The volunteer prepared the training in series to show the importance of rehabilitation services for the children inflicted with polio and other children with impairments or disabilities. The training modules described accordingly:
First, Polio Awareness (97%) is an overview of facts about poliomyelitis. The context of this seminar comprised of the following: medical facts about polio, proper positioning to prevent secondary complications, how to do manual muscle testing, how to execute the proper passive range of motion exercises, orthosis available in Tajikistan, social inclusion of children with polio and other children with impairments or disabilities. These are essential in an acute stage of poliomyelitis.
Second, Range of Motion Exercises (97%) is an essential primary exercise for the child with polio in the acute stage, the particularly passive range of motion exercises. Passive range of motion exercises is done primarily by the caregiver such as parents or family members to move the affected limb. (Note: passive range of motion exercises will not increase muscle strength).
There are other types of range of motion exercises, these are the active-assistive and active range of motion exercises. The active assistive range of motion exercises is done by encouraging the child to move the limb with an assistance of the caregiver such as parents or family members. Active range of motion exercises is done by the child solely.
Third, Stretching Exercises (61%) is done when the child with polio and other children with impairments or disabilities showed secondary complications such as muscle tightness or reversible joint contractures. These secondary complications are the result of not moving the affected limb, improper positioning of the limb, immobility due to muscle or joint pain. The rationale of this technique is to increase the limited joint motion of the affected limb within the normal range.
Fourth, Strengthening or Resistance Exercises (43%) are done in aiming to increase the muscle strength of the affected muscles, especially for the children with polio due to muscle imbalance of the affected limb. These rehabilitation techniques are also essential for the preparation of crutch walking or if the child with polio use a wheelchair. The main goal is to increment the strength of the both upper limbs and the affected lower limb/s.
These rehabilitation techniques can be done: (a) mechanical resistance exercises, using devices such as dumbbells, sandbags, etc. and (b) manual resistance exercises, it is executed manually by giving opposite force to the joint motion.
Fifth, Therapeutic Massage. (71%) The VSO Volunteer aims to show the difference of doing massage to adult in comparison for babies. The massage therapy section identified in providing massage in the combination of the passive range of motion exercises and partly stretching techniques. The training emphasized the proper joint motion to prevent further injuries for children with polio or children with impairments or disabilities. It is also surprisingly that the participants increased in this training sessions compared to other training. Since the massage therapy is the common intervention done in health care system in Tajikistan.
Sixth, Proper Body Mechanics (41%) is included in the training program. This serves as a technique to protect the low back area of the health staff or parents who give care to the children. The importance of this technique will refrain from having low back pain. In this topic, it demonstrates how to do proper way of reaching, carrying and lifting a child with or without impairments or disabilities.
Seventh, Proper Positioning to Prevent Disabilities and How to Make an Alternative Splints (46%). These topics demonstrate the proper usage of alternative splints to prevent from having complications such as muscle tightness, reversible or irreversible joint contractures. This serves as an early management for the child with polio.
Ninth, Gait Training (43%). This topic is very essential incorporating the different walking pattern especially if the child with polio will use axillary crutches. It depends on the prognosis of the child inflicted with polio. The topic includes how to use the axillary crutches in walking on the even surface, going up and down the stairs with or without rales.
Tenth, Play Therapy (52%). Play Therapy is the way of treating children with various impairments or disabilities. Since the attention span of children is short, the play therapy techniques are the best medium for stimulating the child. This topic serves as a refresher course since they have an idea of the principles of play therapy that can improve the child’s physical, mental and social aspects of their life.
Image Credit: Shavkat