Therapeutic gymnastics and massage for disorders of the central nervous system

Unfortunately, dysfunctions of the central nervous system (CNS) and, as a result, impaired muscle tone are the most common pathology in early childhood. Careful daily observation of the child allows you to identify the slightest shortcomings in the development of mental reactions and motor skills.

First, assess the child’s muscle tone.

Your baby is 3-4 months old

Undress your baby completely and place him on his stomach on the changing table. A healthy child likes this position. He is able to hold his head for several minutes and freely turns it to the sides. Hands rest on the forearms, as a rule, carried forward. The fists are already loosely compressed and do not capture the thumbs. The chest is slightly raised above the table surface. The abdomen and pelvis are tightly pressed to the table. The thighs are slightly apart, the legs are raised. The trunk is straight. Convince yourself of this by mentally drawing a line from the middle of the back of the head to the intergluteal crease (Fig. 1).

In children with impaired muscle tone, this line is constantly shifted to one side (asymmetric position of the torso and head).

Straighten the child’s legs, bring them together and see if the gluteal and popliteal folds are symmetrical.

The child freely shifts his head to the right and left, without giving preference to any side.

The bending of the legs should occur freely, without tearing the pelvis off the table surface.

Observe the position of your child on his back. First, make sure the baby is looking at you and smiling. The child holds his head in the midline, freely turning it to the sides. The hands are already quite free, the child plays with them for a long time, trying to put them in his mouth. The torso is straightened: verify this by mentally drawing a line nose — chin — sternum — navel — pubis. The right and left sides should be symmetrical. The legs are bent, the hips are widely separated (Fig. 2).

If the position of the torso and head is often asymmetrical, consult a pediatrician or neurologist.

Your baby is 6-7 months old

Assess his physical development at this age.

Lay the undressed baby on your stomach. Pay attention to the support on outstretched arms, the hand is well opened. The head turns freely in all directions. The chest is raised above the table surface. The abdomen and pelvis are still pressed to the table. The legs are spread apart, the knees are bent, the shins are freely raised (Fig. 3). When viewed from above, the spine occupies a median position, deviating neither to the right nor to the left.

Lying on his back, the child plays with his arms and legs, the movements have become purposeful and coordinated. The head lies in the middle between the shoulders, leaning forward slightly.

The baby independently turns from the back to the stomach.

He starts to sit up. When sitting, pay attention to the back of the child — one should be straight (Fig. 4).

Assess your baby’s development at 9-10 months of age

The kid is on all fours, leaning on his palms and shins. The arms are straightened, the hands are open, the child can only lean on one arm. The head turns freely in all directions. The chest, abdomen and hips are raised, the legs are bent, the feet are placed on the support with the back surface (Fig. 5).

The child begins to crawl back and forth on all fours, freely transferring his weight from hands to feet. Perhaps your baby is already standing, holding on to a support, stepping over with his feet. Make sure that he puts his feet completely, without rising on his toes (Fig. 6).

Massage techniques and exercises that contribute to the overall relaxation of the muscles of the child’s body

Massage of children in the first months of life is mainly relaxing.

Stroking has a wonderful relaxing effect. It is widely used in baby massage. The sliding of an adult’s hand should be very soft and slow. Rubbing and kneading techniques can also promote relaxation if performed gently and gently, at a slower pace than usual.

Of the special techniques, shaking is especially effective, which is often used to reduce the increased tone of the muscles of the limbs when performing passive movements. At the same time, your hand tightly grabs the child’s arm or leg, as if merging with it, and “trembles” finely. The direction of the oscillatory movements depends on the direction of movement that you are helping, the rhythm and speed of the oscillations change in waves. At first, this movement may seem too complicated. For practice, try this exercise: In your palm-down hand, insert a pencil between two fingers. During the reception, the pencil draws a vibration curve on a piece of paper. It should be fairly even, without sharp drops.

To relax the muscles, acupressure is successfully used — point vibration. It consists in the following: with the pad of one finger (thumb, index or middle) they press on a certain zone (point) with simultaneous vibration, without breaking away from it for 5-15 seconds. Oscillatory movements should be very small (almost imperceptible «trembling»), fast, and it is better if their speed changes in waves (at the beginning — slowly, in the middle — quickly, at the end — again slowly). The pressure on the point also changes: from superficial to deep, and weakens again towards the end. Acupressure is done with hands for 2-3 pressures with pauses between them for 3-5 seconds, during which stroking is carried out on the massaged area.

Some postures and exercises of therapeutic gymnastics are very effective for relaxing muscles.

Embryo Pose

The child lies on his back. The baby’s arms are crossed on the chest, legs are bent, knees are brought to the stomach, head is bent forward. The pose is fixed by the hands of an adult. In this position, you can rock the child towards you — away from you and from one side to the other 5-10 times. Movements should be done smoothly, rhythmically (Fig. 7).

Swaying on the ball

Placing the child on the ball and rocking it in this position will also help to eliminate or significantly reduce the pronounced increase in muscle tone. Exercises are carried out as follows: the child is placed on the ball with his stomach and chest and, holding the baby, slowly sway back and forth, left and right and in a circle. Slow measured swaying of the child on the ball (lying on his stomach) can be combined with an increased tone of the flexor muscles of the arms with careful (without violence) bringing them forward (Fig. 8).

Swinging on weight

Holding the child vertically in weight, slightly rock his torso from side to side. This exercise is good to do in the water, shaking the child in a vertical or horizontal position (Fig. 9).

Swimming has the most relaxing effect. Daily bathing in warm (but not hot) water, swimming strokes in a large tub, or swimming in the pool are extremely beneficial for babies.

Massage techniques and exercises that help relax the flexor muscles of the hands, develop grasping and supporting functions of the hands

First of all, you need to achieve good relaxation of the muscles of the whole body, for which do a few swings in the “embryo” position or on the ball. When swinging forward on the ball, try to have the child put his hands in front of him, opening his hands.

To relax the flexor muscles of the arms (which are located on the anterointernal surface), more strokes of the arms and chest are used, acupressure is effective (brake method; Fig. 10-11).

Light shaking of the hand is used to relax the muscles of the forearm. Grab the forearm in its middle part and make 3-5 movements shaking the child’s hand.

These massage techniques are combined and alternated with passive exercises. Moreover, exercises are done only when the muscles of the hands are sufficiently relaxed, and the movements are performed gently, freely and without much effort.

Exercises for children of the first year of life (given according to the degree of increase in complexity)

Abduction of arms bent at the elbows as they slide across the table.

Lifting the bent arm up with the child in the lateral position.

Bringing bent arms forward in the position of the child on the stomach.

Retraction of straightened arms to the sides in combination with shaking (together and alternately).

Crossing the arms over the chest followed by moving them aside.

«Boxing» — alternating flexion and extension of the arms.

Alternately raising your hands up (Fig. 12).

Simultaneously raise your hands up.

Circular movements with your hands.

Compound movement: bend your arms at the elbows, then raise straight arms up, bend again and lower down (palms facing the body).

Forearm rotation. The arms are bent at the elbows, the middle position of the forearms — the palms are facing each other (Fig. 13), turn the forearms outward (supinate) — the palms are facing the child’s face (Fig. 14), return to the middle position and turn inward (pronation of the forearms) — palms facing the adult (Fig. 15).

Abduction and extension of the thumb. To do this, do acupressure at its base (on the back of the hand; Fig. 16).

Sometimes extension of the thumb is achieved only after acupressure from the sides of the base of the nail of all other fingers and their extension (Fig. 17). Simultaneously with the described techniques, a massage (more energetic) and exercises that strengthen the weakened, stretched extensor muscles of the arm (which are located on the posterior surface of the forearm) are carried out.

Patting with the child’s open hand on various surfaces is very useful: on the table, wall, large toys, the game of «patties» (Fig. 18).

Teach your baby to clap on the water while bathing — this is sure to please the child.

Grabbing a child’s hand, run your palm over your face or hand — this is pleasant and useful (Fig. 19).

At a later age, when the child’s hand is sufficiently open, teach him to play “patties” and “magpie” on his own (“Forty-magpie, cooked porridge, fed the children” — stroking on the palm, “I gave this, I gave this” — when transferring (children) — finger massage).

For the development of the grasping function of the hands, it is recommended to train the grasping reflex several times in the first three months, putting your fingers in the palms of the child.

And if the reflex is absent, then a ring or a toy that is easy to grip is put into the child’s palm, around which the child’s fingers are squeezed. It is very important to make sure that the thumb wraps around the ring (toy) on one side, and the other fingers on the opposite side (Fig. 20).

Then they hang the toy at a distance convenient for grabbing it with a hand, or for the same purpose they bring a bright sounding toy to the child, encouraging him to take it from different positions (lying on his back, lying on his stomach, sitting).

For the development of the supporting function of the hand the position of the child on the stomach is very useful. If the baby still does not hold his head well, then put a diaper folded several times under his chest. Make sure that the child, lying on his stomach, leans on bent arms and holds his hands open. In the future, the children lean on straightened arms, lifting the torso.

Teach your child to stand and then crawl on all fours (fig. 21) — this is a wonderful arm support training.

Here are a few special exercises.

— The child is held on weight, with the left hand supporting him under the stomach, with the right hand — by the legs (from above with a «fork»). An adult slightly tosses the child with his left hand over a table (chair) on which lies a large soft toy or a large ball. The reflex of reliance on the toy is called — the arms are stretched forward and the hands and fingers are opened.

— Supporting the child above the chest and by the legs from below, they bring it closer to the support, put the hands on the support and stretch the child back towards you — the hands open (fingers are spread apart) (Fig. 22).

— When rocking the ball down with your stomach, bring the child’s hands forward and, tilting the ball forward, encourage the baby to lean on his hands (Fig. 23).

— Holding the child by the legs with a “fork” with one hand, supporting the body with the other, slowly lower the child from your knees, sofa or chair to the floor with your head down. It is important that the baby at the same time stretches the arms in front of him and leans on them. Later, when moving independently on sofas and armchairs, this skill can be very useful.

It is noted that children with insufficiently developed hand support, falling, often break their noses.

— The child lies on his stomach, leaning on his hands. The adult carefully takes his shoulders back and presses down on the shoulder area, achieving a stable emphasis of straightened arms (Fig. 24).

— The child is on all fours. The adult raises his head — the arms are straightened and the fingers are extended (Fig. 25).

— «Wheelbarrow» — walking on his hands.

In the second half of a child’s life, the manipulative function of the hands should be developed, encouraging him not only to pick up a toy, but also to perform various actions with it: examine it, shift it from hand to hand, throw it, add cubes, break a pyramid. The close connection between the development of fine motor skills of the hand (finger movements) and the mental development of the child has long been known. If you want your baby to speak faster, start reading early and be an excellent student at school, spend more time on massage and exercises for the hands and fingers. In addition to the above, you should practice opposing fingers (large to everyone else) in flexion — extension. Well, if there is an opportunity to let the child press the buttons, turn the phone dial, “play” the piano, etc.

Techniques and exercises that help to relax the adductor muscles of the thigh, the posterior leg muscles, and the development of the supporting function of the feet

With increased tension of the adductor muscles of the thighs, the child hardly spreads the hips to the sides, with support under the armpits, crosses the legs (Fig. 26).

Before performing therapeutic exercises, it is necessary to relax these muscles with a massage.

Massage includes a large number of strokes, including on the inner surface of the thigh (without affecting the genitals). Rubbing and kneading techniques are used only on the outer side of the thighs. Much attention is paid to back massage, especially the lumbar region and buttocks.

Acupressure massage is effective, especially in combination with passive breeding of the child’s legs (with bent knees).

Touch the pad of one finger (or two) in a place corresponding to the projection of the hip joint from the side (Fig. 27). It is necessary to feel, as it were, a deepening when pressing, and then gently, slowly exert both a vibrational and pressing effect on the point (zone). At the same time gently (can be combined with shaking) gradually move the child’s thigh outward.

Spreading the hips, one should not allow sudden movements, violence, this can cause pain during the reflex contraction of the thigh muscles and even more tension.

Do acupressure of the area located approximately in the middle of the inner surface of the thigh (Fig. 28). At the same time, abduction to the side and shaking of the bent leg will help to relax the adductor muscles of the thigh (Fig. 29).

You can significantly reduce the tension in the muscles of the legs by shaking the baby on weight in a vertical position or by shaking the pelvis of a child lying on a table with bent legs.

Breeding of bent legs is performed only after achieving relaxation of the muscles with soft vibrational movements, without violence. Then a diaper folded several times is placed between the legs and fixed with another diaper or pants. This is the so-called «wide» swaddling, which can be recommended to all children in the first months of life for preventive purposes (Fig. 30).

Exercises for the legs — flexion and extension, «gliding steps», «stomping» with the feet on the table surface, etc. — are done only with a wide spread of the hips to the sides (Fig. 31).

Very useful reflex «crawling», breeding bent legs of a child lying on his stomach (Fig. 32).

Teach your baby to play with his legs, pull them up to his mouth — this is important not only for the physical development of the child.

Many exercises can be done while swimming, warm water relaxes the muscles wonderfully.

With increased tension of the posterior muscle group of the legs the child in an upright position (supported under the armpits) leans on the toes, stands “on tiptoe”.

At the same time, the tone of the muscles of the anterior surface of the lower leg and the rear of the foot is reduced (the muscles are weakened and stretched), and the muscles of the back surface of the lower leg are excessively tense. Therefore, foot massage should be differentiated.

Starting position: the child lies on his back, legs at the knees are bent, slightly apart.

First, the sole is massaged with simultaneous shaking of the foot and bending it forward. To facilitate bending, perform acupressure: gently and deeply press at the transition point of the back of the foot to the shin (Fig. 33). Then, in order to strengthen the stretched muscles, massage the muscles of the anterior surface of the lower leg and foot (stroking, rubbing).

The back surface of the lower leg is massaged more gently (stroking, very light rubbing and kneading, shaking the calf muscle).

Then put the baby on his stomach. Bend his legs at the knees, shins vertically, perpendicular to the support, and gently, plastically, with vibrational movements, press on the soles, stretching the Achilles tendon (Fig. 34).

In the position of the child lying on his stomach, his feet should be outside the table (hanging; Fig. 35).

For the development of the support function of the feet foot exercises based on reflexes are recommended. Grab the child’s feet with your index and middle fingers, and press the sole at the base of the fingers with your thumb. This will cause the foot to flex.

Then swipe with pressure along the outer edge of the foot — to the heel. There is an extension of the foot.

Back of feet massage consists in stroking with the thumbs in the direction from the base of the fingers to the lower leg, bending around the ankles from front to back.

The following exercises are very helpful.

— Reflex of support and straightening of the legs. While supporting the baby in an upright position, let him lean on the surface of the table. When the feet of the half-bent legs of the child come into contact with the support, they are extended.

— Reflex «walking». Support your child in an upright position by leaning slightly forward. When the feet come into contact with the hard surface of the table, the baby takes automatic “steps”.

— Leg extension and foot support development contributes to reflex crawling, crawling in a semi-vertical position, crawling on the back.

— When swinging on the ball make sure that the baby, when moving back, puts his feet on the surface of the table and pushes himself off on his own. Avoid being on tiptoe. Help the child if necessary (Fig. 36). Place a large plastic ball at the foot end of the crib and let the baby kick it with his feet (fig. 37).

— «Sliding Steps» are recommended for children older than four months (when the physiological hypertonicity of the leg flexor muscles disappears).

Useful exercise in a warm water bath. They are made directly during the bathing of the child. The child is supported in an upright position, fixing his chest with both hands behind and in front. Put the baby on the bottom of the bath and, transferring the weight from one of his legs to the other, stimulate the stepping over (Fig. 38). For the duration of this exercise, it is advisable to put a rubber corrugated mat on the bottom of the bath.

While swimming, encourage the child to push off the wall of the tub (fig. 39).

For older children who already stand on their own, holding on to a support, squats with support are recommended. You can turn this exercise into a game by telling your baby to «get small», then «get big».

Carefully! Standing and walking should not be stimulated prematurely. The child will get up and go when he is ready for it. Otherwise, the likelihood of deformity of the legs increases sharply. Also, do not use the «jumpers», in which the vicious position of standing on tiptoe is fixed.

Massage techniques and exercises that help strengthen muscles

Many years of experience proves that daily gymnastics and massage can strengthen and develop the child’s muscular system, which is especially important for children with reduced muscle tone (hypotonicity).

To strengthen the muscles of the posterior surface of the body (the posterior muscles of the neck, back, buttocks), all massage techniques are used that are performed more vigorously, especially rubbing and kneading. Light percussion techniques are widely used: tapping with fingers, patting, stimulating tingling.

Effective acupressure is a tonic method. Quick, jerky pressure with the pad of a finger (middle, index or thumb) on a certain point (zone) causes tension in the corresponding muscles.

Exercises are selected according to the age and capabilities of the child.

— Frequent laying on the stomach and looking at toys in the position on the stomach. If the child does not hold his head well, then a roller is placed under his chest.

— Turns to the side with reflex extension of the spine.

— Turns from back to stomach with and without help.

— Reflex crawl.

— Crawling in a semi-vertical position.

— Crawling on the back.

— «Swimmer» pose: an adult supports the child with one hand under the chest, the other — by the legs.

— «Soaring» on the stomach with support: an adult supports the child under the chest with both hands, the baby’s legs rest against his stomach.

— «Soaring» without leg support (Fig. 40).

— Keeping the body on weight: put the child on the edge of the table so that the shoulder girdle and chest are in weight.

— Keeping the legs on the weight: the child lies on the edge of the table so that the legs remain suspended (Fig. 41).

In both of these exercises, you can help the baby by stimulating the muscles of the back and buttocks with acupressure.

— Good for older kids tilts, from a standing position (Fig. 42).

— «Point» — walking on the hands.

— Lifting from a position on the stomach.

— Particularly useful crawling and walking on all fours — this is an excellent workout for the whole body of a child, including the muscles of the back, neck and legs, crawling (Fig. 43), climbing.

To strengthen the muscles of the front surface of the body (anterior surface of the neck, abdominals), in addition to the methods of abdominal massage recommended in age complexes, stimulating pinching around the navel and acupressure are widely used.

In the supine position, any independent movement of the legs is useful.

From one and a half to two months, you can do special exercises (arranged according to the degree of increase in complexity), including them in the daily complex and doing it additionally.

— Turns to the side.

— Turns from back to stomach.

— Transition from horizontal to semi-vertical position and vice versa.

It is convenient to do this exercise while holding the baby on your lap. Make sure that his head does not throw back (Fig. 44).

— Laying back on the ball.

— «Soaring» on the back (Fig. 45) or preparation for it.

— Sitting down for outstretched hands.

— Sitting down with bent arms.

— Tilts, from a standing position (See Fig. 42).

— Raising straightened legs (“get your feet to the stick”), first with the help of an adult, then on your own.

— Lateral torso twists (Fig. 46).

Older children can sit down on their own or by hand (fig. 47).

Exercises and massage techniques for asymmetric muscle tone of the trunk and limbs.

Careful observation of the baby allows you to note the slightest signs of asymmetry in muscle tone. If the child’s torso is more often curved in one direction, this is a cause for concern.

With asymmetry, the child’s body is like an arc with a bulge in the direction of less muscle tone. The legs and pelvis are turned in the direction of increased muscle tone, sometimes the shoulder girdle is lower on this side, and the head is often tilted to the same side. Limb movements on the side of increased muscle tone may be either more or less pronounced than on the other side.

Special massage and therapeutic exercises are carried out against the background of general strengthening classes for age complexes. The main task is to normalize the tone of the muscles of the entire body of the child, that is, to relax tense and strengthen weakened muscles.

On the side of increased muscle tone (the concave side of the arc), relaxing massage techniques are used: stroking, light rubbing and gentle kneading, vibration, shaking.

On the side of low tone, a firming massage is done: stroking, more vigorous rubbing and kneading, stimulating pinching and percussion techniques.

It is necessary to massage the entire body of the child (back, chest, abdomen, arms and legs), observing the above principle. Special exercises are necessarily interspersed and combined with relaxing massage techniques. So, the vibration of the muscles of the trunk and legs (from the side of increased tone) is accompanied by stretching of these muscles. This is done in the following way. Lay the child on his stomach with a “bulging” side towards you, closer to the edge of the table. With both hands, grasp the child from the side of the spastic contracted muscles and, pressing him to you, carry out vibration and stretching of the torso and legs, as if encircling yourself with a child. In this case, the palms, fingers to each other, lie flat on the lateral surface of the body. Producing simultaneously stretching and vibration, the palms move, one towards the armpit, the other towards the child’s leg and down it to the foot. The baby’s head is between your forearm and shoulder and gently leans in the opposite direction, the pelvis takes a position of slight hypercorrection (Fig. 48). In this position, you can carry the baby in your arms.

In addition to this exercise, you should do more with that arm and leg that are tense, relaxing them. When moving the limbs, shaking is widely used.

Turns from the back to the stomach can also help to even out muscle tone if they are performed more often through the “concave” side. Hold the baby while turning for a few seconds, run your fingers along the spine (Fig. 49).

It is very important that during sleep in the crib and for a walk the child lies in a strictly symmetrical position (mentally draw a straight line: nose — chin — sternum — navel — pubis). Styling will help to maintain this position, the simplest version of which is two rolls of diapers or blankets located on the sides from the armpit to the child’s leg.

Exercises to improve your sense of balance

Do not be afraid to carry the baby in your arms in various positions: on the right and left hand, facing and back to you. Change his position in bed often. The following exercises are effective for training the vestibular apparatus.

— Swinging in the «embryo» position.

— Swinging on the ball with the stomach and back down.

— Swinging on the hands. Taking the child in your arms facing you and supporting him under the back, shake the baby up and down (towards you — away from you).

— Taking the child in your arms in a vertical or horizontal position, spin around with him on both sides.

— Horizontal circling. Stand up, put the baby on your shoulder with your stomach down (Fig. 50).

Start spinning, but be careful not to lose your balance. Change the direction of circling — either clockwise or counterclockwise.

— Then circle the child, holding him on the side (Fig. 51).

— Repeat the circling, shifting the baby to the other side.

— Spinning with the baby, lift him into the air and spin with him again. Before you finish, lower the child down almost to the floor and lift up again.

Start the exercise slowly and carefully.

If for some reason your baby does not like something, then most likely you are acting too quickly. Slow down the pace.

Gradually increase the time of classes from 10-15 seconds for each exercise to 30-40 seconds. Always stop before your child wants.

— Swinging. Try rocking your baby up and down in a vertical position, lifting him into the air and lowering his legs to your stomach. This will not only give him pleasure, but also provide leg support training.

Lie on your back and swing your baby over you. Grab it tightly by the sides under the armpits, lift it above you and look into each other’s eyes. Tell him he’s an airplane. Gently rock it to the right and left, lower it to your chest and lift it up again. Rock the baby on your lap, putting him on one knee, then on the other.

— Rolling «log». With both hands, lay the baby on its side, and then roll further, moving behind him yourself. After that, roll it to the other side and help yourself return to the starting position. When the child learns to roll independently several times in a row, ask him to roll in both directions.

— Pushing. If the child is stable on all fours, lightly push him forward, backward, to the sides. The exercise is carried out in the form of a game with the urge to stay on all fours.

— Swinging with a baby in her arms on a swing, in a hammock, on a carousel. Later, let the child swing on his own, you just need to secure him.

— Circling by the hands. Turning the child to face you, take him by the wrists and rotate on straight arms. Circle first in one direction, then in the other direction (Fig. 52).

— Acceleration. Turn the child towards you and take it under the armpits. Throw it low in the air and catch it. Usually this exercise is very popular with kids. Thanks to him, the child feels the force of gravity on himself, especially at the moment when he falls into your hands.

— Shaking head down. For the bravest parents! Grasp the child tenaciously by the ankles and lift. It is better if he is facing you. Start gently, like a pendulum, swinging it from side to side. When lowering the baby, be especially careful, take care of the neck.

Parents sometimes experience fear at the mere thought of having to hold their child upside down. However, this position is well known to every newborn. In a normal pregnancy, the baby is turned upside down during the last month whenever the mother is standing or sitting. Therefore, be bolder, play more actively with your baby, change the position of his body in space more often.