PT on the Net Research

Teenager with Dyspraxia


Question:

I have just secured a client who is a 16 year old boy who has dyspraxia. His main goals are to raise his level of fitness, increase his stamina and hopefully increase his coordination skills. He currently does very little exercise and has very poor stamina. I was wondering if you had any tips to give with regard to training this client.

Answer:

I'm assuming this is a case of motor dyspraxia as opposed to oral or verbal. On that ground, I'll make some suggestions: When I did a training intensive with Vladimir Janda, MD, PT, and Karel Lewit, MD in Prague at St. Charles hospital, he informed us that as many as 20% of adults today suffer from what he termed minimal brain disorder; while he did not call it dyspraxia, essentially it is very similar if not just semantics.

Janda explained that among other possible influences (which we may or may not be able to control, such as environmental pressures), minimal brain dysfunction could result from (and/or cause) aberrant infant motor skills development. Typically, this begins with short term or no bottle feeding. Minimal or no breast feeding removes an essential ground development phase of infant motor development, as the action of milking a nipple, which is much different than milking a bottle, serves to activate the deep core stabilizers (inner unit). When the essential breast feeding phase is missed or interrupted, all succeeding phases are proportionately deficient; you can't build a safe house on a weak foundation. Further, if infants are not allowed to move naturally through each developmental phase of sensory-motor (which is actually motor-sensory!) development (naval radiation, homologous, homolateral, contralateral, mammalian, lunging/squatting and finally gait), there is a strong possibility of colateral disorder in other biological systems (neurological and hormonal for example). My approach to a patient with minimal brain disorder (dyspraxia in your case) is exactly the same as taken with a spinal cord injury or stroke patient. As you can imagine, this is much too complex for an Internet explanation! With that said, I can make the following suggestions:

  1. Look at the book Wisdom Of The Body Moving by Linda Hartley. Apply as many of the infant development exercises as you can. In short order, you will be able to determine where your client's development terminated. Begin working just under the point at which his motor skills begin to break down. You will basically be working him back through his crawling phases.
  2. Use the Swiss Ball. In my video, Swiss Ball Exercises for Better Abs, Bunns and Backs, I offer many simple, very effective exercises that I actually developed for spine rehabilitation. Start with those and migrate to more complex variations as your client's motor skills improve. There are several other excellent courses on stability ball training available on the PTontheNET.com web site. Click here and do a search under "Stability Ball Training."
  3. Don't over exercise him on a given set, and allow optimal rest. Optimal rest will not be determined in the usual way. It will be determined by how long it takes for his motor skills to return to optimum; how long a set lasts is determined by when the motor skills begin to break down. If you feel his performance is dropping more than 10%, even with adequate rest, he has hit what is referred to as the critical point. Training further will actually do more damage than good with regard to motor skill development; the same actually applies to anyone in the gym or athletic training, but you'd never know it walking around the gym these days!
  4. You may need to use stretching to inhibit spasticity or hyperactivity in given muscles. You can use the basic length/tension assessment in my Golf Biomechanics Manual.
  5. Great care must be taken to keep his diet clean of processed foods and stimulants such as white sugar or any stimulants. Caffeine and artificial sweeteners (particularly aspartame! See the DVD Sweet Mysery) can cause real trouble in your training sessions and his life! My book How To Eat, Move and Be Healthy! has the eating plan he needs to follow if results of significance are to be obtained. This is a whole-body problem and should NOT be seen as a neuromuscular problem alone.
  6. I suggest you do your training programs with him in the morning when he's fresh. You'll get better results. Just be careful not to fatigue him so much that he gets hurt from an unwanted fall or by dropping something from his hands later in the day due to deep neural or stabilizer fatigue.
  7. You may be well served to watch a good physio that works with neurologically impaired patients work. You can get many good ideas, such as how to stimulate and inhibit the right muscles. A CHEK Level IV Practitioner could also do a lot to assist you. Unfortunately, there are few of them due to the rigorous amount of training it takes to get there!

I hope my advice serves of use to you, and I wish you both the best on the journey.