Pediatric Tuina Yang Xiao: What is motor retardation? Training methods for infants and young children with motor delay
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In the outpatient clinic we often encounter this situation, some babies in the physical examination by the doctor found obvious motor development delay, but parents do not know, when we inform parents of the existence of children's development abnormalities, parents often ask, what is developmental delay? Such a small baby, what is exercise?
1. What is motor delay?
Commonly seen in infancy and early childhood, it is manifested as motor development lagging behind normal infants, such as 3 months of head can not stand up, 6 months will not turn over, can not grasp things and so on. The prognosis of motor retardation during this period can be normal, but it is more likely to be an early manifestation of brain injury, cerebral palsy, and mental retardation. If there is a significant motor abnormality in infancy, such as stiff limbs, a limb that does not move, or there is no significant improvement in motor development delay in early childhood, there may be a lifelong movement abnormality.
Second, the common causes of children's motor development delay
1. Due to perinatal brain injury, including muscle tone is too high or too low, there may be primitive reflex movements; Muscle weakness, often accompanied by abnormal patterns of movement; May be accompanied by sensory dysfunction, difficulty coordinating movements, etc.; The most common disease is cerebral palsy, mental retardation.
2. Caused by birth defects, including limb deformities, mutilations or paralysis.
3. Caused by genetic diseases, muscle atrophy and more serious dysfunction may occur, such as spinal muscular atrophy.
4. Caused by peripheral nerve damage or muscular system lesions.
5. Chromosomal diseases: such as fragile X chromosomal syndrome.
6. Legacy metabolic defect disease. Wait a minute
III. What are the manifestations of children's motor developmental delay?
1. The baby's body is soft and the exercise is significantly reduced, which is the manifestation of low muscle tone, which is manifested in the infant's one-month period; the body is hard, that is, the performance of hypermuscular tone.
2. Unresponsiveness, mostly manifested in hearing and vision. This is an early manifestation of damage to the hearing system or mental retardation.
3. Abnormal head circumference, head circumference is a morphological indicator of brain development, and babies with brain injury often have abnormal head circumference.
4. Poor weight gain, decreased eating, weak breastfeeding.
5. Fixed posture, mostly due to abnormal muscle tone caused by brain injury. For example, the bow angle is reversed, the frog position, the inverted U-shape posture, etc.
6, do not laugh, 3 months of baby will normally begin to smile phenomenon, slow movement will not laugh or postpone the time to laugh.
7. The small hand is clenched, and the fist cannot be opened often, or the thumb is adducted, especially if there is an upper limb on one side, it is impossible to reach out and grasp the object.
8. Body torsion, 3 to 4 months of age infants with body torsion, often suggesting extrapyramidal injury.
9. The head is unstable, such as the head of a 4-month-old infant cannot stand upright or cannot look up.
Infants aged 10, 3 to 4 months have poor eye movements.
11, can not reach out to grasp things: such as 4 to 5 months can not reach out to grasp things, pay attention to the occurrence of mental retardation or cerebral palsy.
12, look at the hand: still exists after 6 months, pay attention to the occurrence of mental retardation.
The above phenomena are manifestations of motor development retardation, because children continue to grow and develop, and various phenomena will also behave differently with development. Providing accurate age information is therefore essential for the diagnosis and treatment of symptoms. If your baby encounters a similar situation, you should consult a doctor in time and treat the !!!
Fourth, how can parents simply judge the baby's motor development delay?
Children's large motor development usually follows the law of "two lifts, four flips, six will sit, eight climbs and ten stations will walk". That is to say, the baby will look up at the age of 2 months, turn over at the age of 4 months, sit alone at the age of 6 months, climb at the age of 8 months, stand at the age of 10 months, and walk alone at the age of 10 months.
Fine motor development can be summarized as: three play hands, five grasps, seven hands, nine pairs of fingers, 1-year-old scribble, 2-year-old origami, 3-year-old bridge. The above is the average age of normal children's motor development.
If the baby cannot look up at 3 months of prone lying, 6 months of sitting, 8 months of not sitting alone, 12 months of not standing on the railing, 18 months of not walking alone is a warning indicator of major motor retardation. 3 months without follow-up, 6 months without enough, 8 months without hand down, 12 months without thumb pinching are warning indicators of fine motor developmental delay.
Due to the large differences in developmental individuals, the existence of the above warning indicators is not necessarily abnormal, some babies can catch up with it in the future is not abnormal, but the frequency of monitoring needs to be strengthened; at the same time, the doctor must also combine the child's muscle tone, body posture and other energy area development conditions to make a comprehensive judgment.
Fifth, the training method of infants and young children with motor delay
1. Posture training
This training is used to improve dystonia, relieve trunk reclining, straighten the lower limbs, adduct, scissor-shaped, and different types of babies can adopt different holding positions.
If the child is able to hold the trainer's neck and the torso control is good, one hand can be used to support the child's hips, and put his legs apart, placed in front of the hip on the trainer's side.
If the child cannot hold the trainer's neck and the torso control is poor, one hand can be used to support the child's shoulders, the other hand to support the hips, and place his legs apart on the sides of the trainer's waist and hips.
2. Head stability training
That is, to train the flexibility and stability of the baby's head, promote the development of slow development of infants to develop head-up movements, and alleviate neck stiffness. The child is lying prone on a wedge-shaped cushion or pillow, the elbow is flexed, the forearm is on the bed, the shoulders and elbows are in the same line, and the trainer sits on the child's side.
If the child's head cannot be lifted, the index and middle fingers of one hand can be used to gently support his jaw, the other hand can gently tap his shoulder, and he can also take a brightly colored toy to shake in front of and on both sides of the child's head, inducing him to reach forward and sideways to take things, and gradually appear protective reactions in all directions.
3. Sitting stability training
It is used to enhance sitting stability, improve muscle tone and non-sitting postures, such as directly pulling into an upright position. Slowly pull the child from the supine to the seat when the child is in a prone position with both hands supporting the head, chest lifting, or extending both upper limbs while lying on the back.
4. Turnaround training
Used to develop rollover movements while increasing joint flexibility. For children who cannot turn over, when lying on their backs, the lower limbs on the flip side are flexed, and the flexion leg is assisted to drive the body to rotate, or the upper limbs on the flip side are held to stretch and adduct, and the trunk is flipped.
5. Crawling training
It is used to develop reptile movements in infants and improve abnormal muscle tone in children. On the basis of the child's elbow support, train the hand support and kneeling position.
According to different developments, give appropriate support to the child's shoulders or hips, and when the child can complete the kneeling position independently, place some toys in front of the child's side and let the child grasp. Crawl training is carried out on this basis. You can also kneel behind the child, hold the child's ankle joints with both hands, when the child extends his right hand, push the child's left leg forward, when the child extends his left hand forward, then push the right leg forward, thus repeated training.
6. Kneeling training
Used to suppress lower extremity extensor spasm, it improves the pelvis's control and coordination of the lower extremities and is the basis for successful standing and walking training.
When training, you can clip a pillow or other object between your child's legs. Hold your child's bilateral hips with both hands, or hold one hand against the chest and the other on the hip, and repeatedly do the up and down movements of the torso. Then perform the training of kneeling on one leg and standing on both legs. The child's hip should be supported so that the center of gravity of the body should be shifted to the kneeling lower limbs and become a kneeling position on both legs. Then the other side of the training is carried out, repeatedly
Bridge exercise is divided into double bridge and single bridge exercise, the former will be the child lying on his back, the legs are flexed, for the child to extend the hips, hips, and maintain the form of double bridge movement. The latter flexes one leg and straightens the other leg, stretching the child's hips, lifting the hips, and maintaining a single bridge exercise form.
7. Standing training
According to different developmental conditions, the corresponding training is carried out.
(1) It is used to train the stability of standing, squat, and increase the flexibility of joints such as knees, ankles, elbows and wrists.
Spread your child's legs apart, support your child's hips with both hands, and after your child is able to stand more steadily, grab your child's hands with both hands, train your child to squat, stand up and stand on one leg, and assist if necessary.
(2) For infants who cannot heel the ground when walking, walk with their toes, and cross their legs.
When the child is lying on his back, heels are held with four fingers, and the palm of the hand is pressed to the center of the foot, so that the foot is flexed back in the direction of the calf, so as to facilitate the correction of the pointed foot, stabilize the ankle joint, and better stand and walk training.
8. Walking training
Used to correct abnormal posture and promote infant learning to walk while relieving dystonia.
Stand opposite the child, hold the child's bilateral upper arms, and first give upward and forward pull on one side so that the child's lower limbs can step forward. Then the training is on the opposite side, repeatedly, or using a walker.