First Step Therapy Method -
A Dynamic, Functional and Integrated Approach

The First Step Therapy Method is made up of Suit Therapy, Universal Exercise Unit, Neuro-Respiratory Therapy and Intensive Exercise & Training. The programme can be delivered for up to 3 hours of Physical & Occupational Therapy a day, 5 days a week for 3 weeks. This intensity results in better functional improvement when compared with less intensive traditional therapeutic methods.

The First Step Therapy Method is designed for Children & Adults with neuromuscular disorders performed on a one-to-one basis by skilled professionals. The intensive programme focuses on strength & flexibility, with the use of Suit Therapy, Neuro Respiratory Therapy, Universal Exercise Unit / Spider Cage and progressive resistance exercises. This approach is ideal to enhance & improve the individual's developmental & functional abilities (e.g. mobility, balance & co-ordination, gait, etc).

Suit Therapy

The First Step Therapy Method utlises SUIT THERAPY (A Soft Dynamic Proprioceptive Orthosis such as the 'Therasuit'). The Therasuit aligns the body as close to normal as possible re-establishing correct postural alignment and weight bearing which is crucial in normalising muscle tone, sensory and vestibular functions (the body's balance system). The Therasuit serves as an external skeletal support for patients with neuromuscular disorders (such as Cerebral Palsy). It facilitates independence in the development of new gross and fine motor skills like sitting, standing, and walking. When worn during and in conjunction with physical and occupational therapy, the Therasuit can accelerate a patient's progress.

Niall Working In The Therasuit

The Universal Exercise Unit

The second key elementof the First Step Therapy Method is an individualised strengthening approach by using the UNIVERSAL EXERCISE UNIT established for the patient and based on his or her individual needs, strengths and weaknesses. Increased strength will be reflected in the daily functional activities that usually follow, or in those that are combined with the strengthening exercises.

The Universal Exercise Unit (UEU) is used to train a patient to gain the ability to isolate the desired movements and strengthen the muscle groups responsible for that movement. The Universal Exercise Unit allows the patient to gain range of motion, muscle and joint flexibility, as well as functional skills. As the name 'universal' suggests, the exercise unit is used in many other ways. Another way is called the 'Spider Cage'. Through the system of elastic bands and a wide belt worn around the waist, the UEU provides very dynamic, vertical or horizontal suspension.

The goals of the exercises performed in the 'Spider Cage' are to improve functional skills (sitting, crawling, standing, walking), balance, coordination, and sensory-motor integration. The biggest goal in mind would always be promoting independent movement. Not only is it a lot of fun for the patient, but it also substitutes for the work of two additional people. Parallel bars installed inside the UEU allow one to combine any of the previously mentioned concepts with gait training, functional skills and transfers. It can be done either with the use of the 'Spider Cage' tracking rail or independently. Very often the parallel bars are replaced with two suspended ropes, creating a version of a 'suspended bridge' which allows the patient to walk by supporting their own body weight with their arms. There is no age limit to use the UEU and the patient weight-limit is 160 kgs (350 lbs).

Neuro Respiratory Therapy

The third key element of the First Step Therapy Method is NEURO-RESPIRATORY THERAPY (NRT), which is a unique, predictable, restorative therapy for children and adults with brain injury or brain abnormality. NRT develops the pattern of respiration and recovery mechanism of breathing by addressing deep core weaknesses within the biomechanics of the respiratory system which affects structure, metabolism, motor and cognitive function. NRT uses gentle, rhythmical pressure to strengthen the weak tissue structures of the diaphragm and other respiratory muscles. This approach actively imitates changes in internal air pressures that come from normal breathing. Tissue blood-supply increases in weak muscles, allowing them to become electrically active and under voluntary control.

What does it do? - Neuro Respiratory Therapy reveals and treats the often hidden but complex weaknesses and deformities of the trunk caused by poor respiratory mechanics which may be the real cause behind limb abnormalities and the broad range of symptoms associated with brain injuries or brain abnormalities. NRT improves blood flow through the internal organs and enhances general metabolism.

Scientific Research Explanation of NRT - Respiratory development is fundamental to the development of structure, function and general cerebral metabolism in normal patients. Breakdown or failure of the normal development of the respiratory system occurs after brain injury and in cases of neurological abnormality. Weak inflexible breathing creates further tissue weaknesses within the musculo-skeletal system. This leads to a reduction in neurological connection between the weak tissue and the brain apart from basic reflexive breathing. It is widely recognised and understood that breathing is a learnt and widely varied behaviour in individuals.

Children with neurological abnormalities do not learn to breathe normally and this affects the complex metabolic feedback systems between the body tissues, the respiratory system and the brain. Breathing supports both the general and cerebral metabolism and the postural systems of the body via separate but integrated systems. Restoring the strength and flexibility of the respiratory system permits the restoration of structure and the restoration of motor and cognitive abilities.

Step-by-Step restorative results of NRT:

It restores the diaphragm and upper respiratory mechanics

It restores volume to the chest and abdomen

It relaxes abnormally strong muscles

It strengthens abnormally weak muscles

It restores the shape and form of the pelvis and shoulder girdle so that the proportions become increasingly more normal, allowing a gradual recovery of limb activity

It restores strength to the trachea, larynx and pharynx, restoring biomechanics of speech and swallowing

It steadily restores cerebral and general metabolism

It creates the foundation for normal function which develops steadily as a result of increasing hours of therapy

It restores increasingly better blood flow within and nutrition to the brain.

It creates increasingly normal structures leading to increasingly normal abilities and THE RESULTS ARE PERMANENT

Advantages of NRT:

A steady normalisation of respiration, growth and structure, including:

Co-ordination, posture, balance and motor development, on to walking, swallowing, digestion and elimination

Speech mechanics (including the structure of the trachea, pharynx and larynx), leading to clear speech

Improved vision

A seizure-free cerebral metabolism

Improved cognitive abilities

Increased emotional maturity

How is NRT progress predicted?

Structural changes steadily produce spontaneous function with hours of home exercise:

By 200 hours NRT exercise prescription - abnormal structure begins to reverse. Small changes in function are noticed.

By 500 hours NRT exercise prescription - structure and function beginning to alter more obviously.

By 1000 hours NRT exercise prescription and beyond substantial permanent and continuous changes in structure & function. NRT prescription also involves prescribed rest periods as well as exercise periods during the day.

Intensive Exercise & Training

The final part of the First Step Therapy Method, is INTENSIVE EXERCISE & TRAINING which is given for 45 hours over 3 weeks. With traditional therapy, 45 hours would normally be delivered over 26 weeks (up to 2 hours per week). Children require repetition to learn new tasks; Children with disabilities require many more repetitions to learn the same task, often thousands compared to hundreds of repetitions in a normal child. Intensive Exercise & Training helps to accomplish this goal.

The First Step Therapy Method delivers an additional 6 hours of therapy per week for a further 16 weeks after Intensive Exercise & Training to hold the gains made over the previous 10 weeks of therapy. This again will be a customised approach based on the assessed needs of the patient.

An intensive First Step Therapy Method Treatment Schedule is contained in our brochure. Complete the details below to download the brochure.

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