Comfort With Movement

 
 
We all know the characters who have a new adventure sport each year.  Rappelling just isn’t
exciting enough so they move on to ice climbing.  Because hanging off frozen rocks 2,000 feet off the ground is so much more fun.  Some people love sailing.  They find the motion soothing  or exhilarating-or both at the same time.  Frequently these individuals love all those tossing and turning roller coaster rides as well.  Some folks crave speed; fast skiing, fast cycling, fast cars ...

While we learn to enjoy many athletic activities through exposure and experience,  each individual is somewhat biased towards particular kinds of motor activity.  This is because our sensory systems have specific preferences.   

Many individuals need proprioceptive input.  We receive this input primarily through the pound, pound, pound that occurs when we run.  Long distance runners may clock the miles ostensibly for the caloric burn, virtue and/or discipline required, but many NEED the input jogging provides.   Resistive sports such as weight lifting and wrestling also stimulate the propriceptors.  Activities such as basketball, tennis, soccer, football, hockey, lacrosse gymnastics and dance give a great deal of this input as well.

Amusement parks are a huge business.  The sensation of spinning (rotation), free falling and very fast movement of the roller coaster all stimulate the vestibular system.  Some people find this very organizing and  love these rides.  Thus, the popularity and success of these parks.
Others’ neurological systems can’t stand this stimulation.  They are hypersensitive and a ride on the Twirling Teacups makes them sick for the entire day. 

           
      A little rotation                         and more....                      hold on for the ride! 

Most people fall somewhere in the middle.  The outliers, those who can’t get enough movement, and those who can’t stand any form of movement, generally reflect a sensory system somewhat out of balance.  This does not refer to the child who rushes to the scariest, fastest ride over and over again.  Or the Mom who gets sick whenever compelled to accompany the toddler on the Merry-go-round.  

  


The “I can’t get enough” profile relates to the individual who can’t stay still.  Climbing, crashing and running around are constants.    

The hypersensitive folks, refer to people who exhibit genuine fear when on moving, unstable surfaces.  Walking on a dock may be terrifying, and the escalator is a regular challenge.  Along with dizziness on rides,  they may get sick in cars and feel bad in any other moving vehicle. 
  
 Some people love the challenge of unsteady moving experiences; others find them terrifying.



Certain individuals struggle with just one or two of these features, or have a mixture of many.
They may love the Bumper Cars but can’t stand the Flying Saucers.  They may enjoy a trampoline but when they get on an unstable platform they panic.

    
                Unstable walkway                              Rotation: loved by some, hated by others

The trouble relates to the processing of the body senses from the
       joints:  proprioceptors-detects position of the body parts
       muscles: kinesthesia-detects movement
       inner ear: vestibular system-detects rotary and speed motion and position of the head.
                
All these senses send messages to the brain that help organize movement, but also give the individual a sense of comfort or security in knowing the body is safely centered, balanced and out of harms way.  When the information is not accurately recorded or processed in the brain, for whatever the reason, the individual can become fearful of movement.

The individual who craves movement has a system that needs a lot of information coming in to  keep a sense of balance and centering.  When they engage in motor activities, the brain gets flooded with the kind of input that helps organize all the sensory stimuli.  In addition, the areas that get bombarded are partially responsible for attention and influence emotions.  So, when they get that adrenaline rush from a fast ride down a ski hill or parachute out of an airplane, they really are refueling their brains.

      
                                     Some seek out unnecessary challenges

Individuals who struggle with movement sensations of one form or another have difficulty processing all the stimuli entering the brain.  The overload may be so intense that it spills over, so to speak, even to areas of the brain that regulate physiological functions,  thereby causing physical reactions such as sweating, changes in respiration and heart rate as well as nausea and vomiting.

   
    
                          Others are happy to stay on solid surfaces at all times

It is important to reach a happy medium.  The individual who can’t sit still will need to move and a healthy lifestyle should always include opportunities to exercise and move.
Activities vary based on preferences.  

                              

The person who cannot tolerate movement, lives in a constant state of anxiety.  It is important to coax the neurological system to be more efficient in processing incoming sensory stimuli, and coaching the body to become comfortable with movement.

The person struggling with many forms of movement is referred to as “Posturally Insecure,” or experiencing “Gravitational Insecurity.” 

These terms refer to a person’s discomfort with movement and lack of trust in the body’s ability to manage and remain safe when the feet are not firmly planted on a flat unmoving surface.

Coaching the Posturally Insecure/Gravitationally Insecure

 The trunk needs to be strong enough to work against gravity.

 Developing familiarity and comfort with all forms of movement:
     Rotation-fast and slow
     Linear-straight line movement (e.g. a car moving forward)
     Rocking-side to side and back and forth
     Positional Changes-inverted position (up side down)

 Learning to perform activities while moving.

Strategies:

Trunk Strengthening: Refer to sections that address this specifically
     Building Trunk Strength
     Muscle Tone, Endurance and Strength

 Familiarity and Comfort with Movement:

     The first priority is to help the individual overcome a fear of movement.  Exposure to     
     different forms of movement should be introduced gradually.  
     
RULE OF THUMB:  Identify a movement that is well tolerated and/or enjoyed.
                                Begin with this and veer off slightly for a few reps then go back to 
                                the preferred movement.
               
METHODS TO INTRODUCE MOVEMENT:
                                Swings
                                Exercise Balls and Rolls
                                Scooters
                                Barrels
                                Giant Lycra Slings

       
   Gently rolling back and forth      Side to side (lap or exercise ball)   Up and down!

            
Push slightly off kilter to add slight rotation.         Full rotation: add fast/slow

              
                 Barrel                                   Swinging                              Hanging


EXAMPLE:     A child tolerates slow swinging back of forth on a swing.  Push the child
                                back and forth (linear movement) several times, then push slightly
                                off center so the swing sways at a slight angle.  Allow to sway two, three 
                                times then immediately return to back and forth in a straight line.  Repeat   
                                this sequence.  Each time the angle of the line can increase slightly; the 
                                number of reps increases.  If the child begins to show signs of fear, go
                                back to basic swinging for a while before starting the drill again OR wait
                                until the next session.

Reduce Fear of Falling 

This is a main ingredient of the posturally and gravitationally insecure person.  It is important that protective extension is present.  This means that the arms automatically extend and are strong enough to bear weight when falling.   This is important to prevent “face plants.”  Kidding aside, it is a basic protective response that protects humans from head injuries and other potential life threatening damage.  

If protective extension is not present yet,  go back to Trunk Strengthening and Muscle Tone.
The arms should extend in all directions automatically (forward, to the right, left and behind).

Once protective extension is present, games to help the child feel comfortable with falling can begin.  

The purpose of this is to:

Reinforce use of protective extension
 Build confidence that the body will be able to protect itself when falling
- Become comfortable with the sensation of falling
Learn to enjoy the sensation of contact when falling onto safe/soft surfaces.

                     
              Protective Extension: Arms extended to protect the head when falling.

Falling Games:

Ball crashes
Scooter rides
Swing crashing games (falling off onto mats or piles of pillows)
Jumping into pillows, mats, ball pits 

 Continue improving tolerance for movement by increasing speed and making  frequent
and rapid directional changes.  This should be done with input from the child (asking
regularly, “Faster, slower, the same ..”

 As the child gains confidence and comfort with movement and falling safely, add an additional motor component to the activity.  

EXAMPLES:

Swings:  reaching down to pick a bean bag up
Exercise balls:  work on a puzzle while lying or sitting on ball with partial balancing
Scooters:  knock over foam or cardboard blocks while moving across the room
Jumping: throw or catch a ball while jumping

 Add balance challenges:  the child needs to keep balance while on an unstable surface.
Falling off onto a safe (matted or well cushioned surface) is understood as a probable outcome if balance is lost.
     
EXAMPLES:

Exercise balls:  shifting slowly back and forth, right and left, while the child maintains balance
Swings:  maintaining balance on platform or tire swing while it is moved; speed increases
              gradually.  Move from sitting upright to kneeling to standing on platform.

For the individual craving movement:

Take all of the ideas reviewed above and basically reverse them.  This individual wants fast speed, lots of crashing, rotation beyond belief.  Same guidelines apply.  Ask the child how fast, how slow, back and forth or around in a circle-tight spin like the earth rotating on its axis or big rotation as a planet moves in its orbit.

Regarding rotation:   Caution should ALWAYS be used when using rotation. The child may ask for more spinning and not be aware when the body has gotten enough and is about to overload.  It is important, therefore to “gate” the rotation the child gets.  Even if the child keeps demanding more,  breaks should occur frequently (at least every 10- 15 seconds) and after rapid spinning with these short breaks a longer rest period should occur after 10 minutes.  Alternating a heavy work activity with rotation assures less chance of sensory overload.  It is a good idea to consult a professional specializing in Sensory Integration* if planning on using rotary swings with children.

As the child gets all the movement craved, the need begins to diminish.  Over time this should carry over into everyday life.  The need to swing from a chandelier  will end (true story-I’ve worked with several children who were reported by parents to do this!) and other distracting and disruptive motor activity should diminish.

Case study example:  I worked with a girl who struggled in her main stream second grade classroom.  She craved all forms of movement.  For approximately 8 months she chose to use various swings and with each she requested rapid spinning for more than 40 minutes.  I would make sure she had breaks and heavy work to counterbalance the excitatory stimuli bombarding her neurological system.  Gradually, over the next year she became interested in coupling the rotary activities with another game, such as picking up a koosh and tossing it at a target while flying around on the tire swing.  Eventually, she preferred skilled motor games exclusively and she rarely requested the rapid rotation she once insisted on.

AS CHILDREN GET THE INPUT THEY NEED, OVER TIME THE CRAVING DIMINISHES AND THE CHILD CAN MOVE ON TO MORE GOALS DIRECTED MOTOR ACTIVITIES.



Additional Resources:
http://www.comeunity.com/disability/sensory_integration/resources.html

Equipment:
http://www.southpawenterprises.com/
http://www.therapro.com:80/PhysioRolls-P321821C5567.aspx

Additional Reading:
The Out of Sync Child  by Carol S. Kranowitz
The Out of Sync Child has Fun  by Carol Kranowitz


                   
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