Beyond Achondroplasia

Growing together with Clara

Lying to sitting to standing up in achondroplasia

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Children with achondroplasia usually have strategies to pass by different phases of gross motor skills acquisition.

In the article “Development in children with achondroplasia: a prospective clinical cohort study” Ireland, P. J., Donaghey, S., McGill, J., Zankl, A., Ware, R. S., Pacey, V., Ault, J., Savarirayan, R., Sillence, D., Thompson, E., Townshend, S. and Johnston, L. M., 2012, Developmental Medicine & Child Neurology, 54: 532–537. doi: 10.1111/j.1469-8749.2012.04234, the authors studied a population of 48 children under 15 months old with achondroplasia,for specific developmental information across gross motor, fine motor, feeding, and communication skills.

The following excerpts were taken from the article: “When transitioning between lying to sitting, the most frequently reported strategy demonstrated by 30 children was to lie prone (when one lies flat with the chest down and back up), fully abduct the lower limbs (legs wide open) and push up through the arms on the floor or on their legs, until able to extend backwards into a fully upright position.”

This is the typical movement the children adopt for sitting up.

“When moving from a sitting to standing position, the cohort demonstrated two different strategies: 21 children came up through a kneeling or squatting position or lay in prone position (n=19) or sat with full lower limb abduction before using their arms to pull up into a standing position.

Table III.   Transitional movement strategies used by children with achondroplasia
Transition Movement strategya Number of children (n=48)

aParents may have identified movement strategy but not reported on age of acquisition for skill.

Into sitting from lying Roll onto one side 9
Push up from stomach 29
Other 3
From standing up into sitting Dropping backwards 13
Squatting down 21
Spreading legs 8
Other 3
Pull into standing from sitting down Kneeling up on both knees 21
Lying on stomach 19
Other 6

The goal is to teach children strategies for standing up unsupported that will prevent damage in their lower spine while transitioning from the sitting to the stand up position.

Clara was able to walk alone around 17-18 months old and she could only stand up without support when she was about 26 months-old. She started to stand up unsupported open widely her legs, hands on the floor and lifting her head for back impulse. That was producing stress in her lower spine and she wasn´t working her abdomen.

Her physiotherapist and us have been working for several months with Clara for her to stand up using the movement you will see in the video. No stress in her spine and also working the abdominal muscles.

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