I frequently get asked where you can find norms to measure core strength in children. As pediatric therapists, we sometimes use supine flexion, prone extension, modified sit ups and push ups as measures of core strength. I don’t usually refer to the norms but more look at the quality of how the exercise is performed and progress over time for each individual child. I do realize though that parents, teachers and administrators do like to understand norms to compare what a child should accomplish. The norms used for supine flexion and prone extension are older but seem to be the most referenced articles. If anyone knows of more updated, larger studies I would love to hear about them.
Supine Flexion – for each age group there were 40 participants. Lying in supine, children were instructed to hold the following position: cross arms, flex knees to 90 degrees and “roll into a ball” by flexing neck, upper trunk and hips. The results were recorded comparing boys to girls with the standard deviations ranging from 6.7 to 39.7.
SUPINE FLEXION (LEFKOF RESULTS)
AGE IN YEARS BOYS (SECONDS) GIRLS (SECONDS)
3 15.5 15.8
4 17 20.1
5 27.4 29.5
6 55.4 52
Reference: Marsha B Lefkof. Trunk Flexion in Healthy Children Aged 3 to 7 Years. PHYS THER January 1986 66:39-44
Prone Extension – There were 26 four year olds, 28 six year olds and 30 eight year olds in the study. They were instructed to lay on their stomach and lift up head, chest, arms and legs off the floor with knees straight and elbows bent. The standard deviation ranged from 5.67-13.45.
PRONE EXTENSION (HARRIS RESULTS) AGE IN YEARS POSITION HELD (SECONDS)
8 Every participant held position for 30 seconds
Reference: Harris, N. Duration and Quality of the Prone Extension Position in Four, Six and Eight Year Old Normal Children. AJOT. January 1981Vol 35 No 1.
PRONE EXTENSION 6-9 YEAR OLDS (BOWMAN & KATZ RESULTS) – 153 right hand dominant participants
AGE IN YEARS POSITION HELD (SECONDS)
Reference: Bowman, JO and Katz, B. Hand Strength and Prone Extension in RIght Dominant 6-9 Year Olds. Am J Occup Ther. 1984; 38(6):367-376. doi: 10.5014/ajot.38.6.367.
PRESIDENTIAL YOUTH FITNESS PROGRAM – The program uses FITNESSGRAM®, which provides an efficient way for physical educators to perform evidence-based health-related fitness assessments. Here is more info about the program and directions – http://www.pyfp.org/doc/fitnessgram/fg-07-muscular.pdf
BOYS AND GIRLS
AGE CURL UP(# COMPLETED) TRUNK LIFT (INCHES) PUSH UP (#COMPLETED)
Here are a few freebies that work great for indoor recess when you need something in a hurry. They would make a fun back to school gift for teachers – print them off, toss them in a file folder and teachers have some “go to” activities for when the weather takes a turn for the worse. You can download the entire packet here – http://www.yourtherapysource.com/indoorrecess.html
Did you know some research indicates that brain activation when identifying letters is influenced by previous handwriting of letters? Researchers at Indiana University have published several research articles on visual perceptual skills in children. One article that was published in Trends in Neuroscience and Education examined 15 preliterate, right handed children (ages 4.2-5 years old).During functional MRI scanning, each child was shown a letter or shape on an index card and asked to draw, trace or type the item without it being named by the experimenter.
The following results were recorded:
after self-generated printing experience, letter perception in the young child recruits components of the reading systems in the brain more than other forms of sensori-motor practice (tracing or typing).
The researchers concluded that “handwriting is important for the early recruitment in letter processing of brain regions known to underlie successful reading. Handwriting therefore may facilitate reading acquisition in young children”
Reference: James KH, Engelhardt L. The effects of handwriting experience on functional brain development in preliterate children. Trends in Neuroscience and Education (2012), http://dx.doi.org/10.1016/j.tine.2012.08.001.
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Pediatric Physical Therapy published a single case study comparing physiological functioning, communication switch activation, and response accuracy in a 19-year-old young man with quadriplegic cerebral palsy and neurological scoliosis using 2 seating systems within the school setting. A alternating treatment design was used recording data from the following conditions: baseline (standard planar inserts), using a custom molded back with original seat and again at baseline.
Data collection included oxygen saturation (SaO2), heart rate (HR), respiration rate (RR), body temperature (BT), processing time to activate switches, and response accuracy.
The following results were recorded: 1. SaO2 levels increased from “distressed” to “normal” – variability decreased. 2. HR, RR, and BT fluctuations decreased with the custom-molded back. 3. Processing time decreased with increased variability, affected by subject’s motivation. 4. accuracy improved slightly. 5. social approachability and student-initiated communication increased.
The researchers concluded that SaO2 increased and HR, RR, and BT fluctuations decreased with a custom-molded back and recommend graphing data to help clarify the effects of different seating systems with complex clients.
Reference: Lephart, Kim PT, DPT, MBA, PCS; Kaplan, Sandra L. PT, DPT, PhD. Two Seating Systems’ Effects on an Adolescent With Cerebral Palsy and Severe Scoliosis. Pediatric Physical Therapy. Fall 2015 Vol. 27 – Issue 3: p 258–266