Same issues, different week

Here is E doing leg lifts on the left...



And on the right...well, not really, but she's trying...



We tend to get the "extremity freeze" when she's either really trying or really frustrated...this PT session was a little of both, I think.

New drill: I call this Superknees! Take a little piece of velcro, and have it *just* fit. Then Elena pushes her knees out to bust through the velcro. SUPERKNEES! (She tends to bust out by moving her right leg out, which allows her to have her weight on her left side, typical for her.)





One way to see how well our Knees Out message is sinking in is to have Elena go up steps. At home, she holds the railing with her left hand and my hand with her right. She has definitely improved her stance, and now has her knee over the heel (more neutral alignment) than before, but she still doesn't transfer weight very well. One problem is she has a hard time remembering to move her hands up the railing before she steps. Another is she doesn't know how to transfer her weight through her hips very well.
At PT, they have a stairwell that is thin enough for E to have handrail support on both sides. She looked pretty good here.





We finished up the session with the kick-scooter, but my camera ran out of batteries. One thing I have noticed in the past week is that Elena is doing more "pigeon-toed" walking, regardless of equipment (walker, loftstrands, hand-held). This was REALLY evident during scooter time, the tips of her shoes were trying to get under the board as she took little scoots. At first I though that this wasn't getting worse, but that I was noticing it more b/c the rest of her gait looked that much better. Now I'm not so sure. I feel like we have to be working harder on her knee awareness...she'll be tripping over her own feet before too long.

Preparing for SDR

Elena has a busy schedule normally, with PT and school, but right before Christmas (under the guidance of our main PT) we ramped up her workout schedule to best prepare her for SDR this year.
I'm not sure if this is for everyone, but here is what we're doing:

Elena's normal PT schedule:
Monday: PT (public school), school (all school days include PE)
Tuesday: school, Little Gym class (gross motor play sessions)
Wednesday: school, speech therapy (she doesn't really need it anymore)
Thursday: private PT, school
Friday: PT (public school), school
Saturday: therapeutic horseback riding
Sunday: "day off", but if it's warm enough, we go to a park or the mall, or the hospital (where I work) to walk around/play
EVERY NIGHT: Stretching regimen (takes about 10 minutes, includes hip "bridges", sit ups, and transitional sit-ups to partial standing)

So, in addition to this, we added weight training, strength training, and treadmill to her schedule. I had been trying to get Elena to use her pediatric treadmill by introducing her to videos on my computer, which she only got to watch while walking on the treadmill. It worked--all too well, actually, as we initially added treadmilling Wednesday and Sunday nights, but she soon demanded it EVERY NIGHT (no joke). She walks (assisted) 5-20 minutes, we end whenever she says she's finished.
Weight training consists of 1-lb velcro weights we wrap around her ankles to do sitting leg raises. While sitting straight up, she is to straighten her leg out as far as possible with the weight on--this was initially difficult, as she wants to move both legs at the same time. We hold down her non-weighted leg to help her differentiate the two. She has gotten better at singularly using one leg at a time. She does (ideally) 5 raises/side, repeated 5 times, with a "playtime reward" after each set (we use magnetic dress-up dolls). It didn't take her long to insist on doing these every night also. Her leg strength increased dramatically once we started the weight regimen.
Strength/flexibility training consists of wall sits (normally bare-footed), where she puts her back against a wall (we have a growth chart here) and with her back on the wall, she squats down and then stands back up, with her feet as flat on the floor as possible. We call this "tall and short". We also do leg lifts--on all fours, with her head up, she raises one leg as straight as possible, as tall as possible, with the end goal being that her back and leg are in the same horizontal plane. We call these "puppy exercises" and tell her she's a puppy looking for something to chase. When she finds it, she points her leg (backwards, but who cares) and after holding it for 5 seconds, she can go chase (we put out stuffed animals down the hallway).

I'll try to get pictures up.