Meet Marcellus

Marcellus has a condition known as Osteogenesis Imperfecta (OI) Type III Severe, more commonly known as Brittle Bones. OI is a genetic disorder characterized by bones that break easily, often from little or no apparent cause. A person with OI may have just a few or as many as several hundred fractures in a lifetime.

What is OI Type III:

OI Type III is the MOST SEVERE type among children who survive the neonatal period. The degree of bone fragility and the fracture rate vary widely. This type is characterized by structurally defective type I collagen. This poor quality type I collagen is present in reduced amounts in the bone matrix. Spine curvatures, compression fractures of the vertebrae, scoliosis, and chest deformities occur frequently.

HIS EXERCISE JOURNEY

In 2016 I started working with a 2 yr old, Marcellus, using Hydrotherapy and Rock Tape to help manage his complications caused from OI. In particular, helping to improve his walking gait, bowing of his leg bones, bone and muscle strength, and his stooping.

The progress he has made so far is AMAZING!!!

Based on the spiral technique of Rock Tape and the benefit of Hydrotherapy, Marcellus has grown a massive 13cm taller and is now walking straighter, with less stopping and bowing of his legs. This is a big deal for Type III OI patients. X-Rays have revealed his bones are growing and becoming stronger and he has yet again avoided having an operation for rod fixation in his femurs, tibias, and radius bones.

We use Rock Tape to assist with improving the bowing of his legs and also for muscle facilitation and muscle cueing. The Hydrotherapy helps improve Marcellus’ bone and muscle strength, stooping, and motor skills. I see Marcellus twice per week in the hydro pool for 30min and his parents usually spend another 30min in the pool with him as well as lots of pool time at home.

Marcellus also receives pamidronate infusions in hospital to help strengthen his bones. This treatment started when he was 2.5months old. At first infusions went for 3 days 8 hours per day then progressively reduced down to 1 day for 5 hours. He has this treatment every 4 weeks.

Story by Bree Sauer, Accredited Exercise Physiologist – Lockyer Valley MHPN Coordinator & Fresh Start Professional Healthcare

Meet Kai

Kai first came to us presenting left sided Legg-Calves-Perthes disease (LCPD). This rare, idiopathic, self-limiting disease is a result of decreased blood supply to the femoral head leading to avascular necrosis. Shortly after Kai’s initial consult with us, he had follow up X-rays which revealed he was developing LCPD of his right femoral head also.

Kai’s teacher noticed he grew agitated when asked to sit cross-legged on the mat. This lead to further investigation. At the time, Kai was 4 years old and an active and adventurous boy was told he was no longer able to run, jump and kick.

HIS EXERCISE JOURNEY

Due to the varying presentation of LCPD, there are no consistent and reliable guidelines for treatment and management. From a musculoskeletal point of view, we have been aiming to improve Kai’s hip range of motion, particularly into abduction. We have aimed to keep Kai moving as much as possible in his pain free range of movement whilst avoiding high impact activities to reduce pain and stiffness.

Kai is now 5 years old. Through our PAEDS program, we have been able to prevent secondary delays in several of Kai’s fundamental movement skills. He has become a confident modified basketball goal shooter, baseball hitter, ten-pin bowler and his throwing and catching skills are progressing ahead of his age group.

Kai has been given the opportunity to develop these skills in a safe environment under the care of an Exercise Physiologist. We are optimistic that at the resolution of the disease, Kai will have the confidence and acquisition of skills to excel in playground activities.

Story from Rosie Sciacca, Accredited Exercise Physiologist – Curtin University

Meet Aaron

Aaron started working with The Next Step Spinal Cord Injury Recovery Centre in July 2014. For a then 9 year old boy, he presented incredibly well with independent mobility in his manual wheelchair. But despite this, he was getting older and it was the goal of both himself and his family for him to become stronger and more independent.

Aaron attended exercise sessions here with our Accredited Exercise Physiologists two days per week for a one hour each session. During these sessions we focused on working on fundamental movement patterns, transfers, functional mobility and general education on appropriate sitting posture and alignment.

Initially exercises such as Bosu Ball Balance, crawling forward and backwards, hip ROM (range of motion) and assisted bridging were used to focus on postural awareness and pelvic stability – These exercises may sound boring, but we made them fun with games and prizes.

It wasn’t long before we began to see major improvements in Aaron’s independence with the completion of his first independent car transfer on the 26^th of September 2014!

From there, our main focus became increasing his strength and coordination in preparation for standing and potentially… walking.

Aaron showed promising signs of strength through his glutes, however the tightness in his hip flexors (a common problem for those with Spina Bifida) was something we really needed to work on. SO his new homework – begrudgingly completed on top of his normal school work – became stretching his these as often as possible! While they may never reach the flexibility we would like to see, he showed significant improvements which were easily identified when we got him standing with a gutter frame. After many months of stretching and strengthening his lower limbs, increasing his hip stability and working on foot placement for walking, on the 22^nd of July 2015 Aaron took his first steps – EVER! While he still required assistance for foot placement and movement of the gutter frame we couldn’t be more proud!

Aaron continues to progress with us here at The Next Step, with his new goal to walk with forearm crutches… seeing the amazing improvements he’s already made over the past two years, you just never know what this amazing boy could achieve!

Story from Stacey Hynes, Senior Accredited Exercise Physiologist – The Next Step, Spinal Cord Recovery.

James the Great!

James was referred to Rehab Training by his GP in September 2015, for a program to assist in improving his lung capacity and better manage his asthma. James had suffered atypical pneumonia in August 2013 and had continued to struggle with fatigue and exercise induced asthma with low-moderate exercise.

James had always been active and played various sports both in and out of school. When he first came to Rehab Training he was finding it hard to continue with his usual sporting activities due to his asthma. He was taking a preventer twice daily and required Ventolin several times per day. He found within a few minutes of exercising he had to stop due to breathlessness and a tight chest.

After ceasing exercise he would need to take Ventolin and it took some time for his symptoms to ease. James’ initial exercise program following his assessment included a gradual increase in aerobic exercise up to twenty minutes four days per week, diaphragmatic breathing exercises, and exercises to assist in strengthening the muscles that are activated during inspiration and expiration.

Within one month James was not requiring Ventolin often, he was able to get the next level in the beep test at school, his thoracic expansion had increased by 3cm and his peak flow had significantly improved. Following his one month re-assessment, his exercise program was progressed to include interval training at a moderate intensity, postural correction exercises and a progression with his breathing exercises.

By January 2016 James was no longer using Ventolin, he was able to complete sixty minutes of aerobic exercise without any asthma symptoms, his peak flow had improved further, and his thoracic expansion had improved by 4.5cm from his initial assessment. James continues with a maintenance program and is back taking part in his sporting activities.

Emma Sansalone- Accredited Exercise Physiologist- Rehab Training www.rehabtraining.com.au