Restraint Therapy

[Debbie]

I would definetly not restain the child with a sling, belt, or cloth. We tried this when my son was little. He got so frustrated, and refused to even try to use his arm.
Out pt wanted us to do this. My son got to hate his pt. And we discontinued this, and switched to another pt, who uses gentle movements, of just holding the hand. (Like Francine said) We were only with the other pt for 3 times, and it took a few weeks to get my son to even communicate with his other pt. I would also wonder about the emotional issues of this. For if the nerves are not there to work, what good does this kind of therapy bring about. Do we cause greater mental problems in our children with this kind of therapy? And if there are problems emotionaly in the future years? That won't show up till they are older?
I often wonder this. My son likes pt now. Please consider other options, or ways to do this type of therapy. (Like Fracine said, gentleness)
Good luck.

[Debbie]

Hi. Don't ever take anything on the boards personally.
There is nothing wrong with people having different opinions about things. It actually helps us grow, and think about things, even if they are different.
That is what is called having a GOOD discussion on a topic. Wow, if only we had people discussing our labor this way, we would not have had a bpi child!
For it might have brought about a doctor respecting his patients views.
For having so many views on one issue, really makes us think things through. Don't ya think?
Take care, and keep up the opinions!

[Kathleen]

Kristie:

I hope I did not hurt your feelings. If I did I am sorry. I just reacted from my gut. I also have partial use of my arm and was often forced to try to drink milk or eat or things that are so impossible for me to do... so to me this just stired up very deep feelings. I know you would only do what is best for your child out of LOVE... I was not judging you at all.

I cannot supinate the doctors insisted that if my parents forced me to use my arm more I would...I know now that medically it was impossible for me... I spent many a night in tears at the dinner table because the doctor said to force me to eat right handed... I still can't physically.... my Dad thought my Mom was too easy.... not to do it.... My Mother realized it was impossible... so it was that thought that brought such frustration....

I was constantly nagged to use the right arm... They did not understand then that I don't connect to it! Today we know and perhaps this is a way of retraining the mind... but still... I struggled so hard to use my hand and arm in any way.... it is frustrating when you want to do something and your arm won't/can't... I still try things and get annoyed when I can't do it righ handed...

I hope this helps you to understand my post... I am sure you are doing what is best... I just am not sure that some of the PT and Dr. who suggest this therapy fully understand bpi and all of its many drawbacks...
Kath

[francine]

Kathleen - this brings up a very good issue that we once discussed a long time ago. At what point do we stop pushing our children to try to do something and at what point do we give up and just allow them to use an adaptive method? And with that comment I will tell you that outside of Maia being very angry about being splinted, she is really moving forward in her life in many ways because she's not held back by 'the arm'. She's going forward completely one handed and she's strong, willing, and doing for herself what she couldn't do before! And she's happy!!! (Yes - you can easily separate the moments she is very frustrated and angry about the splint and then you can see pure joy in her face when she could do something she didn't have the guts to do before because there's nothing holding her back). She's using her feet again to hold things - her chin - her mouth and she's independent !

Don't ask me what's going to happen when the splint comes off and we start rehab. It's going to put us in a whole different space and quite frankly I don't know what to think of all of it. I'm just going to go with one day at a time. But for now, I think that continuing with one-handed learning during her splinting time has given and will continue to give Maia a LOT of benefit. I think that her therapy should come in two parts - one handed learning and her rehab therapy. Part of me wonders if this is giving up on her hand/arm but the other part of me wonders what's realistic. (and this is today and tomorrow I might have a whole different take on it)

-francine

ps - kristie - you gotta trust me, this has been a VERY respectful conversation. We've come a long way on this message board. Things were MUCH different not too long ago! Don't take things personally.

[Kristie]

I totally agree that this thread has been very respectful when compared to other threads of the past. And I generally don't take posted comments personally... this time I had a harder time not. I apperciate other people's perspectives. I just wanted a few to see it my way or acknowledge that it might be different for us since Ian can do a lot with his OBPI arm... and all I kept reading was that it not right or fair to expect them to do something they can't do... but for us he can and does.

And like I said if I stepped outside of the emotions I realized that people where giving advice to Julie who asked for input. As well all know sometimes our emotions will get the better of us. I appericate your comments and for validating my feelings.

I can also tell you that when Ian is older I think the restraint therapy will not be something we will use. For me it makes sense to use it while he is young since he doesn't just respond to use your other arm too. Overall I think this has been a good topic. I and I truly hope that Julie got the advice she has been looking for!
Thanks,
Kristie

[Kathleen]

Hi All

Just one more thing I want to say... My mother never gave up nagging... I just stopped listening...LOL...

Right before I got married she remeinded me to hang on to the doorway and do stretches.!!!! and told my husband he should stretch my arm.... I said NOT on his life... LOL... but she never gave up trying and reminding me to use my arm...

It was always questions like---- do you think you can do it with your right arm?

If you think the kids resist now!!! wait till they are teens...yikes!!! I was forced to write with my bpi hand... now that was painful... I also realize why I hated pencils... I can't feel it in my hand and I liked pens...they are cold and heavy I can feel them... it took me years to realize I have a loss of feeling on the right side and I squeezed the pencil till I had cramps in my hand as a child.....just a hint for those kids who will have to write with bpi hands.

I thought this conversation was interesting... sorry again but the frustration memories do not leave... some days when I can't do what I want... I still want to throw something and jump up and down... LOL...
I believe that all of the parents on this board are doing what they feel is best for them and for their child... and with love... and above all a parent must follow their own gut when it comes to their child....
Kath

[admin]

I think it depends on the extent of the injury and also the temperment of the child. We have gently restrained Maia's unaffected arm regularly and this does not bother her at all. She is 1 year post primary surgery now and has regained significant movement but still naturally favours her left arm.So by restraining her unaffected arm we are just reminding her that she can use her right arm she just has to work a little harder.But I would never force her if she becomes frustrated.
I was quite shocked that a Dr suggested using a cast on the unaffected arm, that to me seems pretty harsh to say the least.

[kelli_]

We have used forced use therapy on our daughter. I think it is a good thing, but we know from surgurical interventions that she does have nerve conduction to the muscles, just needs to strengthen the muscles. She is now 3 1/2. We don't make her do it to the point of frustration though. We make her attempt tasks for a certain period of time with the other hand restrained. Activities such as eating popcorn alone with that hand, eating a lollipop, popsicle. We also have her do putty and playdough exercises and over head arm exercises with righty restrained. When she starts to balk, we say ok, just 2 more times ( or 2 more minutes, whatever we choose)and then we take it off. We have a light weight cast that her PT made for her. She made a cast of the arm from I guess a mold of her arm and then cut the cast in half lenghth wise. There are two pieces....one that goes on the palm side and the other over the top of the hand. We enclose her fingers as well in the cast. Then we take this ace wrap sort of thing and wrap it around the cast halves to secure it to her arm. We then use this velcro stuff to hold the ace type badage onto the cast. It is not heavy at all. We just set goals for the forced use and use it for portions of time in a therapy period. We are trying to strengthen her biceps, especially.
Just my two cents
Kelli

[sonofTessie258]

HELLO im 12 years old and i have BPI this is the first time i have replied to any thing i have read but it just frusterates me to hear what parents are doing to there children. just imagine only having one good arm to begin whith then you temporarily chop it off(RESTRIANT THERAPY) leaving your damaged arm that has little to no movement in it and dosnt respond to what your brain is telling it just imagine trying to get it to move imagine how discuraging and frusterating it would be.I personally have a fairly wide range of motion and strength in my BPI arm but i still know it is extremly agrevating and frusterating to have a BPI injury. this may seem to be a crude view of the situation but it is a view and every view i belive should be taken into account before a parent conseders this (THERAPY) for there child.

[admin]

Kyle's therapists have all made him to use his right bp arm by holding his left arm. I have not done it at home, but I do see how it could be effective in therapy. They want to make him to use it as much as possible in therapy. I am lucky, Kyle always at least attempted to use his right arm.
Good Luck,
Jean