three levels of movement
As we face this current phase of particularly evident disablement,
From the profound shift in Isaac’s ability post adenoid-tonsillectomy,
I begin to really question what is happening for him,
In a system I felt so confident in,
In a skill-set on a slow but constant incline,
Because it is hard not to feel the whip of helplessness,
Hit fast and sharp across my being.
For me personally in times of desperation,
I’m driven towards knowledge,
In a craving to categorically compartmentalise,
In hope of gaining control.
I become frantic with my note book and pen,
Madly believing the more I understand,
The better Isaac’s outcome will be,
And the more at peace I can feel,
Sitting within the murky waters of impediment.
There is a lot to be said for the saying knowledge is power.
And I want to know what Isaac is missing,
Where he needs to be going,
And quite simply how movements work,
In order for him to get there.
And I am grateful for the wealth of knowledge our practitioner holds,
And so readily shares with me in layman’s terms.
So she begins by breaking down the three levels of movement,
In order of complexity or maturity:
Homologous – symmetrical movement,
Where both arms legs move together,
Without any concept of weight shift,
As in a two handed pull (working together) in a primitive action.
Homolateral – involves asymmetrical movement,
Where the hand and leg on the same side work together,
At the same time.
Often seen when children begin to walk,
Raising the leg and arm on one side in a exaggerated lean motion in order to step,
Followed by the other side doing the same for the subsequent step.
By way of shifting all of ones weight to one side at a time.
More advanced than Homologous yet with it’s own limitations.
Contralateral – Opposition movement,
Where diagonal movement becomes possible,
As an arm on one side and the opposite sides leg work together,
Allowing for a much more sophisticated movement,
Greater ability to weight-shift,
And advanced control of movement.
We need all three levels of movement,
For everything we do.
The overall impact of not having access to these movements,
Is having so much less available.
And I can immediately see how this is so apparent in Isaac.
While homologous and homolateral movements are more available,
In the act of knee walking,
Or using his walker with arm gutters,
Where diagonals are not utilised,
Or pulling himself to stand by way of both arms,
Where very little weight-shift or even weight-bearing occurs.
It is reassuring to recognise that,
The sophistication of contralateral movement while no way near age level,
Is present in his crawling,
Despite the diagonals not as yet translating into many other actions clearly.
And by knowing this,
I do feel more at ease,
And see more clearly through educated eyes,
That despite setbacks,
Isaac continues to progress through vital stages of movement,
And it now becomes our job to help those movements translate,
Into a great plethora of actions.
So one of the many things we begin working on,
To help re-establish his contralateral movement concepts,
Is having Isaac lying on his back and pushing backwards along the therapy table,
With one flat foot at a time,
By way of lying down,
As always it limits the all too familiar excess-demand,
And more apparent post -op,
That being in standing provokes,
And by making the challenge too great,
We know hinders the space to learn.
And so this must be our latest approach,
As it has been,
Even if somewhat hazy to me,
To minimise effort,
By way of teaching him the essential components of movement,
In task in sitting,
Or lying down,
So they’re accessible,
And then once familiar,
And a confident part of his repertoire,
Will begin to translate in more demanding situations,
Like getting to standing and walking.
But we cannot rush.
And we cannot miss any of the elements.