From the Guidelines
Orlando's delayed gross motor development is likely to significantly impact his physical activity and participation, and as a physiotherapist, I strongly recommend a comprehensive assessment and individualized intervention plan to address his developmental coordination disorder or mild cerebral palsy. The patient's history of commando crawling from 10 months, sitting at 8 months, pulling to stand at 13 months, and walking from 17 months, as well as his current inability to run or jump and crawling on stairs at age 2, suggests a need for early intervention to prevent long-term consequences on his physical fitness, social development, and self-confidence 1.
Key Considerations
- The importance of early identification and evaluation of motor delays, as highlighted in the study on motor delays: early identification and evaluation 1
- The need for a comprehensive assessment of Orlando's gross motor skills, muscle tone, strength, balance, and coordination to develop an effective intervention plan
- The role of play-based activities in improving fundamental movement skills, such as exercises to enhance lower limb strength, balance, coordination, and age-appropriate skills like running, jumping, and stair climbing
Intervention Plan
- Regular physiotherapy sessions (1-2 times weekly) combined with a home exercise program to reinforce skills during daily routines
- Parent education and involvement to support Orlando's development and ensure consistency in his intervention plan
- Gradual progression of activities in difficulty as Orlando's skills improve, incorporating his interests to maintain engagement and motivation
Long-term Implications
- The potential for reduced confidence, social isolation, and decreased physical fitness if Orlando's motor delays are not addressed
- The importance of early intervention in supporting his social development, self-confidence, and long-term physical health
- The need for further neurological assessment to rule out underlying conditions and ensure comprehensive care, as suggested by the study on motor delays: early identification and evaluation 1
From the Research
Physical Activity and Participation
- The case study of Orlando Patel, a 2-year-old boy, presents concerns regarding his gross motor development, including an abnormal gait, inability to run or jump, and crawling up and down stairs 2.
- These limitations are likely to impact Orlando's physical activity and participation in the present and future, potentially affecting his overall development and quality of life.
- Research suggests that children with developmental coordination disorder (DCD) or other motor impairments may experience difficulties with physical activity and participation, emphasizing the need for targeted interventions 3, 4.
Role of the Physiotherapist
- Physiotherapists play a crucial role in promoting development and participation in children with motor impairments, such as Orlando 2, 5.
- A physiotherapist can design and implement a personalized exercise program to improve Orlando's gross motor function, balance, and coordination, ultimately enhancing his physical activity and participation.
- The physiotherapist may also collaborate with other healthcare professionals, such as occupational therapists and pediatricians, to ensure a comprehensive approach to Orlando's care.
Exercise and Development
- Exercise, particularly gross motor training, has been shown to improve motor function and activities of daily living in children with DCD 2.
- Task-oriented physical therapy interventions, which focus on dynamic balance, mobility, and dual-task performance, can also be effective in improving functional mobility and participation in children with motor impairments 3, 4.
- In older individuals, strength training and gross-motor skill exercise have been found to improve postural control, dynamic functional balance, and strength, highlighting the potential benefits of exercise across the lifespan 6.