Casus: Hemiplegie right
Mourrad is a 10-year-old boy who was born with spastic hemiplegia on the right and who has been receiving therapy within our center for several years. He moves completely independently over short distances, can take stairs by using the handrail and has sufficient sitting balance to sit independently for a long time. For traveling long distances, Mourrad still uses his wheelchair as his stamina is still insufficient to sustain heavy movement activities for a long time. At the level of the upper limbs, the spasticity of Mourrad can be better regulated. He has sufficient control over the right arm himself to perform the majority of his ADL tasks independently. However, the spasticity and increased tone of the lower limbs remain more difficult to reduce.
However, the past few months have seen a sharp decline in Mourrad’s motivation and cooperation. During most motor exercises, he responds displeased and reluctant, or performs the tasks so quickly that the quality of the performance is severely affected. Mourrad does achieve very good results on cognitive tasks, and he clearly prefers these exercises. Mourrad himself also indicates that he experiences a lot of frustration about his physical difficulties. He is very bothered that he cannot play with his peers and he feels excluded and “weird”.
Mourrad’s main request for help is to learn how to play football and basketball so that he can join his friends in the neighborhood in the evening. For this he wants to be able to walk well and for a long time, to jump high and to work on his ball skills. The main concern of Mourrad’s parents is his safety, independence and psychological well-being.
They think that Mourrad can sometimes overestimate himself and endanger himself, while at other times he seems to give up and expect everything to be done for him. Mourrad’s framework offers him all the help and care he seems to need. There are few difficulties at school level.
Continue to affect tone regulation from the right side
Upper and lower limb stretching and mobilization
Applying relaxation therapy and techniques
Practice Range of Motion of the hip and shoulder
Stimulating the balance skills (static and dynamic balance)
Stimulation of body coordination
Practice jumping skills
Integration of Matti inside therapy
How can Matti support Mourrad?
In general, we can say that the integration of Matti within Mourrad’s therapy can offer a certain added value in terms of motivation and work attitude. By offering the exercises in a playful way, we can somewhat reduce the frustrations. The visualizations of Mourrad’s progress make the therapy more concrete and can also encourage him to achieve his goals.
Mourrad has a hard time with slow and controlled movements. So it will be important to set up the games to reward slow and controlled actions. During such performances, the Heatmap can be used for every exercise to visualize the pressure distribution over the support points and Mourrad’s statics.