HOME EXERCISE PROGRAMS
- It is important that home exercises be performed twice daily; once in the morning & once in the late afternoon/early evening.
- It is often helpful to do them in the morning before school and in the afternoon before homework as they may help to “set” the child’s nervous system/pathways.
- If the child has an office visit with exercises or participates in any other home or recreational sensory play in a particular day, then one session of the exercises can be skipped that day.
- If done too late at night, the child may not be able to go to sleep.
- If one session of exercises is missed in a particular day, do not worry; however, it is important that they do not make it a habit. The more they stick to the recommended program, the faster/better the results.
- For better compliance, do not make the home exercise routine longer than 15 minutes per session (AM/PM).
- It is recommended that the parent(s) monitor the child’s exercises to ensure that they are doing them correctly.
HOME & RECREATIONAL VESTIBULAR ACTIVITIES
- Bouncing-exercise balls, trampolines
- Swinging-blankets, hammocks
- Spinning-swivel chairs, sit n’ spin, scooter boards, tire swings
- Rocking-rocking horse, rocking chair, seat cushions
- Climbing-playground equip, ladders, designated furniture
- Riding Toys- tricycles, bikes, scooters, skates
- Walking, running, hiking, swimming
- Outdoor Play-slides, teeter-tooter, roller coaster
- Recess Games-hopscotch, ball catch, soccer, tag, etc.
- Slow, rhythmic, linear swinging- blanket swing or net swing
- Gentle, slow spinning in one direction
- Gentle bouncing- start with sitting on exercise ball and bouncing
- Slow, linear, rhythmic rocking- head-to-toe rocking while on tummy or “draped” over exercise ball on tummy
NEGATIVE VESTIBULAR RESPONSES
Exercises should be stopped, decreased in number of repetitions or difficulty if any of the following are experienced:
- Excessive yawning, hiccupping, or sighing.
- Irregular breathing.
- Face pallor (color change).
- Pupil dilation.
- Motor agitation, increased anxiety, significant changes in arousal level (falling asleep or giddiness).
- Changes in sleep-wake patterns.
- Changes in emotional behavior- child becomes more emotional/weepy.
- Feelings of dizziness, nausea, or headaches during or after exercises
HOME & RECREATIONAL PROPRIOCEPTIVE ACTIVITIES
- Stair climbing/sliding
- Crawling- make tunnels out of boxes
- Tug of War- theraband
- Pulling/pushing- weighted wheelbarrow, cart, wagon
- Kicking, jumping (trampoline)
- Carrying weighted items- bucket of water or sand
- Ball activities- exercise balls, BOSU balls
- Scooter Boards
- Pounding/rolling- Play-Doh, clay, cookie dough
- Blanket wrap, wearing weighted vest/lap buddies
- Stretching, joint compression, massage
TANDEM TAPE WALKING & TANDEM BOARD WALKING EXERCISES
Start with making a 10’ straight line using either masking tape or blue painters tape. As the child advances, you can increase the difficulty of any exercise by having them perform any particular exercise on a home-made balance beam. Get a 10’ long 2×4 that has been sanded so that there are no splinters to use as the balance beam. Take three one foot long 4×4 blocks of wood and space them equal distance then place the balance beam across the blocks.
Additional ways to increase difficulty are:
- Use foam balance beams (can be ordered from Power Systems); the downside is the cost. *Good to use as an in-office exercise.
- Take large sheets of bubble wrap to create an unstable surface. Put tape line on top of the bubble wrap to balance on. *Good to do barefoot to increase tactile input.
- Lay down large cushions or pillows to create an unstable surface and put tape line across to balance on.
Things to look for before progressing the exercise or graduating the child from the exercise:
- The child should walk with his/her head up and eyes looking straight forward. *To help the child look straight, you may need to put some type of visual target up or hold something up for them to focus on.
- Make sure that the child maintains good posture throughout the entire exercise
- Must be able to place heel to toe and stay on the line.
- Does not need to look down at feet.
- Does not need to use arms for balance.
- Does not demonstrate “overflow” movements (e.g. tongue hanging out, movement of hands or any other body part that should not be moving).
- Does not lose balance.
- Does not complain of any negative vestibular responses during or after the exercise.
Note: The child may need to look at their feet, use their arms to balance, or use the wall to steady themselves until they progress.
TANDEM WALKING V “A”
- Make a 10’ straight line using masking tape or blue painters tape. (If the child has marked balance problems, you may want to do this in a hallway so they can initially use the wall for support and to feel secure).
- Walk heel to toe along the line; make sure you touch heel to toe and don’t leave space in between.
- Try not to look at your feet; look straight ahead. (It is often helpful to put some type of target point ahead for the child to focus on)
- Do one set with your arms down at your side, one set with your arm crossed across your chest, and one set with your hands clasped behind your head.
- Repeat 5 times. *When you master this going forwards then try adding backwards (go once forward and come back going backwards) 5 times.
TANDEM WALKING V, P “B”
- Carrying a weight in one hand, walk heel to toe along the line.
- When you get to the end, change the weight to the opposite hand and walk back the other way (still going forwards).
- Do a total of five times up and five times back.
- Then, walk heel to toe forwards with the weight in one hand and at the half-way point, change the weight to the other hand without stopping!
- Start with the weight in the right hand and pass to the left five times and vice versa five times. *Tips: Use a bucket about ¼ filled with water or a 1-2 pound weighted exercise ball. Mark the half-way point on the line with another piece of tape going perpendicular to the tape line. *Increase difficulty: Have some body call out “change” several times as you walk along the line. Without stopping change the weight to the other hand.