Initial Site Survey: Municipal Park

Our first impression of Municipal Park was rather disappointing due to several reasons. 

• The park is right next to an electrical power source, which is very dangerous to the children 

• Although separated by a tall fence, a busy intersection is right next to the park

• Tall bushes invade the park, making it hard for children to roam

• The park is in decent shape, simply just too small

• The step ladders are high, which may make it harder for some children to climb

• The walking surface is not very comfortable or soft, which may increase the children's risk for injury

• Very sharp corners for the base of the teeter-totter, increasing risk for injury

• Swing is high off the ground, which makes it difficult for some children to use

• Random stomps appear throughout the park, increasing risk for injury

• Step ladder again high off the ground

• Very small park

• Cell phone tower right next to the park, making it unwelcoming 

• Millage fund used for restroom and concession, not for the actual park

• Baseball field could be utilized more efficiently, but the gates are closed often

• Gas station and liquor store surrounds the park, not supporting a family atmosphere

• Non-functioning lamp, making the park unsafe 

The effect of Cystic Fibrosis on infants

• Cystic Fibrosis is caused by a genetic disorder involving the CF gene, in which both mother and father must carry the gene in order for the disorder to occur in the fetus.  At birth, the infant has meconium ileus, which  causes obstruction of the small and large intestine, making fecal excretion difficult.  
• CF is characterized primarily by excessive production of mucus in the lungs and pancreases. Pulmonary infection is seen because the excess mucus provides a favorable environment for the bacteria to grow, therefore making breathing difficult. It also cloggs the pancreases, in turn affecting digestion.
• Cystic Fibrosis cannot be cured and majority of the individuals with the disease die before age 30. Babies with CF can live a nearly normal life though, with life expectancy increasing as treatment methods increase. It is the most common genetic disorders, with 1 in 3,300 caucasian babies affected.
• Proper nutrition is vital because a child who is otherwise strong, healthy, and well nourished gives the CF therapies a better chance to provide some relief. The earlier it is caught, the more effective the therapy will be.
• It is sometimes hard to diagnose at birth, because babies with CF seem fine at birth but then develop breathing problems 4-6 weeks after birth. Health care providers should look for poor growth, as well as nagging cough and wheezing.

Fundamental Object-Control Skills of Childhood

Introduction:

Once a child can ambulate without assistance, the hands become free to explore the environment, allowing for object-control skills to be developed. Object-control skills include throwing, catching, kicking, punting, and striking.

Throwing:

Throwing is considered the most complex of the object-control skills, and displays five stages of development. The most evident changes are that the movement progresses from an anterior-posterior plan to a horizontal plane, and the base of support changes from stationary to shifting position.

Ø  1^st stage

o   Feet stationary

o   Arm dominated throw

o   Faces direction of intended throw

o   No trunk/hip rotation

Ø  2^nd stage

o   Body moves in horizontal plane, instead of an anterior-posterior plan

o   Segmented motion

o   Feet remain stationary

Ø  3^rd stage

o   Lead step is ipsilateral or unilateral to the throwing arm

o   Elbow flexion seen

Ø  4^th stage

o   Lead step is contralateral to the throwing arm

o   High wind up (Arm horizontally adducted in forward swing)

Ø  5^th stage

o   Contralateral step

o   Follow through observed

Figure 1. Immature thrower.

Catching

               Catching involves bringing an airborne object under control using the hands and arms. Catching has five stages, which is for the two handed catching. One handed catching exists as well, but it is less successful.

Ø  1^st stage

o   Passive movement

o   Feet stationary

o   Palms face upward

o   Minimal, if any, attempt to adjust body or arms

Ø  2^nd stage

o   Palms facing each other

o   Elbows slightly bent

o   Ball is trapped against body or “hugged.”

o   Feet stationary

Ø  3^rd stage

o   Initial step towards the ball

o   “Scooping” of the ball is seen

Ø  4^th stage

o   Use of the hands to catch the object instead of the body

o   Hand-eye coordination present

Ø  5^th stage

o   Entire body adjusted to control the object with only the hands

o   The elbows are flexed to absorb the shock

Figure 2. Palms facing each other as infant catches ball.

Kicking

Kicking is a form of striking but with your foot. Place kicking involves the ball being stationary during the approach of the kick, and is differentiated by the level of kicking skills.

Beginner level kicker

Ø  May only push the ball forward with their feet or not pull their leg back before kicking it

Ø  No follow through

Intermediate level kicker

Ø  Some flexion of the knee and

Ø  Backswing present

Ø  Arms elevated

Ø  Some follow through but not as complete as an advanced kicker.

Advanced level kicker

Ø  Running start

Ø  Leap step onto support foot prior to striking the ball

Ø  Kicking leg flexed at the knee and hyper-extended at the hip

Ø  Foot thrust forward to strike the ball

Figure 3. Child runs up to ball and pauses.

Punting

       
          Punting is different from kicking because it a) uses a ball that’s always stationary and b) is a more complex process. Three components of punting include the ball release arm component, ball contact, and leg action component. There are also four stages of punting.

Ø  Stage 1

o  Stationary preparatory position

o  Ball is held with both hands

o  Flexion at the hip and knee of punting legs

Ø  Stage 2

o   Stationary during preparatory phase

o   Ball held in both hands and usually dropped forward or upward

o   Non support leg flexed at the knee

o   Generally the force created is upward, causing performer to take step backward after the strike

Ø  Stage 3

o   Performer moves forward for one or more steps in preparation for the punt

o   Ball generally released in forward and downward direction

o   Follow through of the punting leg will carry the punter ahead of the point where the ball was hit

Ø  Stage 4

o   Punters approach is rapid, one or more steps then usually ends in a leap just prior to contact

o   Ball is contacted at or below knee level

o   Momentum of the swinging leg carries the performer off the surface in an upward and forward direction

Figure 4. Stage 4 punter.

Striking

          Striking involves some sort of contact with an object with either one of your hands, both, or a tool such as a racket.

Inexperienced Striker

Ø  Arms up and flexed

Ø  Upward-downward swing

Ø  They may take a step forward once with the same arm they are striking with

Advanced Striker

Ø Swing becomes more horizontal

Ø Contralateral step

Ø Trunk rotation added onto motion.

Figure 5. Use of the hands as the striking implement.

Applied Section

               Knowledge of the object control skills has some important application to our future work in the medical field. By understanding the normal from the abnormal development, we can properly intervene and potentially solve the dilemma with the proper intervention. Although it will be difficult to prescribe treatment due to the many constraints, knowledge of the object control skill will aid us to the right diagnosis.

               Possible constraints we may be looking for includes:

  Ø  Ball size

  Ø  Ball velocity

  Ø  Instruction

  Ø  Knowledge and experience of the skill

          With the proper diagnosis we could find ways to help a developing child become strong enough to perform these tasks. Also, in order to test for certain diseases and disorders, a child could be assessed using some of these skills.

Ch. 13 blog: Fundamental motor skills

Walking: or upright bipedal locomotion, is a critical fundamental locomotion skill as the hands become free to explore, and consists of two phases. These two phases are the swing phase and the support phase, and makes up the gait cycle. Balance consists of two types, static and dynamic, that are essential to the development of walking. Static balance is the ability to maintain posture in a stationary position.  Dynamic balance is balance obtained when the body is in motion. At the beginning of walking, the infant is said to have a dynamic base, which is where the child's feet are widened to increase balance.  Children also have a high guard arm position which helps protect them if they fall and increases their balance.  In terms of the infants feet, they tend to have a flat footed step where the toes are pointed laterally or away from the body’s center line. As the child gains neuromuscular control and the muscles become more developed, they walk with improved balance, arms lower to side and work in opposition to the legs, and the toes point in a more forward direction. 

Figure 1. Toes pointed outward from body

Running: is sometimes referred to as the extension of walking, and consists of an alternate support phase and an airborne phase. The support phase consists of the absorption of impact by the leg, body support, and maintaining forward motion. The flight phase is where the body is projected through space by the thrust leg. Lastly, a recovery phase is achieved where the leg that thrust the body into the air (support leg) enters a period of recovery. As with walking and jumping, balance and muscular strength are needed for the development of running.

Figure 2. Body is projected through space by the thrust leg

Jumping: is different from running, in that the body is airborne from force generated by one or both legs, and the body can also land on one or both feet. Jumping can be accomplished in several ways, including hopping and leaping. To differentiate between the two, the landing of a hop will be on the same leg it propelled with while a leap would result in landing on the non-propelling leg.  Two other types of jumping are the vertical and horizontal jump. A vertical jump is when the body is going upward while horizontal is upward, as well as outward.  Jumping usually occurs in 4 different phases which include the preparatory phase, takeoff, flight, and landing. Two constraints in jumping include the strength of the individual and their ability to get their body in the air, as well as the muscular power.

Figure 3.Child displaying a vertical jump

The gallop, slide, and skip: These more complex motor patterns do not appear until after the development of the single motor skills. Gallop is the first to develop after running, and involves a forward step followed by the trailing foot. The lead foot is initially with the dominant leg, but leading with the non-preferred leg appear several years later.

            The slide is very similar to the gallop, except instead of moving forward, one moves horizontally in sliding. This skill is hard to grasp for children because the child must face a different direction from the intended movement. Finally, skipping is the most difficult, because it involves an uneven rhythmical pattern. Both step and hop must be accomplished on the same foot before alternating.

Figure 4. Child skipping

Applied Section: The fundamental locomotion skills described have some application to our future in the medical field. As healthcare providers, it is critical to understand the normal from the abnormal in order for proper diagnosis to be accomplished. Furthermore, girls typically develop the fundamental locomotion skills earlier than boys, so if a concerned mother came in with her boy not skipping at six to seven years of age, we could inform her that it is a normal occurrence. We could also prescribe her with the proper exercise module to increase her child’s locomotion skills.

It is also essential to understand the process of how each fundamental motor skill is obtained.  Working as a future physical therapist, it would be essential to understand the sequence of motor movement in a fundamental skill to teach a patient who may have a disability how to walk again.  Another example would be trying to help an athlete who has had knee surgery to rehabilitate his/her knee in the most efficient manner, so he/she could return to play as quickly as possible.  

Figure 5. Learning how to walk