HeartSpacePT

HeartSpacePT Shelley Mannell PT has over 25 years experience in pediatric Physical Therapy.

HeartSpace provides Physical Therapy clinic services to babies, children and adolescents with motor and sensory challenges at our Kids Therapy Circle location. Shelley has been a clinical faculty member at McMaster University and has developed HeartSpace Yoga and Meditation for children with special needs. She has co-created Dynamic Core for Kids, an approach to treating core strategy in children with challenges. As well as clinical work, Shelley teaches continuing education courses for pediatric therapists internationally. HeartSpace has Michelle Duncanson PT who provides home-based services in Niagara and Kristyn Watters PT who serves children at home in the Hamilton area.

03/19/2026

Great to have such an engaged group join and I for Paediatric Pelvic Health: Dynamic Core for Kids Edition (Day 1) last week. We had a discussion about the unfortunate prolonged use of Restoralax for our clients and several participants shared Senna might be an alternative. Here's a 2018 literature review that discusses the use of Senna in children.
Clinical takeaways:
*Senna is safe for children
*The only side effect noted was the rare occurrence of dermatitis, localized to the a**l area and only at higher doses.
https://pubmed.ncbi.nlm.nih.gov/29429768/

03/17/2026

Are you a school-based PT or OT who regularly works with children experiencing continence difficulties? Ever wondered how continence fits within a dynamic systems framework?
I'm thrilled to be co-teaching a live online Paediatric Pelvic Health webinar on May 4, 2026 with Julie Wiebe, PT — designed for school-based therapists. Together, we'll explore a new model of paediatric pelvic health: one that's child-centred, trauma-informed, and grounded in brain-based strategies.
It's time to change the way we support neurotypical and neurodiverse kids in pelvic health. Register today and bring these tools back to your school community!

https://heartspacept.com/events/pediatric-pelvic-health-dynamic-core-for-kids-edition-2/

03/12/2026

I've been seeing paediatric come up quite a bit lately on social media. Regardless of the child, this intervention — like all treatment interventions — should come with clear goal setting, thorough screening for contraindications (yes, there are contraindications), and well-defined treatment parameters. These include the type of vibration, frequency (measured in Hz, not the machine's speed setting), position and movement activities, duration, repetitions, session frequency, and the age of the child. All of this needs to be clearly explained to families for informed consent and properly documented.
There is a solid body of published research on WBV in paediatrics, and I've included a literature overview in my online course. This course was designed to support clinical decision making rather than serve as a recipe for treatment.
https://heartspacept.thinkific.com/courses/good-vibrations.

03/11/2026

In the fall I discussed several articles that looked at bodyweight support during treadmill training for children with CP. This 2026 article examined the energy cost of walking. We know from previous work that children with CP have an increased energy cost of walking. The study examined whether increased demand for body weight support and lateral stabilization determined the energy costs.
Clinical takeaways:
*Body weight support decreased the energy cost of walking for children with CP by 41%
*Lateral stabilization produced very little energy effect
*Greater knee flexion in standing was associated with higher energy reduction from the body weight support
What I'm still thinking about:
*In addition to supporting body weight, does the apparatus impact the central alignment and recruitment of muscles involved in postural control?
https://pubmed.ncbi.nlm.nih.gov/41756464/

03/05/2026

When we talk to parents we hear this - there are many layers that speak to the increased complexity of continence and constipation issues and their increased prevalence in ND children. This 2018 article (https://pubmed.ncbi.nlm.nih.gov/29866597/) discussed that emergency department visits were more likely to be constipation related in autistic children than for either children with other chronic conditions or children without chronic conditions. The authors talk about the need to develop effective outpatient treatments but parents need support and assistance to begin to understand these issues. It's time for a new model of paediatric pelvic health. Join us on March 7, 2026 for Pediatric Pelvic Health: Dynamic Core for Kids Edition. Register here: https://bit.ly/4bFDQ1m

03/04/2026

In a 2026 study, authors looked at the association between task-specific differences in postural control and lower limb proprioception in children with CP. The Kids-BESTest was the outcome measure of postural control.
Cilnical takeaways:
*Proprioceptive differences are apparent in 46% to 90% of children with CP
*The postural control difficulties of the children with CP were found to be due to multiple systems differences AND joint specific proprioception differences
*Different domains of the BESTest corresponded with different joint involvement:
*Therapy should incorporate proprioceptive input during functional, task-oriented balance training
What I'm still thinking about:
*Could these results explain the success of whole body vibration (an intervention where the method of action is thought to be proprioception) in improving balance in children with CP?
https://pubmed.ncbi.nlm.nih.gov/41712183/

02/27/2026

Lots on the feed this week about CP so let's begin with this 2025 article examining sleep disturbances in children with CP, age 3-18 years, in Northern Ireland. The authors discuss that sleep plays a prominent role in development, health and well-being of child and family. The study used the parent-report Sleep Disturbances Scale for Children (SDSC) as the measure.
Clinical takeaways:
*The SDSC is easily administered
*It has 6 subscales that allow a nuanced understanding of sleep issues
*43% of the children with CP demonstrated clinical sleep disorders
*These children had increased rates of clinical sleep disturbances particularly in the subscales of initiating-maintaining sleep and sleep-wake transitions
*Sleep disorders were NOT associated with age, socioeconomics or clinical variables (ie GMFCS level).
*Recommendation: health pros need to incorporate inquiry about sleep as part of routine assessment
What I'm still thinking about:
*There are so many facets to a comprehensive assessment for a child with CP. How can we best meet this challenge clinically without overwhelming parents?
2025Article link: https://pubmed.ncbi.nlm.nih.gov/41702278/
Link for article containing the SDSC: https://pubmed.ncbi.nlm.nih.gov/9065877/

02/20/2026

This article is a long read but well worth it. "Motor Development: Embodied, Embedded, Enculturated, Enabling" argues that motor development and psychological development are fundamentally related. Karen Adolph is a gifted researcher and writer. My thanks to the mom who sent it my way via her work with .
https://pubmed.ncbi.nlm.nih.gov/30256718

02/17/2026

We know autistic children have differences in their postural control. This 2026 study demonstrated that the autistic children had less adaptability in their postural control in sitting, sitting while performing a fine motor task and standing.
Clinical takeaways:
When considering supporting these clients, therapists should:
*Consider all the dynamic systems involved
*Assess and optimize the base of support need
*Think about the goal of the task ie could the goal be achieved in another way
Things I'm still thinking about:
**In the longer term, how can we support autistic clients earlier to address improvement in the postural control that is foundational for functional tasks
https://pubmed.ncbi.nlm.nih.gov/41619640/

02/12/2026

In the previous post we talked about lower visual field and postural control. What I'm still thinking about:
🧠 Why the lower visual field matters:
*It provides information about the ground and support surfaces
*It helps the brain judge body position relative to the environment
*Strongly links with ankle, trunk and postural muscle activity
*Supports anticipatory postural control.
In typical development, the brain learns very early to rely on lower field vision to help stabilize the body.

02/10/2026

This week's study looked at lower visual field input and postural control.
Clinical takeaways:
*When movement is seen in the lower part of our visual field, we naturally shift a little forward (= forward lean) and the muscles around the ankles work together more to help keep us stable.
*The brain uses visual information from the lower visual field more effectively to organize balance, especially by adjusting how the ankle muscles work together.
https://pubmed.ncbi.nlm.nih.gov/41412105/

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Saint Catharines, ON
L2T2S4

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+19053801627

Website

http://www.heartspacept.com/

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Our Story

HeartSpace provides Physical Therapy clinic services to babies, children and adolescents with motor and sensory challenges at our Kids Therapy Circle location. Shelley Mannell PT has over 30 years experience in pediatric Physical Therapy. She began teaching as a clinical faculty member in the School of Rehabilitation at McMaster University. Shelley developed HeartSpace Yoga and Meditation for children in her clinic and more recently co-created Dynamic Core for Kids, an approach to treating core stability in children with challenges; this approach is used by therapists all over the world. In addition to her clinical work, Shelley teaches continuing education courses for pediatric therapists internationally. HeartSpace PT includes associate Michelle Duncanson PT who provides home-based services in Niagara.