#41: Sit-to-Stand Transfers from the Wheelchair: Exercises for a Child with Cerebral Palsy

I neglected to say in this video that I always make sure the wheelchair is not tilted or as close to upright as possible.
Meet Sebastian. He is a young boy with Spastic Quadriplegic Cerebral Palsy. His family wants to help me share treatment suggestions to help children like him across the world. My clinic, Child and Family Development, in Charlotte, NC, allowed me to use their facilities and their equipment to showcase Sebastian's skill and charming personality. We review techniques to reduce stiffness, encourage strength and control. I think you'll love spending time with him. Thank you to this family and my clinic for allowing this to happen.
I also have available 3 children's educational books, "A is for Autism," "D is for Down Syndrome," "C is for Cerebral Palsy," and now 2 professional books "Pediatric Physical Therapy Exercises for the Hips", and "Pediatric Physical Therapy Exercises for the Knees" available on Amazon. I have forthcoming "A is for ADHD" as well. If you have questions or suggestions, feel free to contact me at [e-mail]. Please note: I am unable to provide treatment suggestions for a child I have not personally evaluated.
I am so honored to have people from all over the world watch my videos. I have reviewed and corrected the closed captions for this video so that you might understand what I am saying even if you don't speak English. I hope the directions below are helpful to you.
To turn on Captions, click CC in the bottom right corner of the video
To choose a different caption language:
At the bottom right, click Settings. It looks like a wheel.
Click Subtitles/CC.
Select a language.
If the language isn't listed when you click Subtitles/CC:
Click Auto-translate.
Select a language.
Of course, if the captions are in the way of viewing the details in the video, you can always turn them off in the bottom right-hand corner of your video screen.
Here are the links for my books on Amazon:
"C is for Cerebral Palsy"
www.amazon.com...
"D is for Down Syndrome"
www.amazon.com...
"A is for Autism"
www.amazon.com...
"Pediatric Physical Therapy Strengthening Exercises for the Hips"
www.amazon.com...
"Pediatric Physical Therapy Strengthening Exercises for the Knees"
www.amazon.com/...

[@nothing0953]

I love you both and God bless u 😘

[@pediatricPTexercises]

Thank you for your kind words and blessings. I let Sebastian’s family know as well

[@balletktmc]

Love your channel! I'm a school based physical therapist and though I know your videos are geared towards families, I still enjoy your videos very much! This is just my opinion, but my number 1 pet peeve for those with extensor tone is offset footplates. With the knees at even just a slightly greater angle than 90, I feel like tone is triggered so much more easily. Even for those with spasticity that isn't quite so severe, I still notice a rounded back caused by a posterior pelvic tuck secondary to hamstring spasticity when using offset footplates. Again, that's just my take on it- there're always exceptions, etc. I'd be interested to hear your opinion. Thanks again for your great videos!

[@pediatricPTexercises]

Thank you! I think I have seen different scenarios work with different kids. This is just what worked for Sebastian. Your point about the raised knees causing a posterior pelvic tilt and rounded back makes sense to me. Sebastian has a strongly anteriorly tilted pelvis. A posterior tilt is not even an option for him right now. That will be the subject of future videos. I think what is most important is to look at how the chair positioning affects each child individually. Thank you for taking the time to write a comment. I appreciate different opinions.

[@balletktmc]

@@pediatricPTexercises Thank you for your reply!! Yes, you're right- I can see that. I had a student on my caseload with a very severe "bowstring-like" spasticity a few years ago who's tone was triggered so easily, also. If any one segment was in just slight extension, off she would go! I remember her sitting much, much better in a rifton activity chair than in her WC, where I could easily make sure her feet were right under her knees (can't remember if she had offset footplates on her WC, though, or what the problem was with it). Anyway, this was not a magic fix of course, her body still hyperextended back often and it did make her very uncomfortable at times. Later, the problem was truly solved by a baclofen pump. It took away a lot of her function, sadly, but in her case it was worth it for her comfort and well being. Thanks again!

[@pediatricPTexercises]

@@balletktmc You are welcome. And thank you for your kind words about the channel. I work really hard on it, so I appreciate the encouragement.

[@ssoottss]

Hello Amy, At first many thanks for this video. Nice cooperation by Sebastian as well. I was looking for some videos like this. I would also like to if there are any belts that could be tied to the caregivers. So that carry caregiver can carry on their back. please let me know. Thanks

[@pediatricPTexercises]

I don’t know of anything like that

[@bobkitfrank]

Thank you for this video. Can you, or anyone, comment on the possibility of standing transfers for children who already have subluxed or dislocated hip(s)

[@pediatricPTexercises]

I can’t speak for your child but I certainly have done sit to stand transfers with children whose hips are sublimed or dislocated. I have heard of people walking on them.

[@bobkitfrank]

Thank you so much for your reply. I have worked in the US for decades and we try to get everyone possible standing and doing standing transfers, if they are comfortable. Now I am working in South America and much less of that is done. Some people think that having subluxed hips means that standing transfers are contraindicated. That would mean that 35% of children with CP will require to a two-person lift when they grow heavier. I can't find any source material or research confirming or contradicting standing transfers when hips have already been sublimed or dislocated.

[@pediatricPTexercises]

@@bobkitfrank Glad to help

[@pediatricPTexercises]

@@bobkitfrankYou want to avoid combinations of hip Flexion, internal rotation and adduction. Certainly if they are in pain, pay attention

[@jdforbis8357]

Hey

[@pediatricPTexercises]

Hello!

[@taongaphiri3089]

up o

[@pediatricPTexercises]

I’m sorry. Can you try again with your question or comment?