Occupational Therapy -> Gross Motor Skills

Gross Motor Skills

Gross motor skills require the control and coordination of large muscles in the body often including the arms and/or legs. Occupational therapists address gross motor skills as they relate to important daily routines and activities for example: a child participating in recess or physical education, an adult transferring into and out of the shower, a child sitting on the floor for learning. Occupational therapists may collaborate with physical therapists when implementing interventions and strategies to improve gross motor skills.

Skilled interventions

  • Body Mechanics

    Body Mechanics involves the use of proper postures and movement techniques to minimize stress on the body during activities such as lifting, bending, and sitting. The goal is to enhance movement efficiency and prevent injuries by aligning the body correctly and using muscles most effectively.

    Occupational therapists assess the individual's typical movement patterns and identify areas for improvement. Training includes educating patients on the principles of ergonomics and safe body alignment. Practical applications are demonstrated through simulated activities that the individual performs regularly, whether at home, work, or in leisure activities.

    Exercises might include core strengthening, flexibility routines, and specific techniques for lifting or reaching. These are tailored to the individual’s lifestyle and occupational needs. For instance, a warehouse worker might practice lifting boxes with proper knee and back alignment, while an office worker might learn ergonomic sitting positions and the correct setup of a workstation.

  • Head Control

    Head Control exercises aim to develop and enhance the ability to stabilize and move the head independently, which is foundational for all subsequent motor skills and daily activities. Effective head control is crucial for swallowing, speech, and visual tracking, and forms the basis for developing further gross motor skills like sitting and walking.

    The intervention begins with assessing the individual’s current level of head control. For those with limited control, therapy might start with passive exercises, where the therapist gently guides the head movement to stimulate muscle activity. As abilities improve, patients are encouraged to perform active exercises, which might involve following a visual target, maintaining head alignment while the body is moved, or lifting the head from a prone position.

    Therapists use a variety of techniques and positions to challenge and strengthen the muscles around the neck and upper back. Exercises are gradually progressed from lying down positions to sitting and standing, as appropriate for the patient's development and abilities.

  • Range of Motion

    Range of Motion exercises involve moving a joint through its full possible movement without causing pain. These exercises are categorized into Passive Range of Motion (PROM), where the therapist or another person moves the joint; Active-Assistive Range of Motion (AAROM), where the patient performs the movement with some assistance; and Active Range of Motion (AROM), where the patient performs the movement independently.

    Therapeutic sessions typically begin with an assessment of the individual’s current range of motion, followed by the appropriate type of ROM exercises depending on the patient's condition and capabilities. PROM exercises are used for patients who cannot move a joint by themselves, often seen in early stages of recovery. As the patient progresses, they transition through AAROM to AROM, gradually regaining independence and strength.

    The goal of ROM exercises is to improve or maintain joint function, alleviate stiffness, and prevent contractures. These exercises are not only crucial for the affected areas but are also performed on all major joints to maintain overall body mobility.

  • Strengthening

    Gross motor strengthening involves exercises that target the core, legs, and arms, enhancing stability and mobility. Common activities include sit-to-stands, leg lifts, and the use of resistance bands or weights to add challenge to movements. These exercises are particularly important for patients with conditions like muscular dystrophy, cerebral palsy, or after orthopedic surgeries.

    Therapists customize exercise plans based on an individual’s specific health needs and functional goals. Early sessions may focus on low-intensity activities, such as holding a squat position or using light weights, with gradual progression to more demanding tasks like climbing steps or carrying weighted objects across a room.

    The intervention also emphasizes functional integration, where exercises mimic real-life activities to ensure that strength gains translate into practical improvements. This approach not only increases physical capabilities but also boosts confidence in daily tasks and enhances quality of life.

  • Stretching

    Stretching in occupational therapy involves a variety of techniques designed to elongate muscles and increase the range of motion in joints. These techniques include static stretching, where the muscle is gently stretched and held in a position for a period of time, and dynamic stretching, which involves moving parts of the body gradually increasing reach, speed, or both.

    Therapists carefully assess each individual's flexibility and mobility needs to tailor a stretching regimen that suits their specific conditions and goals. The regimen typically begins with gentle stretches to minimize the risk of injury, especially important for patients with high muscle tone or spasticity.

    As the patient progresses, more advanced stretches are introduced, and the duration and intensity of each stretch are increased. The therapy sessions also incorporate education on proper stretching techniques and the importance of regular practice to maintain and improve flexibility.

  • Therapy Ball

    Therapy Ball exercises involve a variety of movements that require maintaining balance and control while seated or lying on the ball. These activities are particularly beneficial for developing core muscle strength, improving postural alignment, and enhancing proprioceptive feedback, which are essential for daily activities and overall physical health.

    The therapeutic use of the Therapy Ball includes exercises such as rolling forwards and backwards, performing "bridges," or lifting and holding limbs while maintaining balance on the ball. These exercises not only strengthen the muscles but also improve joint mobility and flexibility.

    Occupational therapists customize the intensity and complexity of the exercises based on the individual's capabilities and therapeutic goals. Progression might include moving from assisted to independent exercises, increasing the duration of each exercise, or incorporating additional challenges like catching a ball or performing tasks while balancing.

    Safety is paramount during Therapy Ball activities, with therapists ensuring that the environment is secure and that support, such as safety mats and spotter assistance, is available to prevent falls.

  • Trunk Control

    Trunk Control exercises focus on improving the ability to maintain and control the position of the trunk during static and dynamic activities. This includes tasks such as sitting upright without support, transitioning from sitting to standing, and stabilizing the body during arm or leg movements. Effective trunk control is foundational for all motor activities and directly impacts an individual's ability to perform daily tasks independently.

    Therapeutic activities typically start with static exercises, such as balancing in a seated position on a therapy ball or bench, and gradually progress to dynamic tasks that incorporate upper and lower body movements. Techniques might involve resistance bands, weights, or manual resistance provided by the therapist to challenge the patient and build core muscle strength.

    The progression of these exercises is carefully monitored, with adjustments made based on the individual's improvement in strength, endurance, and functional capabilities. Sessions may also include activities that mimic daily life challenges to ensure the practical application of the skills developed during therapy.

  • Weight-Bearing

    Weight-Bearing exercises in occupational therapy involve activities where the patient supports weight through their limbs or trunk, which helps to strengthen bones, muscles, and joints. This type of exercise is particularly effective in promoting bone growth and increasing joint stability, which are essential for mobility and daily functioning.

    Therapeutic sessions might include activities like standing, walking, or performing partial squats, where the amount of weight borne by the patient is gradually increased. For patients unable to stand, therapists might use specialized equipment to assist in partial weight-bearing exercises.

    The progression of these exercises is carefully tailored to the individual's abilities and recovery goals. Therapists ensure that exercises are performed with proper alignment to prevent injuries and maximize benefits. They also integrate functional activities that involve weight-bearing tasks, such as climbing stairs or moving from sitting to standing, to make the therapy more relevant to everyday life.

  • Yoga Poses

    Yoga Poses in occupational therapy involve a series of controlled, physical postures that require precise muscle coordination and balance. These poses are adapted to meet the specific needs of individuals, whether they are recovering from injuries, managing chronic conditions, or seeking to improve their overall motor skills and body control.

    The therapy typically starts with simpler poses that focus on breathing and gentle stretching to increase body awareness and reduce stress. As individuals gain strength and flexibility, more complex poses are introduced, challenging their balance and coordination further. These may include standing poses, bends, and gentle twists, which help strengthen the core muscles and improve postural alignment.

    Occupational therapists ensure that each session is tailored to the patient's physical capabilities and therapeutic goals. Modifications are made as necessary to accommodate physical limitations, using props such as blocks, straps, and pillows for support. The holistic approach of yoga not only aids in physical rehabilitation but also promotes relaxation and mental focus, which are crucial for effective therapy.

Reference links

  • Medicare Guidelines For Group Therapy 1
    www.asha.org
    Author: The American Speech-Language-Hearing Association (ASHA) - Medicare Benefit Policy Manual, Chapter 15 230-Practice of Physical Therapy, Occupational Therapy, and Speech-Language Pathology A. Group Therapy Services. Contractors pay for outpatient physical therapy services (which includes outpatient speech-language pathology services) and outpatient occupational therapy services provided simultaneously to two or more individuals by a practitioner as group therapy services (97150). The individuals can be, but need not be, performing the same activity. The physician or therapist involved in group therapy services must be in constant attendance, but one-on-one patient contact is not required. The Medicare Benefit Policy Manual does not establish a specific restriction on the use of group therapy, particularly as it pertains to the size of the group. In the absence of such guidance, speech-language pathologists must refer to the LCD developed by their MAC to determine any such restrictions. LCDs may be accessed through the Medicare Coverage Database.
  • Milestone Moments 1
    www.cdc.gov
    Author: Centers For Disease Control and Prevention - These developmental milestones show what most children (75% or more) can do by each age. Subject matter experts selected these milestones based on available data and expert consensus.
  • Occupational Therapy Practice Guidelines For Early Childhood: Birth–5 Years 2
    watermark.silverchair.com
    Author: Clark and Kingsley - Cognitive delays: home-, community-, and preschool-based interventions. To address cognitive development in premature infants, use of NIDCAP, home-based EI, touch-based interventions, and reading aloud to the child and incorporating home programs when working in clinics. The REDI program, the Read It Again program, and teaching specific cognitive skills all improved cognitive outcomes for a range of preschool-age children who were at risk for or had a specific diagnosis associated with developmental delays. Infant–maternal attachment: skin-to-skin, KC, and parent training programs such as the MIT program. The Incredible Years, MIT, and teacher training in PBIS were all effective in improving child behavior. Parenting behaviors: direct parent training, the Incredible Years, and PCIT. Parent-delivered massage, attachment training, and the Play Project are all interventions that showed a significant impact on parental stress, anxiety, or depression. Motor outcomes: use of NIDCAP, CIMT, and BIT for children at risk for and diagnosed with CP. Home-based interventions using parent coaching and clinic-based interventions that used home programs were also effective for short-term motor development, underscoring the value and benefit of well-written home programs and coaching parents to support their child’s development. Feeding and eating: repeated-exposure interventions, nonnutritive suck, and parent training to support the child’s feeding and eating are all effective options. Toileting: The use of a wetting alarm is supported when toilet training toddlers. Sleep: use of parent training, positioning devices in the NICU, and touch-based interventions are all effective. Citation: Gloria Frolek Clark, Karrie L. Kingsley; Occupational Therapy Practice Guidelines for Early Childhood: Birth–5 Years. Am J Occup Ther May/June 2020, Vol. 74(3), 7403397010p1–7403397010p42. doi: https://doi.org/10.5014/ajot.2020.743001
  • Gross Motor Skills | Gross Motor Skills Development 0
    childdevelopment.com.au
    Author: Kid Sense - Occupational Therapy helps children with gross motor skills by developing: muscle strength, endurance, balance, coordination & postural control.
  • PROMOTING PHYSICAL ACTIVITY THROUGH SCHOOLS: POLICY BRIEF 1
    www.who.int
    Author: World Health Organization - Physical activity is good for hearts, bodies and minds. Regular physical activity can improve physical fitness; improve heart, vascular and metabolic health, and bone health; and reduce adiposity in children and adolescents (1). Being active can also improve cognitive function, including academic performance and mental health, and can reduce symptoms of depression and anxiety (1). In contrast, too much sedentary behavior can be unhealthy; it increases the risk of obesity and poorer fitness and cardiometabolic health and can affect sleep duration

Activity List(s)

Visual Schedule Cards

Related Disorder(s)

  • Neurological Conditions - Types of neurological conditions may include: Alzheimer’s Disease, Dementias, Brain Cancer, Epilepsy and Other Seizure Disorders, Mental Disorders, Parkinson’s and Other Movement Disorders, and Stroke and Transient Ischemic Attack (TIA).

Assessments

Goal Bank

  • To demonstrate improved gross motor movements, Peter will catch a ball during play 90% of the time by May 1, 2023 . 0