestone assessments are just one reason why kids or babies come to physiotherapy! Stay tuned for more information on why kids come to physiotherapy. I will be releasing more blog posts on different reasons of why kids come to physiotherapy!

           

 

 

Photo by li tzuni