Intensive Physical Therapy
The intensive method of therapy is being embraced by
an increasing number of pediatric therapy clinics. Typically the term
“intensive” describes therapy that occurs for multiple hours on a daily basis
for a limited number of weeks. The idea behind intensive therapy is to train or
retrain the brain and body to work together by teaching high repetitions of
movement patterns and exercises in a concentrated period of time.
Intensive therapy for children has been in practice for years in European
countries. American families who were interested in this innovative approach
would travel for weeks at a time for their child to participate in intensive
therapy programs overseas. Since the late 1990s, the idea has begun to spread
across the United States. Now families have more than 40 clinics to choose from
in the U.S. Each clinic may vary in its individual approach, but they share the
basic concept of short duration, intense daily therapy.
Most children who require physical therapy for chronic developmental conditions
receive hour-long therapy sessions one or two times per week on an ongoing basis
for years. A child’s progress is measured on an individual basis, based on
objective and subjective report of the therapist and family. Although
large-scale research has not been conducted to evaluate the effectiveness of
this ongoing model of therapy, it has long been accepted by the therapy
community and reimbursed by insurance companies. Similarly, progress using the
intensive model of therapy is measured on an individual basis, using common
therapy tests and measures, as well as the goals of the family, to establish if
acceptable progress is being made. What therapists and families are finding is
remarkable: Children can make measurable gains in a fraction of the time by
condensing months’ worth of therapy into a few weeks.
For children with neuromuscular disorders, such as cerebral palsy, intensive
therapy provides the opportunity to practice correct movement patterns
repetitively in a controlled environment. This repetition and consistency is
necessary for neurological reeducation, which means the brain is being taught to
automatically use the correct pattern of movement.
Children with developmental delays, such as Down’s Syndrome, can also benefit
from the intensive model of therapy. All children learn by process of trial and
error. A child attempts a new skill many times, learning many ways that do not
work before achieving success. A child with developmental delays may require
more trials before mastering a new skill. Intensive therapy allows for many
repetitions of functional skills, to facilitate mastery in a shorter time frame.
If children have muscle weakness that is contributing to their delayed motor
development, strengthening may be a necessary component of the therapy plan.
Physical therapists know that muscle does not become stronger if it is
challenged on an inconsistent basis. Just as a person will not get stronger by
going to the gym for one hour per week, a child’s muscles will not get stronger
with therapy once per week. Intensive therapy allows the therapist to use
strengthening exercises consistently to improve the child’s flexibility and
strength. With this new strength, new functional skills are possible. Once the
child is utilizing his new strength in a functional way, for instance in the
ability to jump, the functional strength will be maintained.
Why Intensive Therapy Works
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Strengthening:
Strengthening weak muscles is a big part of our intensive program. Muscles will
not gain strength unless they are worked out consistently. Just as an athlete
would not expect to improve by training one time a week, kids with weak muscles
will not gain strength with therapy once weekly. By challenging weak muscles
everyday, those muscles will respond by getting stronger.
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“Magic
Number”:
Intensive
therapy operates under the theory that brain development occurs when exposed to
a “magic number” of repetitions. A toddler learning to stand up from the floor
will attempt many times before mastering the skill. In children with
neurological impairment, that number is thought to be much higher than in
typical children. Through intensive therapy, we can expose the child to a high
number of repetitions to facilitate mastery in a shorter time frame.
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Consistency:
With 2-4
hours of therapy daily, we have time to address all of the goals of therapy
everyday, rather than having to choose one or two areas to focus on each
session.
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Faster Progress:
Research
indicates that the intensive model works to promote faster progress in the
neurologically impaired patients than the traditional 1-2 hours of therapy per
week.
Specialized tools/techniques we use:
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Suit Therapy using the Therasuit™:
The suit
is a dynamic orthotic worn during therapy.
It
is comprised of a cap, vest, shorts, kneepads, and shoes that are connected
to each other
through a system of elastic bands. It aligns the body, improves proprioception,
and can provide resistance for strengthening.
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Universal Exercise Unit:
The UEU
is a system of pulleys, straps, weights, and splints utilized to perform a
variety of exercises for improving strength, active range of motion, and muscle
flexibility. The therapist can isolate and strengthen specific muscle groups.
The “Spider Cage” utilizes partial or full suspension in the UEU using elastic
cords. This dynamic support allows the client to perform
functional movements that would not be possible if unsupported.
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Partial Weight Bearing Treadmill Training (PWBTT):
By
supporting a portion of the individual’s weight over a treadmill, he can focus
on the movement of walking, without having to focus on balance and moving
against gravity. This research-based tool has been shown to facilitate walking
and improve gait.
Intensive therapy at Beyond Therapy
At Beyond Therapy each client is treated one-on-one by a licensed physical
therapist at all times. Therapy sessions are tailored to the individual’s needs
and goals, and typically last 2-4 hours daily, Monday through Friday, for three
weeks. When appropriate Therasuit suit-therapy is utilized. For more information
on this therapy, please call Beyond Therapy at
(816) 801-7878.
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