Wednesday, June 20, 2012

Constraint induced movement therapy ...

Well, we have been toying with the idea, Zoey's therapist and I, for awhile now and it seems like the time has come to give it a try.  And what exactly is constraint induced movement therapy you ask?

Constraint-induced therapy focuses on regaining movement on the affected side of the body.  More specifically, in children with hemiplegia, it focuses on increasing movement of the affected arm and hand. Constraint-induced therapy consists of restraining the non-affected arm, thus forcing the child to learn to move the affected arm. The thought is that this treatment may overcome the effects of learned non-use of the arm and will also ensure that the affected arm has increased practice or use.

So that is the long and the short of it. Certainly not as simple as it sounds. We talked about doing this almost 2 years ago and our main concern then was that Zoey was just becoming an emergent signer and because her signs are mostly sign approximation because of her effected left hand/arm, we wanted to wait. And as we have waited , Zoey has become more proficient in her signing. Her left arm is showing more "life" so to speak and she has her very own little verbal language, that those close to her, can sometimes understand. So with those cumulative factors, now is as good a time as any.

We will be casting her next week. A removable cast. She and I will need to spend some serious hours, yes hours, daily, working together. Won't be easy. On either of us. But if we want to see her achieve some semblance of purposeful use in that arm and hand, this seems like the next step.

I do not like making my girl work. That is no secret. I think in the past and perhaps even the present, there are people that think I do her the greatest disservice by doing for her, the things that maybe she could and should begin learning to do for herself. But it is truly difficult for me. Truly hurts me to watch her struggle and work. I tend to subscribe to the theory that she has had to work enough in her little life, just to be here in this world, and more work seems unfair. Right or wrong, that is what I believe. The truth of the matter also is, is that although I do not know this with 100% certainty, I am fairly confident in saying that Zoey will never be living on her own, in say a group home. She will not be working in say a store and the the fact remains, even with this therapy and it's possibility of success, Zoey will more than likey remain dependent on another human being for most all of her life skill needs.  So doing for her is just something that has become second nature to me. And, I might add, I feel honored and privileged to be doing so. This is not low balling my girl. This is not being pessimistic. This is my reality. And in the end, more than likely, Zoey's reality as well.

But we will give this a shot. And hope good things will come from it. It certainly can't hurt. Well, all except my heart maybe just a bit but it does hold the promise of yielding some really exciting improvements. And that is a good thing, right?


Elizabeth said...

We did this a bit with Sophie's left hand early on -- not with a full cast but a weight. It actually helped her to gain better coordination and use of her right side. Periodically, I'll hold down her left hand and tempt her to reach with her right hand, still.

It's all good -- it is.

Kristin said...

Yes, good. But I'm with you. Facing reality is not low balling anyone. If she (or my kid or anyone else's) is happy as an adult, that's what's going to matter, I think :)

Cammie Heflin said...

You KNOW Zoey is going to rock this! She is so strong and capable, smart, and amazing! She will WANT to do this, I've seen this girl in action and I constantly tell you that you underestimate her (sorry about that!), let her fly Heather, she can do it!

Michelle said...

Isn't that us just being parents when we want to do everything we can to make our children's lives easier? But easier (though a relative term when someone has to work as hard as Zoey does every single day) is not always better. I have found over the years that when my kids have to work for something they have a sense of pride and accomplishment that they don't get when I just do it for them. I would never presume to understand how difficult it is for you to watch Zoey struggle - but I would encourage you to help her work hard. Look how far she has come in her life - she may yet have more wonderful surprises in store for you! Good for you that no matter how hard it might be for you, you are giving her the chance to reach for the stars.

Lisa Lilienthal said...

You're brave and strong, and Zoey is a never-ending font of wow, so I am expecting good things to come from this :)

Melissa said...

I'm with Cammie. Zoey is going to do fabulous with this. She surprises so many people, in so many ways and I think this is going to be another one of those areas. I hope she totally blows you away when she is forced to use her other arm. :)

Becca said...

This will be fascinating to see, from an outside perspective, although I can only guess how difficult it'll be to do. I bet Zoey's going to rock this, too! It sounds like an amazing opportunity, and one that could yield some pretty spectacular results. Your little Supergirl is a sweet little inspiration. <3

Salinas family said...

"Ditto" to the comments already made - it will be hard to watch and do, but I bet, yet again, she will amaze even you, who knows her the very best. When Scotty was a baby, his Dad made him hold his own bottle. I couldn't do it, I didn't want him to be frustrated. But you know what? He learned to hold his bottle. My one thought about this adventure you are about to embark on is that it would be good to get your other kids involved in working with her on specific tasks. Everyone will share in the joy of accomplishing things previously thought beyond Zoey's grasp; and it will likely be less frustrating if you're not having to do all the "exercises" yourself.

Bea Braun said...

She's going to do great! This will make her life easier in the long run. Easier to do things for herself, easier to communicate, and less frustrating for her. You can do it Heather! And Zoey, well she's just surprised you at every turn, so she's going to do it her way!

Anonymous said...

I fight this daily. My Ben will never be independent either, mostly due to his low communication issues and because his dad and I would wither up and die without him. His dad is just as bad, he calls me at lunch every day to see how his baby boy is and he is 21 years old. But we are happy and so is Ben and that is all that matters to us.

Peter Olson said...

Hasn't that girl surpassed all expectations already?
Why would she ever stop knocking our socks off?
Ha! Ha!
Make sure to keep telling her that the work is because you love her and want the best (most) for her.
(You may have to keep telling yourself that too.)
Keep up the great work!
I have a new respect for that saying, "Fight like a Girl"
Love & Hugs

Just Another Ordinary Miracle said...

Cast away!! We were going to recast Ivey's legs this past spring. After she broke her leg , the coasted led had more flexibility in the joint. So doctor purposes webcast both to increase her rang of motion. We are waitin now until fall because it is so stinking hot and humid here.
And please tell me why we throw out the information about what's going technically in their little lives and then always follow it up with some disclaimer about why we are doing it? Hmm, could it be our momma guilt, or trying to throw people off our backs who will question the validity of the choices that we moms HAVE to make, whether we like it or not. And anyone who knows you knows the depths of your live and that you would never do something it negative backdrop. I hope you get a sassy bright pink cast like Ivey's if you can! Good luck. !!

Shelly Turpin said...

Oh gosh - I can just see the frustration in Bella's eyes and hear it in my ears. I applaud you Mama - I think this might be harder on you to watch her struggle than on her. The results will be awesome, I'm sure, but the short term is going to be hard. Hoping and cheering from afar!

Lindsay Marie said...

I'm sure Miss Zoey will completely blow us out of the water with her amazing spirit as usual :) I'll be thinking about both of you next week!

Anonymous said...

Heather: somehow I missed this blog.. I believe that little Zoey Grace will shine like a little star through this. That is the "Zoey way"!

Actually, since this is late, hope it is going well


Ps Beautiful photo of Jake & Zoey!!!!!

Doodle On Yoo said...

I somehow stumbled upon your blog, but just wanted to note how beautiful the photo with this post is!
So much love captured in a single photo!

Prayers and Best Wishes for your little one!

Amy Benfield said...

Having stumbled across this blog whilst conducting some research on Constraint Induced Movement Therapy (CIMT), I must simply tell you how overcome I am with Zoey's (and yours) strength. I have no children or close family members who suffer from CP, but I'm a student studying Occupational Therapy and eventually want to specialise in some aspect of it as I want to help families like yours and enable beautiful children (like Zoey) to lead a more independent life (wherever possible).
I'm currently researching the use of CIMT in children who suffer with hemiplegic CP, and was wondering if you would be happy to fill out a short online questionnaire? I fully appreciate the sensitivity of this nature and understand completely if it's something you would not be happy doing, but if you would, please just follow the link. It will be treated in the utmost confidence and anonymity and all of the questions have been approved by an ethics committee.
I hope this post finds you both well and the therapy is working? I send warmest wishes to you both.
Kindest regards,
LinkConstraint Induced Movement Therapy - Hi, my name is Amy Benfield and I am a 23 year old student training to be an Occupational Therapist. I'm conducting research into the effects of Constraint Induced Movement Therapy (CIMT) and would be very grateful if any parents of children who are undergoing/ have undergone CIMT could fill in an online questionnaire for me? It's completely confidential and anonymous and treated with the utmost respect. I would be very grateful if you could go straight to the link (which I will post below) or if you want to ask anymore questions or want to contact me for any reason, then please do not hesitate to send me a private message. I thank you in advance for your help and co-operation.
Thank you,

The link for the questionnaire -