HeartSpace Physical Therapy for Children

22/07/2025

A 2025 systematic review of balance in autistic children provides some overall insight. The authors suggest that more detailed research using the BESTest framework (a dynamic systems-based outcome measure) could provide valuable standardized insights and be useful in the creation of supports.
Key insights include:
*autistic children displayed differences in their anticipatory postural adjustments
*the children with ASD also had sensory differences in verticality
*muscle strength and hypermobility may have a role in these balance differences
*although autistic children display balance differences in infancy and this continues into childhood, many parents do not seek support
https://pmc.ncbi.nlm.nih.gov/articles/PMC12231408

21/07/2025

This 2025 article indicated that motor differences are present in autistic children and those with delays were evaluated for ASD 8 months earlier, creating the possibility for earlier support for children and families.
https://bit.ly/4lDtelO

18/07/2025

Gross motor skills at 6 months and fine motor skills at 12 months were positively associated with communication skills at 24 months in this population-based study. Children who are at-risk for delay should be supported.
https://pubmed.ncbi.nlm.nih.gov/32191337/

11/07/2025

Continuing on the theme. This free full-text article outlining 2021 position statement of the Canadian Pediatric Society. Recommendations include the evaluation and management of brachial plexus injury, including timing of referral to multidisciplinary teams and dialogue with community health care teams. Based on the info shared by Esther De Ru we should also ensure that these children are monitored over the long term for scoliosis.
https://pubmed.ncbi.nlm.nih.gov/34992702/

08/07/2025

In case anyone is interested in a nice overview of the many functions of the diaphragm, this free full-text article does a pretty good job discussing anatomy, mechanics, postural, cardiac, lymphatic, reflux, emesis and swallowing. They didn't address spinal decompression, emotional regulation, phonation and continence but you can't have everything.
https://pubmed.ncbi.nlm.nih.gov/28871591/

04/07/2025

While I've seen a number of babies with brachial plexus palsy (BPP) over the years, I've never seen anyone who had involvement of the phrenic nerve impacting diaphragm function. This article discusses that though this most frequently involves the diaphragm on the ipsilateral side as the BPP, rarely it occurrs on the contralateral side. Close clinical monitoring and proper imaging are noted to be crucial for accurate diagnosis. Not long ago I discussed a study that indicated that trunk control was also implicated in BPP. This discussion leads me to wonder if this child's clinical course will be complicated/prolonged by the phrenic nerve injury and subsequent surgery required.
https://pubmed.ncbi.nlm.nih.gov/33274099/

03/07/2025

Wow there has been a lot of research on the feed lately and I've fallen a little behind because . Follow along for the rest of July and August as we review the highlights from each article and learn what's up in the world of late preterm births, cerebral palsy, upper extremity function, dystonia, the diaphragm, brachial plexus injuries and more.

28/06/2025

This makes me wonder about all of our clients who experience significant sleep disturbances.........

Sleep Learning: How Synapses Strengthen While We Rest

A new study has revealed that synaptic connections in the cerebral cortex can strengthen during sleep, following the same rules that govern learning while awake.

Researchers used computer simulations to model neural networks and found that when specific neuronal activity patterns occur during sleep, synapses can grow stronger.

These patterns aligned with established "synaptic learning rules," suggesting that real learning might happen even in our sleep.

This supports the long-standing idea of “sleep learning” and clarifies the biological conditions under which it may occur.

The findings also deepen our understanding of how sleep consolidates memory and supports brain plasticity.

They may even help explain how sleep disturbances contribute to neuropsychiatric disorders.

https://neurosciencenews.com/sleep-synaptic-learning-29365/

27/06/2025

Another article supporting the use of inspiratory muscle training (IMT) for clients post-stroke. The diaphragm is the gateway to the inner core team and central stability. Adding IMT to our therapeutic support can be a valuable tool in advancing functional movement by improving postural control.
https://pubmed.ncbi.nlm.nih.gov/33412997/

24/06/2025

A very interesting discussion regarding the maturation of pain perception in neural networks. Some interesting info:
*pain perception involves a number of regions for 1. sensory-discriminative processes 2. affective-motivational processes and 3. cognitive-evaluative processes.
*areas of the brain form structural and functional connections to form the "pain connectome"
*although there are rapid changes to pain perception in the last trimester, at 40 weeks it is unlikely to be the same as an adult
*later maturation of emotional networks may explain the vulnerability of pain emotion processing to early life injury and stress.
https://pubmed.ncbi.nlm.nih.gov/40532739/

19/06/2025

Some good insight into the flexor musculature of children with hemiCP. Decreased muscle volume, atrophy, fibrosis and shorter bone length indicate macro and micro structural adaptations that should be considered in treatment planning.
https://pubmed.ncbi.nlm.nih.gov/40474790/