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  • Danielle Diglio, MOT, OTR/L

Postural Control

What is postural control?

Postural control is defined as the act of maintaining, achieving or restoring a state of balance during any posture or activity. A child who has proper postural control can maintain an upright seated position without feeling fatigue or losing balance. A child who has difficulty sitting with good posture will struggle to complete any activity that requires fine motor precision.

What Causes Poor Posture?

  • Abnormal muscle tone

  • Core Weakness

  • Sensory-integrative disorders

  • Poor body awareness

What Does Poor Posture Look Like?

  • Difficulty laying on their stomach with elbows at a 90 degree angle

  • Instead of sitting upright at a desk or table, the child may lie and slouch all over the desk, supporting their weight on the arms and propping their head in their hands

  • Leaning/slouching against wall rather than sitting upright

  • Prefer to lie down on the floor instead of sitting upright in a chair

  • Poor gross motor skills

  • Clumsiness

  • Loses balance easily during motor tasks

  • Difficulty sitting still in a chair

  • Child fatigues easiliy or is disengaged in activities

  • Falling out of their chair

What the research is saying:

According to research, postural control and eye-hand coordination are linked functionally. A stable platform is required for manual control tasks, such as handwriting. Such skills are unable to develop without a stable upright posture in sitting and standing.

Poor postural stability can be seen early on during infancy and this can affect their ability to reach and grasp various objects effectively.

Importance of Postural Control:

A child who has poor postural control will have difficulty maintaining an upright posture while seated at a table. This can lead to difficulties with fine motor tasks such as writing and crafts. Having good core stability will help develop a stable, supportive base for gross motor and fine motor movements.

Keep in mind the 90-90-90 rule. This means that when a child is seated at a desk we want to make sure that:

Their feet are flat on the floor 90 degrees at ankles

Knees are bent at 90 degrees

Hips at 90 degrees

Activities that Help Improve Postural Control:

1) Lying on a therapy ball: Have child lie on the therapy ball with their hands weight bearing on the ground (stabilize child’s hips). Have your child complete an activity while weight bearing such as inserting puzzle pieces.

2) Sitting on a therapy ball: Have your child use the therapy ball as a chair while completing work activities or playing games at the desktop.

3) Wheelbarrow Walking: Have your child place their hands on the floor. Carefully lift their legs by their ankles (harder for the child), their knees (less challenging), or their hips (most support and easiest for child). Have your child “walk” on their hands 8-10 steps.

More Challenging: Have your child wheelbarrow walk on an uneven surface such as pillows.

4) Bear Walking: Have your child walk forward with both hands and both feet on the floor

5) Crab Walking: Have your child sit down with feet on the floor and hands behind them. Lift and keep their bottom off the floor while moving forward feet first.

6) Superman: Have your child lie on their stomach and hold arms and legs off the floor. Try to hold the position for 30 seconds and repeat for 3-4 repetitions.

Other activities to improve postural control:

1) At the playground, encourage your child to use climbing equipment (e.g. ladders, rock walls,). Also have them climb up the slide and then slide back down.

2) Read books or play games while lying on stomach and propped up on elbows.

3) Walk across uneven surfaces (e.g. pillows placed across the floor, couch cushions placed across the floor, bean bags)

4) Riding tricycles or bicycles

5) Paint on an easle or draw on a chalkboard wall

6) Have your children help with house hold chores (e.g. carrying groceries, taking out the trash, carrying the laundry)

7) Chair push-ups: Have the child sit in the chair and push themselves off their chair 8-10 times

References:

1) Frick, S. M., Kawar. M, J. (2004) Core Concepts in Action. Vital Links, Madison, WI. 2004.

2) Pollock AS1, Durward BR, Rowe PJ, Paul JP. What is balance? Clin Rehabil. 2000 Aug;14(4):402-6.

3) Flatters I, Mushtaq F, Hill LJB, Holt RJ, Wilkie RM, Mon-Williams M. The relationshipbetween a child’s postural stability and manual dexterity. Exp Brain Res. 2014; 232(9): 2907–2917.

DISCLAIMER

The content in this blog should not be used in place of medical advice/treatment and is solely for informational purposes. All activities/exercises posted in this blog should be performed with adult supervision, caution, and at your own risk. Big Leaps, LLC is not responsible for any injury while performing an activity/exercise that has been posted on this blog. If you have any information on the content of our blog, feel free to contact us at info@bigleapsct.com.

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